Supplement article - Research | Volume 39 (1): 7. 29 Jul 2021 | 10.11604/pamj.supp.2021.39.1.21343

Epidemiology of intussusception among infants in Togo, 2015-2018

Enyonam Tsolenyanu, Komlatsè Akakpo-Numado, Djatougbe Eliane Akolly, Jason Mwenda, Jacqueline Tate, Amevegbe Boko, Dadja Landoh, Komlan Gnassingne, Yawo Atakouma, Umesh Parashar

Corresponding author: Enyonam Tsolenyanu, Department of Pediatrics, National coordinator for New Vaccines Surveillance, Lome, Togo

Received: 18 Dec 2019 - Accepted: 17 Jul 2020 - Published: 29 Jul 2021

Domain: Urgent Care Medicine

Keywords: Intussusception, infant, Togo, Sub-saharan Africa

This articles is published as part of the supplement Intussusception in African Infants, commissioned by Supported by the Gavi Alliance through the CDC Foundation.

©Enyonam Tsolenyanu et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Enyonam Tsolenyanu et al. Epidemiology of intussusception among infants in Togo, 2015-2018. Pan African Medical Journal. 2021;39(1):7. [doi: 10.11604/pamj.supp.2021.39.1.21343]

Available online at:

Home | Supplements | Volume 39 | This supplement | Article number 7


Epidemiology of intussusception among infants in Togo, 2015-2018

Epidemiology of intussusception among infants in Togo, 2015-2018

Enyonam Tsolenyanu1,2,&, Komlatsè Akakpo-Numado3, Djatougbe Eliane Akolly1, Jason Mwenda4, Jacqueline Tate5, Amevegbe Boko2, Dadja Landoh6, Komlan Gnassingne3, Yawo Atakouma1, Umesh Parashar5


1Department of Paediatrics, Medical School of Lome, Lome, Togo, West Africa, 2Ministry of Health, Togo, 3Department of Paediatrics Surgery, Medical School of Lome, Lome, Togo, West Africa, 4The World Health Organization, Regional Office for Africa, Brazzaville, Congo, 5National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, USA, 6The World Health Organization, Country Office, Togo



&Corresponding author
Enyonam Tsolenyanu, Department of Paediatrics, Medical School of Lome, Lome, Togo, West Africa




Introduction: intussusception is the leading cause of bowel obstruction in infants and young children. We describe the epidemiology and diagnostic and treatment characteristics of intussusception among Togolese infants over a 4-year period.


Methods: we implemented active surveillance among infants younger than 1 year of age admitted with intussusception from 2015 to 2018 at Sylvanus Olympio Teaching Hospital and in 2018 at Campus Teaching Hospital. Brighton Collaboration Level 1 case definition criteria were used to confirm the diagnosis of intussusception.


Results: during four years, 41 cases of intussusception, with an annual range of 8 to 14 cases (median: 10) were reported; and the highest number of cases (89%) was enrolled at Sylvanus Olympio teaching hospital. Intussusception was uncommon in the first 2 months of life, peaked from 5 to 7 months old (63%), with male predominance (63%), and showed no significant seasonality. One third of cases (34%) were transferred to the sentinel surveillance site from another health facility; and the median delay in seeking care was 4 days (range: 0-11) with ≥ 48-hour delay in 59% of cases. Clinical symptoms, ultrasound and surgery were combined to diagnose intussusception in all the cases (100%). The treatment was exclusively surgical, and intestinal resection was common (28/41, 68%). A high case fatality rate (23%) was observed and the average length of hospital stay was 10 days (range: 1-23).


Conclusion: active surveillance for intussusception in Togo has highlighted exclusive use of surgical therapy; often associated to an intestinal resection with a very high case fatality rate.



Introduction    Down

Intussusception (IS) is defined as invagination of one segment of intestine within a more distal segment [1]. It is the leading cause of intestinal obstruction in children and infants, occurring without any identifiable cause in 90% of cases [2]. Boys are often more affected than girls; and delay in treatment may result death [3]. Globally, the rate of naturally occurring IS in infants younger than 1 year of age was estimated to be 74 cases per 100 000 infants, with a peak incidence among 5-7 month old infants [4]. Data are available on IS worldwide before rotavirus vaccine introduction in immunization schedules [4-10]; but few studies were published from the African region [11-13]. The incidence rate of IS was 56 per 100 000 among infants younger than 1 year of age in South Africa. This incidence ranged from 31 per 100 000 in South Africa to 60 per 100 000 in Zambia among children younger than 2 years of age [4, 14]. In Togo, at least two studies have been published prior to rotavirus vaccine introduction; both at Sylvanus Olympio teaching hospital; but none of them was specifically about epidemiology of the disease. The first was a 6-year retrospective IS study included 37 infants aged 2-13 month; and the second was a cross-sectional prospective study over a 2-year period that included 15 young children aged 4-42 months. Boys were predominant in both studies. The average delay in seeking care was 4 days; with 66% of cases treated after > 48 hours. Surgery was the treatment method in over 94% of cases; with a range of 22 to 27% case fatality rate [15, 16].

