Case-control study on intestinal intussusception: implications for anti-rotavirus vaccination

• Published in: Expert review of vaccines Vol. 17; no. 12; pp. 1135 - 1141
• Main Authors: Restivo, Vincenzo, Costantino, Claudio, Giorgianni, Gabriele, Cuccia, Mario, Tramuto, Fabio, Corsello, Giovanni, Casuccio, Alessandra, Vitale, Francesco
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Group 02.12.2018
• Subjects: Anti-Bacterial Agents - adverse effects; anti-rotavirus vaccine; antibiotic use; Birth Order; Breast Feeding - statistics & numerical data; breastfeeding; Case-Control Studies; Child, Preschool; Female; gastroenteritis; Gastroenteritis - complications; Gastroenteritis - epidemiology; Hospitalization - statistics & numerical data; Humans; Infant; Infant, Newborn; intussusception; Intussusception - epidemiology; Intussusception - etiology; Male; Protective Factors; risk factor; Risk Factors; Rotavirus Vaccines - administration & dosage; Rotavirus Vaccines - adverse effects; Sicily - epidemiology; Sicily; Antibiotic use; anti-rotavirus vaccine; breastfeeding; intussusception; gastroenteritis; risk factor
• ISSN: 1476-0584; 1744-8395
• DOI: 10.1080/14760584.2018.1546122

Intussusception represents the most common cause of abdominal emergency among young children but nearly 75% of cases are still considered idiopathic. A case-control study was conducted among Sicilian children aged 0-59 months with a hospital admission for intussusception between 2009 and 2015 to identify factors associated with intussusception onset. Overall, 125 cases and 190 controls were recruited for the study. Birth order (OR 1.49, 95%CI: 1.10, 2.02, P = 0.02) and having had gastroenteritis or having taken antibiotics during the 30 days prior to hospitalization (OR 11.55, 95%CI: 3.23, 41.23, P < 0.001; 3.09, 95%CI: 1.17, 8.12, P = 0.009, respectively) were significantly associated with intussusception. On the other hand, exclusive breastfeeding for at least two months was a protective factor (OR 0.48, 95%CI: 0.23, 0.99, P = 0.009). Anti-rotavirus vaccination did not correlate with risk of intussusception (OR 0.96, 95% CI: 0.41, 2.25, P = 0.92). These findings increase the awareness of intussusception among clinical and public health service providers to obtain a better susceptibility profile. Moreover, identifying children at higher risk of intussusception could be useful in vaccination counselling to intercept early symptoms and to reduce the number of serious cases.