Indian journal of pediatrics · 2025
Epidemiological and Clinical Characteristics of Intussusception in Children Aged Under 2 Years: Comparison of the Southern and Western States in India, 2019-2022.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Chaudhary Varsha Sudhir, Kharat Namrata, Machathi Anupama, Lingam Ragavi, Kannan Poovarasan, Ramasamy Ayyapan Vellathur, Premkumar Prasanna Samuel, Mohan Venkata Raghava
Аннотация
OBJECTIVES: To compare the epidemiological and clinical characteristics, management, and outcome of intussusception in children in the southern and western states in India.
METHODS: This multicenter observational study, conducted in 21 hospitals between August 2019 and December 2022, compared the characteristics of intussusception among children younger than 2 y hospitalized with intussusception in the southern (Kerala and Karnataka) and western (Maharashtra and Gujarat) states in India. Children were diagnosed with intussusception according to level 1 Brighton Collaboration criteria.
RESULTS: Of the 1,319 children enrolled, 860 (65.2%) and 459 (34.8%) were from the southern and western states, respectively. Clinical manifestations were similar in both regions; however, children from the southern states exhibited more frequent incessant crying (32.2% vs. 1.3%; p < 0.001). The predominance of ileo-colic presentation was significantly more marked in the southern states vs. the western states (91.7% vs. 80.6%; p < 0.001). Significantly more cases were resolved by radiological reduction in the southern states (89.2% vs. 56.9%; p < 0.001), whereas surgical intervention was more common in the western states. The case fatality rate was 0.3%. All four deaths occurred in the western states (p = 0.022).
CONCLUSIONS: The poorer outcome in the western states might be attributable to longer delays in seeking treatment, and disparities in healthcare access. These regional divergences highlight the differences in healthcare infrastructure, and socioeconomic inequities between regions. Managing these differences through health education, improving access to diagnostic tools, and timely intervention could reduce the burden of intussusception in India.
METHODS: This multicenter observational study, conducted in 21 hospitals between August 2019 and December 2022, compared the characteristics of intussusception among children younger than 2 y hospitalized with intussusception in the southern (Kerala and Karnataka) and western (Maharashtra and Gujarat) states in India. Children were diagnosed with intussusception according to level 1 Brighton Collaboration criteria.
RESULTS: Of the 1,319 children enrolled, 860 (65.2%) and 459 (34.8%) were from the southern and western states, respectively. Clinical manifestations were similar in both regions; however, children from the southern states exhibited more frequent incessant crying (32.2% vs. 1.3%; p < 0.001). The predominance of ileo-colic presentation was significantly more marked in the southern states vs. the western states (91.7% vs. 80.6%; p < 0.001). Significantly more cases were resolved by radiological reduction in the southern states (89.2% vs. 56.9%; p < 0.001), whereas surgical intervention was more common in the western states. The case fatality rate was 0.3%. All four deaths occurred in the western states (p = 0.022).
CONCLUSIONS: The poorer outcome in the western states might be attributable to longer delays in seeking treatment, and disparities in healthcare access. These regional divergences highlight the differences in healthcare infrastructure, and socioeconomic inequities between regions. Managing these differences through health education, improving access to diagnostic tools, and timely intervention could reduce the burden of intussusception in India.