Vaccines are now available against rotavirus, the leading cause of severe diarrhea associated to death among children worldwide [17]. A previously available rotavirus vaccine was associated with IS [18, 19]; thus large clinical trials (~70,000 infants) were conducted in US, Europe, and South America for the currently available vaccines (Rotarix® and RotaTeq®). These pre-licensure data found no evidence of an association between IS and rotavirus vaccines [20, 21]. Clinical trials from two newer rotavirus vaccines (Rotavac® and Rotasiil®), which were recently pre-qualified for use by the World Health Organization, were not powered to assess an association of vaccination with IS [22-24]. However, post licensure data from middle and high-income countries such as USA, Mexico, Australia and Brazil suggest a minimally increased IS risk in vaccinated infants [25-33]. Nevertheless, given the magnitude of declines in rotavirus disease and associated mortality, compared with this small increase in the risk of IS, the benefits of rotavirus vaccination outweigh the small increase risk of IS [34-36]. Further, active surveillance for IS in seven lower-income sub-Saharan countries has shown that the risk of IS after administration of monovalent human rotavirus vaccine (Rotarix) was not higher than the background risk of IS [37]. According to the recommendation from the World Health Organization [38], Togo introduced the monovalent human rotavirus vaccine -Rotarix®- in its routine immunization schedule in June 2014 (first dose at 6 weeks old and second dose at 10 weeks old). Evidence of early impact of the vaccine on diarrheal disease magnitude among Togolese children has been observed [39-41]. The current study describes the epidemiology and diagnostic and treatment characteristics of intussusception among Togolese infants.



Methods Up    Down

Study design

We conducted active surveillance for IS among infants younger than 1 year of age at Sylvanus Olympio Teaching Hospital from January 2015 through December 2018 and at Campus Teaching Hospital from January to December 2018. All infants in this age group that were admitted to one of these surveillance health facilities with a diagnosis of IS during the surveillance period were enrolled. All surgeons in the surveillance health facilities received standardized training on inclusion criteria for IS cases. Case investigation forms were available at each surveillance health facility. One paediatric surgeon coordinated IS surveillance activities. Periodic visits and phone calls were made to surgeons to encourage reporting of cases and to address likely concerns. Additionally, periodic review of surgical and ultrasound registers was conducted to ensure the thoroughness of reporting.

Study sites and population under surveillance

Total population of infants younger than 1 year of age in Togo was more than 280 700; and more than 118 500 (42%) of them lived in the geographical catchment area of the two surveillance health facilities. These health facilities were the main national referral hospitals in Togo; and were both located in Lome, the capital city. They are the only health facilities with paediatric surgeons in their staff. The current IS surveillance coordinator was based at Sylvanus Olympio Teaching Hospital from January 2015 to December 2017 and in January 2018, he moved to Campus Teaching Hospital to inaugurate a paediatric surgical ward at this health facility. No health facilities in the country have the ability to perform enema contrast in children, due to the lack of adequate contrast medium. Often in case of IS, the child was first admitted to pediatric ward; and was only referred to surgery when ultrasound result was in favour of diagnosis.

Case definition

We used Brighton Collaboration Level 1 case definition criteria for the diagnosis certainty of IS. Confirmation of IS by air and/or liquid contrast enema, and/or ultrasound (with confirmed reduction on subsequent ultrasound or enema), and/or at surgery and/or autopsy is classified as Level 1 [1]. As enema contrast medium was not availability during surveillance period, included cases were those confirmed by ultrasound and/or surgical criteria.

Data collection and analysis

The main variables collected by the study were gender, dates of birth, symptom onset, admission to first health facility, admission to surveillance health facility, and disposition, diagnosis certainty definition criteria, diagnostic method(s), treatment method, and outcome at discharge. Collected data were analysed by Epi Info 7.

