Several studies contribute to the understanding of the epidemiology of intussusception in India. In a 6-year retrospective review from 2007 to 2012 of intussusception cases among children <5 years of age presenting to two facilities, one in Manipal in southern India and one in north-central India in Lucknow, 175 cases of intussusception were identified with 75% of the cases occurring in males [30]. The median age was 8 months with 56% of cases in children <5 years of age occurring by the first birthday. The classic triad of symptoms, vomiting, passage of blood through the rectum, and abdominal pain, were present in only

19% of cases. All cases were diagnosed by either ultrasound or abdominal radiology. The median length of stay was 10 days with 72% of cases managed surgically, 26% managed RGFP966 ic50 by radiological reduction, and 3% of cases spontaneously reduced. No fatalities were observed. In a study in Vellore, data from retrospective surveillance of intussusception

cases among children <2 years of age who presented to a large tertiary referral center during January 2010 through August 2013 were compared to data on cases of intussusception identified through active surveillance as part of a clinical trial conducted in the region during the same time period [31]. The findings from the retrospective review were similar to those from the two center retrospective study in Manipal and Lucknow. Intussusception peaked in children 4–6 months of age with 85% occurring in the first year of life. Two thirds of intussusception cases occurred in

males. Almost CHIR-99021 in vivo all cases, 97%, met the Megestrol Acetate Brighton Collaboration Intussusception Working Group level 1 criteria for diagnostic certainty with a median of 48 h between symptom onset and arrival at the hospital. Approximately half of the cases required surgery and of those requiring surgery, half had resection performed. There were no deaths identified through retrospective surveillance. In sharp contrast, the active surveillance conducted as part of the phase 3 clinical trial identified 16 cases in the trial population, all of which were outside the known risk window associated with rotavirus vaccination, and only 7 (44%) met the Brighton Collaboration Intussusception Working Group level 1 criteria for diagnostic certainty with a median interval between symptom onset and follow-up of 10 h. None of these cases require surgery, half were <1 year of age, and none of the children died. Another study further examines the intussusception data from the phase 3 clinical trial and included data from all three clinical trial sites, Vellore, Pune, and Delhi [32]. Of the 1432 suspected intussusception events that were screened, only 23 cases of intussusception were identified by ultrasound, of which a total of 11 (48%) met the Brighton Collaboration Intussusception Working Group level 1 criteria for diagnostic certainty.