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Case-control study on intestinal intussusception: implications for anti-rotavirus vaccination
Vincenzo Restivo1, Claudio Costantino1, Gabriele Giorgianni2
1a Department of Science for Health Promotion and Mother-Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy.
Insights
Infant intussusception risk factors include birth order, recent gastroenteritis, and antibiotic use. Exclusive breastfeeding is protective, while rotavirus vaccination shows no correlation. Early identification aids in managing this common childhood abdominal emergency.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Public Health
Background:
- Intussusception is the leading cause of abdominal emergencies in young children.
- A significant proportion, nearly 75%, of intussusception cases remain idiopathic.
- Understanding risk factors is crucial for early diagnosis and management.
Purpose of the Study:
- To identify factors associated with the onset of intussusception in children.
- To investigate the role of birth order, infections, antibiotic use, breastfeeding, and vaccination in intussusception.
- To improve the susceptibility profile for intussusception in pediatric populations.
Main Methods:
- A case-control study was conducted in Sicily involving children aged 0-59 months.
- Data were collected from 125 children with intussusception and 190 controls admitted to the hospital between 2009 and 2015.
- Statistical analysis included calculating odds ratios (OR) and 95% confidence intervals (CI).
Main Results:
- Higher birth order (OR 1.49) and recent gastroenteritis (OR 11.55) or antibiotic use (OR 3.09) significantly increased intussusception risk.
- Exclusive breastfeeding for at least two months demonstrated a protective effect (OR 0.48).
- Anti-rotavirus vaccination did not show a correlation with the risk of intussusception (OR 0.96).
Conclusions:
- Findings enhance awareness among healthcare providers regarding intussusception risk factors.
- Identifying high-risk children can aid in vaccination counseling and early symptom interception.
- This knowledge can help reduce the incidence and severity of intussusception cases.
Background:
Intussusception represents the most common cause of abdominal emergency among young children but nearly 75% of cases are still considered idiopathic.
Research Design And Methods:
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.
Results:
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).
Conclusions:
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.
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