Disclaimer: the findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the World Health Organization or those of Centers for disease control and prevention.



Results Up    Down

Summary of surveillance findings

During IS active surveillance period, 41 cases of IS were reported among infants younger than 1 year of age; 36 (88%) of them were admitted to Sylvanus Olympio National Referral and Teaching Hospital from 2015 to 2018, and 5 (12%) to Campus Teaching Hospital through 2018. A range of 8 to 14 (median: 10) IS cases were reported annually; and 63% (26/41) were boys (Figure 1). A peak of reported cases (26/41, 63%) was observed among 5-7 month old infants (Figure 2). January (19%, 8/41) and December (17%, 7/41) had the highest number of cases (Figure 3).

Description of diagnostic and treatment characteristics

The diagnostic methods were multiple: clinical symptoms (child admission for acute abdominal pain, vomiting, associated with mucous and bloody stools), ultrasound and surgery in all the cases (100%). Air or liquid enema and autopsy were not performed in any case. Thirty-four percent (14/41) of cases were transferred to the surveillance health facility from another health facility. A range of 0 to 7 (median: 3 days) interval occurred from admission to the first health facility to transfer to the surveillance health facility. The overall care seeking median delay was 4 days (range: 0-11) from symptom onset; and 59% (24/41) of the cases were admitted to the surveillance health facility only 48 hours or more after the symptom onset. All IS cases were treated by surgical operation; with an intestinal resection in 68% (28/41) of cases. Nine cases died for a case fatality rate was 22% (9/41). Data on duration of hospital stay was available in 78% (32/41) of cases, and ranged from 1 to 23 days; with 10-day average length of stay (Table 1).



Discussion Up    Down

Our findings compared to available previous data on IS disease in Togo, confirmed also male predominance. Data from previous studies did not allow any comparison for likely change in age distribution [15, 16]. The very small number of intussusception cases identified precluded us from evaluating the possible association between rotavirus vaccine administration and occurrence of IS. Moreover, compared to previous data in Togo, we did not observed any improvement regarding seeking health care delay, treatment method, and case fatality rate; although the problem were already raised since the last two studies published respectively in 2004 and 2012 [15, 16]. Several publications on IS disease had already mentioned this poor management of cases in developing countries, particularly in Africa. Surgery was the common treatment method in Africa and was used in over 76% of cases with highest case fatality rates up to 34% [4, 11-14, 36]. Efforts can be made to improve IS case management in Africa as it is in high-income countries. In high-income countries, seeking health care delay is shortened, non-invasive methods are used to reduce IS in most cases, and surgery is required in less than 30% of cases resulting in dramatically low case fatality rates less than 1% [4]. In some middle-income countries even if surgery is still often use, they are improving in reduction of case fatality rate [4, 6-9]. This example can also be used in Africa with strengthen more over hospitals technical capacity in intensive care before and after surgical therapy [16].

Our study has some limitations that should be noted. Due to inadequacy of technical training in regional hospitals, IS surveillance is ongoing only in national referral hospitals located at the capital city. This limitation is related to a lack of radiological technology system, especially in regional hospitals but also at national referral hospitals. Enema reduction was not performed in children, because of lack of adequate contrast medium for this age even at the national referral hospitals. Ultrasound is performed only at national referral hospitals and pediatric surgeons are not available at regional hospitals. Some infants with IS may died, especially in rural zones far from the capital city, without any identification of the cause of the death. Another limitation of the study is the small population of Togo. It does not allow an evaluation of association between IS and rotavirus vaccine at the local level.



Conclusion Up    Down

This active surveillance for IS in Togo has outlined the exclusive use of surgery as IS therapy method, often associated to an intestinal resection with a very high case fatality rate. Continued enhanced surveillance is needed to identify risk factors for intestinal resection and death.

What is known about this topic

  • Delay in seeking care, intestinal resection is common, and the case fatality rate is high.

What this study adds

  • No significant seasonality, children in 5-7 age-group are more affected, and surgery is the only method of treatment.



Competing interests Up    Down

The authors declare no competing interests.



Authors' contributions Up    Down

All authors have read and agreed to the final version of this manuscript.



Acknowledgments Up    Down

The authors acknowledge participants to this study, GAVI Alliance that provided financial support to WHO/AFRO for supporting new vaccines surveillance, and the Ministry of Health and national expanded program on immunization for their guidance and leadership in implementing the surveillance in Togo.



