OJPed  Vol.3 No.4 , December 2013
Intussusception in Japanese infants: Analysis of health insurance claims database
Abstract: In order to better understand the possible impact of second-generation rotavirus vaccines on the incidence of intussusception (IS), robust knowledge of the baseline childhood epidemiology of IS from various sources is essential. This study estimated the overall and agespecific baseline incidence of IS among young Japanese children. Data on 57 IS cases from 42,438 screened children aged less than 12 months, born between January 2005 and April 2011 and covered by the health insurance claims database were retrospectively extracted (NCT01479491). IS cases were identified using the International Classification of Diseases, 10th revision (K56.1), with relevant examination and procedural codes. The extracted data were used to estimate the incidence of IS. Among all IS cases extracted, 51 (94.4%) were confirmed IS, of which 49/51 (96.1%) were hospitalized, 2/51 (3.9%) visited outpatient wards; 26/51 (51.0%) were males. The overall incidence of confirmed IS and IS hospitalizations among children aged less than 12 months was 143.5 (95% CI: 106.8 - 188.6) and 137.8 (95% CI: 102.0 - 182.2) per 100,000 children-years, respectively. Three (5.9%) IS cases were identified in children aged below 3 months. IS cases peaked between 6 - 11 months of age (40/51 [78.4%]) with the highest incidence (321.5 [95% CI: 138.8 - 633.4] per 100,000 children-years) observed at 10 months of age. The overall recurrence rate of IS was 3.7% (95% CI: 0.5 - 12.7). The baseline incidence of IS in Japanese children aged less than 12 months was higher than that observed in other countries prior to the introduction of second-generation rotavirus vaccines.
Cite this paper: Miura, M. , Sato, K. , Muto, H. , Gopala, K. and Holl, K. (2013) Intussusception in Japanese infants: Analysis of health insurance claims database. Open Journal of Pediatrics, 3, 311-316. doi: 10.4236/ojped.2013.34056.

[1]   Peter, G. and Myers, M.G. (2002) Intussusception, rotavirus, and oral vaccines: Summary of a workshop. Pediatrics, 110, e67.

[2]   Nakagomi, T., Takahashi, Y., Arisawa, K. and Nakagomi, O. (2006) A high incidence of intussusception in Japan as studied in a sentinel hospital over a 25-year period (1978-2002). Epidemiology and Infection, 134, 57-61.

[3]   World Health Organisation (2002) Acute intussusception in infants and children. Incidence, clinical presentation and management: A global perspective. In: Initiative for Vaccine Research Department of Vaccines and Biologicals, Vol. WHO/V&B/02.19, Geneva.

[4]   Ito, Y., Kusakawa, I., Murata, Y., Ukiyama, E., Kawase, H., Kamagata, S., et al. (2012) Japanese guidelines for the management of intussusception in children, 2011. Pediatrics International, 54, 948-958.

[5]   Parashar, U.D., Gibson, C.J., Bresee, J.S. and Glass, R.I. (2006) Rotavirus and severe childhood diarrhea. Emerging Infectious Diseases, 12, 304-306.

[6]   Patel, M.M., Glass, R., Desai, R., Tate, J.E. and Parashar, U.D. (2012) Fulfilling the promise of rotavirus vaccines: How far have we come since licensure? The Lancet Infectious Diseases, 12, 561-570.

[7]   Patel, M.M., Lopez-Collada, V.R., Bulhoes, M.M., De Oliveira, L.H., Bautista Marquez, A., et al. (2011) Intussusception risk and health benefits of rotavirus vaccination in Mexico and Brazil. The New England Journal of Medicine, 364, 2283-2292.

[8]   Takeuchi, M., Osamura, T., Yasunaga, H., Horiguchi, H., Hashimoto, H. and Matsuda, S. (2012) Intussusception among Japanese children: An epidemiologic study using an administrative database. BMC Pediatrics, 12, 36.

[9]   Noguchi, A., Nakagomi, T., Kimura, S., Takahashi, Y., Matsuno, K., Koizumi, H., et al. (2012) Incidence of intussusception as studied from a hospital-based retrospective survey over a 10-year period (2001-2010) in Akita prefecture, Japan. Japanese Journal of Infectious Disease, 65, 301-305.

[10]   Kimura, S., Sato, T., Ikeda, S., Noda, M. and Nakayama, T. (2010) Development of a database of health insurance claims: Standardization of disease classifications and Anonymous record linkage. Journal of Epidemiology, 20, 413-419.

[11]   Japanese Society of Emergency Pediatrics (2012) Evidence-based guidelines for the management of intussusception in children. Herusu-Shuppan, Tokyo.

[12]   Fischer, T.K., Bihrmann, K., Perch, M., Koch, A., Wohlfahrt, J., Kare, M., et al. (2004) Intussusception in early childhood: A cohort study of 1.7 million children. Pediatrics, 114, 782-785. 10.1542/peds.2004-0390

[13]   Boudville, I.C., Phua, K.B., Quak, S.H., Lee, B.W., Han, H.H., Verstraeten, T., et al. (2006) The epidemiology of paediatric intussusception in Singapore: 1997 to 2004. Annals Academy of Medicine, 35, 674-679.

[14]   Chen, S.C., Wang, J.D., Hsu, H.Y., Leong, M.M., Tok, T.S. and Chin, Y.Y. (2010) Epidemiology of childhood intussusception and determinants of recurrence and operation: Analysis of national health insurance data between 1998 and 2007 in Taiwan. Pediatrics and Neonatology, 51, 285-291.

[15]   Chiu, S.S., Ip, K.S., Lau, D., Lau, Y.L., Ng, C.H., Ng, D.K., et al. (2007) Intussusception trends in Hong Kong children. Hong Kong Medical Journal, 13, 279-283.

[16]   Zickafoose, J.S., Benneyworth, B.D., Riebschleger, M.P., Espinosa, C.M. and Davis, M.M. (2012) Hospitalizations for intussusception before and after the reintroduction of rotavirus vaccine in the United States. Archives of Pediatrics and Adolescent Medicine, 166, 350-355. 10.1001/archpediatrics.2011.1501

[17]   Jenke, A.C., Klaassen-Mielke, R., Zilbauer, M., Heininger, U., Trampisch, H. and Wirth, S. (2011) Intussusception: Incidence and treatment-insights from the nationwide German surveillance. Journal of Pediatric Gastroenterology and Nutrition, 52, 446-451. e31820e1bec

[18]   Parashar, U.D., Holman, R.C., Cummings, K.C., Staggs, N.W., Curns, A.T., Zimmerman, C.M., et al. (2000) Trends in intussusception-associated hospitalizations and deaths among US infants. Pediatrics, 106, 1413-1421.

[19]   Huppertz, H.I., Soriano-Gabarro, M., Grimprel, E., Franco, E., Mezner, Z., Desselberger, U., et al. (2006) Intussusception among young children in Europe. The Pediatrics Infectious Disease Journal, 25, S22-S29.

[20]   Justice, F.A., Nguyen, L.T., Tran, S.N., Kirkwood, C.D., Thi, N.T., Carlin, J.B., et al. (2011) Recurrent intussusception in infants. Journal of Pediatrics and Child Health, 47, 802-805. 10.1111/j.1440-1754.2011.02029.x