{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T14:25:55Z","timestamp":1793802355894,"version":"4.6.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,3,17]],"date-time":"2019-03-17T00:00:00Z","timestamp":1552780800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"BMGF","doi-asserted-by":"crossref","award":["OPP1147721"],"award-info":[{"award-number":["OPP1147721"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In some countries that have introduced oral rotavirus vaccines, a small but elevated risk of intussusception\u2014a rare bowel disorder\u2014has been reported. Updated estimates on the global epidemiology of intussusception are needed to help predict the potential number of intussusception cases that could be caused by the vaccine in different settings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We estimated incidence rates, age distributions and case-fatality ratios (CFRs) for intussusception hospital admissions among children aged &lt;5\u2009years, before the introduction of rotavirus vaccines. We included all articles identified in a systematic review between January 2002 and January 2018, and contacted authors for more granular unpublished data on age distributions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 128 articles containing 227 country datasets (61 age distributions, 71 incidence rates and 95 CFRs). The median age of intussusception ranged from 29\u2009weeks in Africa (83% of cases in the first year of life) to 70\u2009weeks in the Western Pacific region (35% of cases in the first year of life). The median (range) annual incidence of intussusception hospital admissions per 100\u2009000 aged &lt;1\u2009year ranged from 34 (13\u201356) in Africa to 90 (9\u2013380) in the Western Pacific region. We found extreme differences between the CFRs in Africa (1 death in every 10 hospital admissions) and the rest of the world (fewer than 1 death in every 100\u20132000 hospital admissions).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Intussusception epidemiology varies by country and region. Understanding and recognizing these differences will be important when assessing the potential number of intussusception cases associated with rotavirus vaccines.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyz028","type":"journal-article","created":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T15:10:37Z","timestamp":1551712237000},"page":"1316-1326","source":"Crossref","is-referenced-by-count":71,"title":["Update on the global epidemiology of intussusception: a systematic review of incidence rates, age distributions and case-fatality ratios among children aged &lt;5\u2009years, before the introduction of rotavirus vaccination"],"prefix":"10.1093","volume":"48","author":[{"given":"Andrew D","family":"Clark","sequence":"first","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Hasso-Agopsowicz","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London, UK"},{"name":"World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W","family":"Kraus","sequence":"additional","affiliation":[{"name":"Last Mile Health, Boston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa K","family":"Stockdale","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London, UK"},{"name":"University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin F B","family":"Sanderson","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh D","family":"Parashar","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline E","family":"Tate","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,16]]},"reference":[{"key":"2019081601250144300_dyz028-B1","doi-asserted-by":"crossref","first-page":"569","DOI":"10.2471\/BLT.05.025445","article-title":"Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia","volume":"84","author":"Bines","year":"2006","journal-title":"Bull World Health Organ"},{"key":"2019081601250144300_dyz028-B2","first-page":"1","volume-title":"Acute Intussusception in Infants and Children. Incidence, Clinical Presentation and Management: A Global Perspective","year":"2002"},{"key":"2019081601250144300_dyz028-B3","doi-asserted-by":"crossref","first-page":"e68482.","DOI":"10.1371\/journal.pone.0068482","article-title":"Childhood intussusception: a literature review","volume":"8","author":"Jiang","year":"2013","journal-title":"PLoS One"},{"key":"2019081601250144300_dyz028-B4","year":"2018"},{"key":"2019081601250144300_dyz028-B5","doi-asserted-by":"crossref","first-page":"e1001330","DOI":"10.1371\/journal.pmed.1001330","article-title":"Removing the age restrictions for rotavirus vaccination: a benefit-risk modeling analysis","volume":"9","author":"Patel","year":"2012","journal-title":"PLoS Med"},{"key":"2019081601250144300_dyz028-B6","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/S1875-9572(10)60055-1","article-title":"Epidemiology of childhood intussusception and determinants of recurrence and operation: analysis of national health insurance data between 1998 and 2007 in Taiwan","volume":"51","author":"Chen","year":"2010","journal-title":"Pediatr Neonatol"},{"key":"2019081601250144300_dyz028-B7","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1016\/j.surg.2016.09.030","article-title":"Age at presentation and management of pediatric intussusception: a Pediatric Health Information System database study","volume":"161","author":"Savoie","year":"2017","journal-title":"Surgery"},{"key":"2019081601250144300_dyz028-B8","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/1471-2431-12-36","article-title":"Intussusception among Japanese children: an epidemiologic study using an administrative database","volume":"12","author":"Takeuchi","year":"2012","journal-title":"BMC Pediatr"},{"key":"2019081601250144300_dyz028-B9","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1016\/S0140-6736(09)60317-2","article-title":"Timing of children's vaccinations in 45 low-income and middle-income countries: an analysis of survey 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No: JVAC-D-16-01124","volume":"34","author":"Stowe","year":"2016","journal-title":"Vaccine"},{"key":"2019081601250144300_dyz028-B38","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1056\/NEJMoa1706804","article-title":"Human neonatal rotavirus vaccine (RV3-BB) to target rotavirus from birth","volume":"378","author":"Bines","year":"2018","journal-title":"N Engl J Med"},{"key":"2019081601250144300_dyz028-B39","doi-asserted-by":"crossref","first-page":"5","DOI":"10.21699\/jns.v7i1.662","article-title":"Neonatal intussusception: a review","volume":"7","author":"Bothara","year":"2018","journal-title":"J Neonatal Surg"}],"container-title":["International Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ije\/article-pdf\/48\/4\/1316\/29169180\/dyz028.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,24]],"date-time":"2019-09-24T01:43:07Z","timestamp":1569289387000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ije\/article\/48\/4\/1316\/5382176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,16]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,3,16]]},"published-print":{"date-parts":[[2019,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ije\/dyz028","relation":{},"ISSN":["0300-5771","1464-3685"],"issn-type":[{"value":"0300-5771","type":"print"},{"value":"1464-3685","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,8]]},"published":{"date-parts":[[2019,3,16]]}}}