Table and figures Up    Down

Table 1: overview of intussusception cases among infants younger than 1 year of age at Sylvanus Olympio Teaching Hospital and Campus Teaching Hospital, 2015 – 2018, Lome, Togo

Figure 1: gender distribution of infants younger than 1 year of age with intussusception by hospitalization year, 2015 - 2018, Sylvanus Olympio Teaching Hospital and Campus Teaching Hospital, Lome, Togo; the proportion of intussusception cases in boys is noted

Figure 2: age distributions of infants younger than 1 year of age with intussusception, 2015 - 2018, Sylvanus Olympio Teaching Hospital and Campus Teaching Hospital, Lome, Togo

Figure 3: monthly distribution of infants younger than 1 year of age with intussusception, 2015- 2018, Sylvanus Olympio Teaching Hospital and Campus Teaching Hospital, Lome, Togo; the proportion of intussusception cases by month is reported



References Up    Down

  1. Bines EJ, Kohl SK, Forster J, Zanardi LR, Davis RL, Hansen J et al. Acute intussusception in infants and children as an adverse event following immunization: case definition and guidelines of data collection, analysis, and presentation. Vaccine. 2004 Jan 26;22(5-6):569-74. PubMed | Google Scholar

  2. Yakan S, Caliskan C, Makay O, Denecli A-G, Korkut M-A. Intussusception in adults: Clinical characteristics, diagnosis and operative strategies. World J Gastroenterol. 2009 Apr 28;15(16):1985-9. PubMed | Google Scholar

  3. Parashar UD, Holman RC, Cummings KC, Staggs NW, Curns AT, Zimmerman CM et al. Trends in intussusception-associated hospitalizations and deaths among US infants. Pediatrics. 2000 Dec;106(6):1413-21. PubMed | Google Scholar

  4. Jiang J, Jiang B, Parashar U, Nguyen T, Bines J, Patel MM. Childhood intussusception: a literature review. PLoS One. 2013 Jul 22;8(7):e68482. PubMed | Google Scholar

  5. Bines EJ, Patel M, Parashar U. Assessment of post licensure safety of rotavirus vaccines, with emphasis on intussusception. J Infect Dis. 2009 Nov 1;200 Suppl 1:S282-90. PubMed | Google Scholar

  6. Muhsen K, Kassem E, Efraim S, Goren S, Dani Cohen, Ephros M. Incidence and risk factors for intussusception among children in northern Israel from 1992 to 2009: a retrospective study. BMC Pediatrics. 2014 Aug 31;14:218. PubMed | Google Scholar

  7. Singh V, Kamath V, Shetty R, Kumar V, Prasad R, Saluja T et al. Retrospective surveillance for intussusception in children aged less than five years at two tertiary care centers in India. Vaccine. 2014 Aug 11;32 Suppl 1:A95-8. PubMed | Google Scholar

  8. Srinivasan R, Kumar CPG, Naaraayan SA, Jehangir S, Jeromie Thangaraj WV, Venkatasubramanian S et al. Intussusception hospitalizations before rotavirus vaccine introduction: Retrospective data from two referral hospitals in Tamil Nadu, India. Vaccine. 2018 Dec 14;36(51):7820-7825. PubMed | Google Scholar

  9. Samad L, Cortina-Borja M, El Bashir H, Sutcliffe AG, Marven S, Claire Cameron J et al. Intussusception incidence among infants in the UK and Republic of Ireland: A pre-rotavirus vaccine prospective surveillance study. Vaccine. 2013 Aug 28;31(38):4098-102. PubMed | Google Scholar

  10. Fernandes EG, Leshem E, Patel M, Flannery B, Guedes Pellini AC, Veras MA et al. Hospital-based surveillance of intussusception among infants. J Pediatr (Rio J). Mar-Apr 2016;92(2):181-7. PubMed | Google Scholar

  11. Ngendahayo E, Bonane A, Ntakiyiruta G, Munyanshongore A, Muganga N, Joel Bikoroti et al. Preparing for safety monitoring after rotavirus vaccine implementation- A retrospective review of intussusception cases among children at a large teaching hospital in Rwanda, 2009-2012. Pediatr Infect Dis J. 2014 Jan;33 Suppl 1:S99-S103. PubMed | Google Scholar

