Intussusception surveillance in a rural demographic surveillance area

Background. Rotavirus is the leading cause of diarrhea-related morbidity and mortality in developing countries, including Bangladesh. The licensed vaccine Rotashield was withdrawn from the market because of an increased risk of intussusception. This study was undertaken to estimate the background incidence rates of intussusception among children aged!2 years, using retrospective and prospective studies in a rural demographic surveillance area in Bangladesh. Methods. All hospital charts of children aged!2 years who presented to the Matlab Hospital and 2 other treatment centers of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), during January 2001–August 2004 were reviewed retrospectively. A prospective surveillance was performed from August 2004 through December 2006 at the 3 treatment centers of ICDDR,B serving Matlab, 4 district and subdistrict government hospitals, and 3 district-based private clinics, to determine population-based rates of intussusception with use of Brighton Collaboration case definitions. All suspected cases of intussusception were referred to the Matlab Hospital by community health research workers for further assessment by a trained medical officer, including performance of an ultrasound examination. Results. In total, 2856 charts of children aged!2 years were reviewed retrospectively, and 4 probable cases and 19 possible cases of intussusception were identified. In the prospective surveillance, of 1508 potential cases