Population-based incidence and burden of childhood intussusception in Jeonbuk Province, South Korea.

OBJECTIVES: The aim of this study was to describe the clinical characteristics of childhood intussusception and to estimate the incidence rate of intussusception before the introduction of rotavirus vaccines in Korea. METHODS: Demographic, clinical, diagnostic, treatment, and outcome data for patients aged <5 years who were diagnosed with intussusception in Jeonbuk Province, South Korea from January 2000 through December 2002, were retrospectively collected using a standardized data collection instrument. RESULTS: During the 3-year period, 408 patients were diagnosed with intussusception; 82.8% of children were aged <24 months. Predominant signs and symptoms were vomiting (64.5%), bloody stool (43.9%), and abdominal pain/irritability (41.9%). The combination of ultrasound and barium or air enema was the most frequently used diagnostic approach (38.7%). Three hundred and thirteen patients (76.7%) were treated by radiologic reduction, 88 (21.6%) patients were treated by surgical intervention, and the remaining seven patients had no treatment. The mean annual incidence rate of intussusception in Jeonbuk Province was 236/100,000 among children aged <2 years and 106/100,000 among children aged <5 years. CONCLUSIONS: This retrospective study provides a background incidence rate of childhood intussusception in Korean children before the introduction of the rotavirus vaccine.

Epidemiological profile of rotavirus infection in the Republic of Korea: results from prospective surveillance in the Jeongeub District, 1 July 2002 through 30 June 2004.

To facilitate future decisions regarding the usefulness of rotavirus vaccines in the Republic of Korea, active surveillance was conducted in a network of clinics, emergency departments, and hospitals serving Jeongeub District, Korea. Children with diarrhea underwent standard clinical evaluations, and stool specimens were collected to test for the presence of rotavirus. Parents were interviewed to collect demographic and family information. From 1 July 2002 through 30 June 2004, a total of 4106 children, representing 1 (50%) of every 2 children <5 years old in the study population, were evaluated for rotavirus diarrhea. Of the 2232 stool specimens obtained throughout the year, 460 (20.6%) were rotavirus positive; however, the monthly prevalence of rotavirus infection peaked at 49.5% in February 2004. Of the 460 rotavirus-positive stool specimens, 366 were obtained from children who visited outpatient clinics, and 94 were obtained from children who were hospitalized. By extrapolating the proportion of rotavirus-positive patients to all children with diarrhea in the surveillance system, we calculate that 882 children in Jeongeub District had rotavirus infection (which would predict that there would be 702 associated clinic visits and 180 hospitalizations). Genotyping of rotavirus strains showed that 39% of strains were type G9P[8], 24% were type G1P[8], 17% were type G3P[8], and 13% were type G2P[4]. The incidence of rotavirus diarrhea peaked at age 13-24 months, and 94% of cases occurred during the first 3 years of life. The annual incidence of all rotavirus disease-associated outcomes was 56.9 cases/1000 children <5 years old (95% confidence interval [CI], 51.9-62.2 cases/1000 children <5 years old). The incidence of rotavirus disease-associated hospitalizations was 11.6 cases/1000 children <5 years old (95% CI, 9.5-14.2 cases/1000 children <5 years old). In Korea, diarrhea is common during childhood, and the incidence of diarrhea due to rotavirus infection suggests that improved programs for the prevention and control of both rotavirus diarrhea and diarrhea due to other causes are needed.