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

ABSTRACT

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.

KEYWORDS:

• Antibiotic use
• anti-rotavirus vaccine
• breastfeeding
• gastroenteritis
• intussusception
• risk factor

Acknowlegements

The authors are very grateful to the following healthcare workers od Sicilian Health Authority for their contribution to conduct the study. Mario Palermo, Sergio Buffa, Giovanni Allegra, Franco Belbruno, Franco Blangiardi, Giuseppe Cammarata, Guiseppe Canzoneri, Nicola Casuccio, Lia Contrino, Claudio D’Angelo, Guiseppe Ferrera, Gaetano Geraci, Francesco lacono, Salvatore Madonia, Fernanda Marano, Gaetano Migliorino, Giovanni Puglisi, Nunziatina Aiello, Lorenza Amato, Carmela Attina, Angela Averna, Alba Maria Barresi, Epifanio Bataglia, Antonio Bellino, Annamaria Bellomo, Rosaria Bellomo, Latizia Belvedere, Alessandra Bonomo, Elenora Cacioppo, Angelo Calenduccia, Loredana Caltabiano, Rosa Camarda, Rosaria Cambria, Fabio Campo, Graziella Catanese, Salvatore Cinconze, Cristiforo Cocchiara, Maria Coparettom Sergio Conti Nibali, Nino Conticuglia, Angela Costa, Rosaria Costagliola, Francesco Costanza, Angelo Cucchiara, Caterina D’Alia, Giovanni D’Urso, Elvira Di Caccamo, Maria Stella Di Giacomo, Maria Vittoria Di Matteo, Maria Grazia Di Paola, Antonio Evangelista, Francesco Fazio, Paolo Felice, Dante Ferrara, Mario Fiamingo, Angela Fornano, Elisabetta Francario, Salvatore Galasso, Silvana Iacono, Maria Vincenza Ingrasciotta, Maria Lucida, Rita La Paglia, Giovanna Lo Iacono, Francesca Lupo, Gabriella Maiolino, Giuliana Mangiameli, Vito Marletta, Antonio Marrone, Giuseppa Mancuso, Rosa Mazzola, Angela Meli, Corrado Micale, Giuseppe Montalbano, Maria Patrizia Muccioli, Angela Muscarella, Guiseppa Nicotra, Olimpia Olivero, Luciana Pace, Maria Grazia Papa, Maria Pappalardo, Amedo Peritore, Mario Perna, Anna Maria Perno, Laura Pirico, Pasquale Pirrera, Francesca Raia, Guiseppe Recupero, Domenica Repici, Alessandra Ricca, Orazio Ricca, Rosaria Ricciardi, Maria Rutella, Alessandra Sacco, Caterina Sagona, Giovanna Santisi, Felicetta Scuderi, Antonio Sinatra, Giovanna Sotera, Angelo Spataro, Guiseppe Spataro, Sergio Speciale, Rosario Tartaro, Monica Tulumello, Maria Lidia Vinciguerra, Concetta Vitale, Guiseppe Vitale, Angela Vittorioso, Francesco Paolo Volpe, Antonio Zingone, Maria Concetta Zinna.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.