Risk factors for intussusception in infants in Vietnam and Australia: adenovirus implicated, but not rotavirus

Julie E Bines1, Nguyen Thanh Liem, Frances A Justice

  • 1Department of Gastroenterology and Clinical Nutrition, Emergency Medicine, Microbiology, Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, Parkville, Australia. julie.bines@rch.org.au

Insights

Infant intussusception is significantly more common in Vietnam than Australia. Adenovirus infection is strongly linked to intussusception in both countries, suggesting a key etiological role.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Intussusception is a common cause of intestinal obstruction in infants.
  • Incidence rates vary globally, with higher rates suspected in developing countries.
  • Understanding risk factors is crucial for prevention and management.

Purpose of the Study:

  • To investigate risk factors for infant intussusception.
  • To compare incidence in a developing (Vietnam) and developed (Australia) country.
  • To identify potential etiological agents, particularly infections.

Main Methods:

  • Prospective case-control study of infants under 2 years.
  • Conducted in Vietnam (n=533) and Australia (n=51).
  • Risk factors assessed via questionnaire; stool samples tested for pathogens.

Main Results:

  • Vietnam incidence: 302/100,000; Australia incidence: 71/100,000.
  • Strong association found between adenovirus infection and intussusception (OR 8.2-44).
  • No link to rotavirus, other pathogens, vaccines, feeding, or living conditions.

Conclusions:

  • Infant intussusception incidence is markedly higher in Vietnam.
  • Adenovirus infection is strongly associated with intussusception.
  • Adenovirus may play a significant role in the etiology of infant intussusception.
Abstract

Related Concept Videos

Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Bacterial Gastroenteritis01:18

Bacterial Gastroenteritis

Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid receptor...
Intestinal Obstruction I: Introduction01:29

Intestinal Obstruction I: Introduction

Intestinal obstruction is a partial or complete blockage of the small or large intestine that disrupts the normal flow of intestinal contents through the lumen. This interruption impairs digestion, absorption, and fluid balance, and may lead to serious complications if not treated promptly.Mechanical ObstructionMechanical obstruction occurs when a physical blockage prevents intestinal contents from passing, arising from within the lumen or the bowel wall, or from external compression.Adhesions,...
Poliomyelitis01:17

Poliomyelitis

Poliomyelitis is caused by poliovirus, a small, non-enveloped, positive-sense RNA virus of the Picornaviridae family and Enterovirus genus. Transmission occurs primarily via the fecal-oral route, often through ingestion of contaminated water or food. The virus initially replicates in the oropharynx and intestinal mucosa, particularly in lymphoid tissues such as the tonsils, Peyer’s patches, and regional lymph nodes. Primary viremia follows, allowing dissemination throughout the body.In most...