  12. Mpabalwani EM, Chitambala P, Chibumbya JN, Matapo B, Mutambo H, Mwenda JM et al. Intussusception incidence rates in 9 Zambian hospitals, 2007-2011-Pre rotavirus vaccine introduction. Pediatr Infect Dis J. 2014 Jan;33 Suppl 1:S94-8. PubMed | Google Scholar

  13. Omore R, Osawa F, Musia J, Brian Rha, Amina Ismail, Nicholas Mukaria Kiulia et al. Intussusception cases among children admitted to referral hospitals in Kenya, 2002-2013: Implications for monitoring post licensure safety of rotavirus vaccines in Africa. Pediatr Infect Dis J. 2016 Dec;5(4):465-469. PubMed | Google Scholar

  14. Mpabalwani EM, Mwenda JM, Tate JE, Parashar UD. Review of naturally occurring intussusception in young children in the WHO African Region prior to the era of rotavirus vaccine utilization in the Expanded Programme of Immunization. Journal of Tropical Pediatrics. 2016;0:1-8. Google Scholar

  15. Gnassingbe K, Abarchi H, Akakpo-Numado GK. Problèmes posés par les invaginations intesnales aiguës du nourrisson au CHU-Tokin de Lome à propos de 37 cas. J Afr Chir Digest. 2004;4(1):333-7.

  16. Boume MA, Akakpo-Numado GK , Gnassingbe K. Prise en charge et pronostic des invaginations intestinales aigues de l'enfant au CHU-Tokoin de Lome (Togo). J Afr Chir Digest. 2012; 12 (1):1274-80.

  17. Tate JE, Parashar UD. Rotavirus vaccines in routine use. Clin Infect Dis. 2014 Nov 1;59(9):1291-301. PubMed | Google Scholar

  18. Murphy TV, Gargiullo PM, Massoudi MS, Nelson DB, Jumaan AO, Okoro CA et al. Intussusception among infants given an oral rotavirus vaccine. N Engl J Med. 2001 Feb 22;344(8):564-72. PubMed | Google Scholar

  19. Patel MM, Haber P, Baggs J, Zuber P, Bines JE, et al. Intussusception and rotavirus vaccination: a review of the available evidence. Expert Rev Vaccines. 2009 Nov;8(11):1555-64. PubMed | Google Scholar

  20. Vesikari T, Matson OD, Dennehy P, et al. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med. 2006 Jan 5;354(1):23-33.. PubMed | Google Scholar

  21. Ruiz-Palacios GM, Pérez-Schael I, Velázquez FR. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med. 2006 Jan 5;354(1):11-22. PubMed | Google Scholar

  22. Bhandari N, Rongsen-Chandola T, Bavdekar A, Jacob John, Kalpana Antony, Sunita Taneja et al. Efficacy of a monovalent human-bovine (116E) rotavirus vaccine in Indian infants: a randomised, double-blind, placebo-controlled trial. Lancet. 2014 Jun 21;383(9935):2136-43 Epub 2014 Mar 12. PubMed | Google Scholar

  23. Coldiron ME, Ousmane Guindo O, Makarimi R, Issaka Soumana, Amadou Matar Seck, Souna Garba et al. Safety of a heat-stable rotavirus vaccine among children in Niger: Data from a phase 3, randomized, double-blind, placebo-controlled trial. Vaccine. 2018 Jun 14;36(25):3674-3680. PubMed | Google Scholar

  24. Kulkarni PS, Desai S, Tewari T, Kawade A, Goyal N, Garg BS et al. A randomized Phase III clinical trial to assess the efficacy of a bovine human reassortant pentavalent rotavirus vaccine in Indian infants. Vaccine. 2017 Oct 27;35(45):6228-6237. PubMed | Google Scholar

  25. Patel MM, Lopez-Collada VR, Bulhoes MM, Lucia Helena De Oliveira, Marquez AB et al. Intussusception risk and health benefits of rotavirus vaccination in Mexico and Brazil. N Engl J Med. 2011 Jun 16;364(24):2283-92. PubMed | Google Scholar

  26. Velazquez FR, Colindres RE, Grajales C, Hernandez MT, Mercadillo MG, Torres FJ et al. Post marketing surveillance of intussusception following mass introduction of the attenuated human rotavirus vaccine in Mexico. Pediatr Infect Dis J. 2012 Jul;31(7):736-44. PubMed | Google Scholar

  27. Buttery JP, Danchin MH, Lee KJ, Carlin JB, Mclntyre PB, Elliott EJ et al. Intussusception following rotavirus vaccine administration: post-marketing surveillance in the National Immunization Program in Australia. Vaccine. 2011 Apr 5;29(16):3061-6. PubMed | Google Scholar

  28. Carlin JB, Macartney KK, Lee KJ, Quinn HE, Buttery J, Lopert R et al. Intussusception risk and disease prevention associated with rotavirus vaccines in Australia´s National Immunization Program. Clin Infect Dis. 2013 Nov;57(10):1427-34 Epub 2013 Aug 26. PubMed | Google Scholar

  29. Haber P, Patel M, Izurieta HS, James Baggs, Paul Gargiullo, Eric Weintraub et al. Post licensure monitoring of intussusception after RotaTeq vaccination in the United States, February 1, 2006, to September 25, 2007. Pediatrics. 2008 Jun;121(6):1206-12. PubMed | Google Scholar

  30. Belongia EA, Irving SA, Shui IM, Kulldorf M, Lewis E, Yin R et al. Real-time surveillance to assess risk of intussusception and other adverse events after pentavalent, bovine-derived rotavirus vaccine. Pediatr Infect Dis J. 2010 Jan;29(1):1-5. PubMed | Google Scholar

  31. Shui IM, Baggs J, Patel M, Parashar UD, Rett M, Belongia EA et al. Risk of intussusception following administration of a pentavalent rotavirus vaccine in US infants. JAMA. 2012 Feb 8;307(6):598-604. PubMed | Google Scholar

  32. Weintraub ES, Baggs J, Duffy J, Vellozzi C, Edward Belongia A, Stephanie Irving et al. Risk of intussusception after monovalent rotavirus vaccination. N Engl J Med. 2014 Feb 6;370(6):513-9. PubMed | Google Scholar

  33. Yih WK, Lieu TA, Kulldorff M, Belongia EA, Irving S, Klein NP et al. Intussusception risk after rotavirus vaccination in U.S. infants. N Engl J Med. 2014 Feb 6;370(6):503-12. PubMed | Google Scholar

  34. Parashar UD, Alexander JP, Glass RI. Prevention of rotavirus gastroenteritis among infants and children. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2006 Aug 11;55(RR-12):1-13. PubMed | Google Scholar

  35. Meeting of the Strategic Advisory Group of Experts on immunization, October 2009 ---conclusions and recommendations. Wkly Epidemiol Rec. 2009 Dec 11;84(50):517-32. Google Scholar

  36. Parashar UD, Cortese MM, Payne DC, Lopman B, Yen C, Tate JE. Value of post-licensure data on benefits and risks of vaccination to inform vaccine policy: The example of rotavirus vaccines Vaccine. 2015 Nov 27;33 Suppl 4:D55-9. Google Scholar

  37. Tate JE, Yen C, Steiner CA, Cortese MM, Parashar UD. Intussusception rates before and after the introduction of rotavirus vaccine. Pediatrics. 2016 Sep;138(3):e20161082. PubMed | Google Scholar

  38. The World Health Organization. Conclusions and recommendations from the global advisory committee on vaccine safety. Wkly Epidemiol Rec. 2009; 32(84):225-32. PubMed | Google Scholar

  39. Tsolenyanu E, Seheri M, Dagnra A, Djadoum E, Tigossou S, Nyaga M et al. Surveillance for rotavirus gastroenteritis in children less than 5 years of age in Togo. Pediatr Infect Dis J. 2014 Jan;33 Suppl 1:S14-8. PubMed | Google Scholar

  40. Tsolenyanu E, Mwenda JM, Dagnra A, Leshem E, Godonou M, Nassoury I et al. Early evidence of impact of monovalent rotavirus vaccine in Togo. Clin Infect Dis. 2016 May 1;62 Suppl 2:S196-9. PubMed | Google Scholar

  41. Tsolenyanu E Djadou KE, Fiawoo M et al. Evidence of the impact of monovalent rotavirus vaccine on childhood acute gastroenteritis hospitalization in Togo. Vaccine. 2018 Nov 12;36(47):7185-7191. PubMed | Google Scholar































Epidemiology of intussusception among infants in Togo, 2015-2018


Epidemiology of intussusception among infants in Togo, 2015-2018


Epidemiology of intussusception among infants in Togo, 2015-2018

Volume 40 (Sep - Dec 2021)
This article authors
On Pubmed
On Google Scholar
Citation [Download]
Reference Manager

Navigate this article
Similar articles in
Key words




Sub-saharan Africa

Article metrics
Countries of access