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. 2024 Oct 23;16(1):61.
doi: 10.1186/s13099-024-00659-z.

Infectious etiology of intussusception in Indian children less than 2 years old: a matched case-control analysis

Ira Praharaj #  1   2 , Samarasimha Nusi Reddy #  1 , Nayana Prabhakaran Nair  1 , Jacqueline Elizabeth Tate  3 , Sidhartha Giri  1   2 , Varunkumar Thiyagarajan  1 , Venkata Raghava Mohan  4 , Rajendiran Revathi  1 , Kalaivanan Maheshwari  1 , Priya Hemavathy  1 , Nirmal Kumar  1 , Mohan Digambar Gupte  5 , Rashmi Arora  5 , Sowmiya Senthamizh  1 , Suhasini Mekala  6 , Krishna Babu Goru  7 , Padmalatha Pamu  8 , Manohar Badur  9 , Subal Pradhan  10 , Mrutunjay Dash  11 , Nirmal Kumar Mohakud  12 , Rajib Kumar Ray  13 , Geetha Gathwala  14 , Madhu Gupta  15 , Ravi Kanojia  15 , Rajkumar Gupta  16 , Suresh Goyal  17 , Pramod Sharma  18 , Mannancheril Abraham Mathew  19 , Tarun John Kochukaleekal Jacob  20 , Balasubramanian Sundaram  21 , Chethrapilly Purusothaman Girish Kumar  22 , Priyadarshini Dorairaj  23 , Ramasubramaniam Pitchumani  24 , Raghul Maniam  25 , Sambandan Kumaravel  26 , Hemant Jain  27 , Jayanta Kumar Goswami  28 , Ashish Wakhlu  29 , Vineeta Gupta  30 , Jie Liu  31 , Eric R Houpt  31 , Umesh D Parashar  1 , Gagandeep Kang  32
Affiliations

Infectious etiology of intussusception in Indian children less than 2 years old: a matched case-control analysis

Ira Praharaj et al. Gut Pathog. .

Abstract

Background: Enteric infections are hypothesized to be associated with intussusception in children. A small increase in intussusception following rotavirus vaccination has been seen in some settings. We conducted post-marketing surveillance for intussusception following rotavirus vaccine, Rotavac introduction in India and evaluated association of intussusception with enteric pathogens.

Methods: In a case-control study nested within a large sentinel hospital-based surveillance program in India, stool samples from 272 children aged less than 2 years admitted for intussusception and 272 age-, gender- and location-matched controls were evaluated with Taqman array card based molecular assays to detect enteric viruses, bacterial enteropathogens and parasites. Matched case-control analysis with conditional logistic regression evaluated association of enteropathogens with intussusception. Population attributable fractions (PAF) were calculated for enteropathogens significantly associated with intussusception.

Results: The most prevalent enteropathogens in cases and controls were enteroaggregative Escherichia coli, adenovirus 40/41, adenovirus C serotypes and enteroviruses. Children with intussusception were more likely to harbor adenovirus C serotypes (adjusted odds-ratio (aOR) = 1.74; 95% confidence interval (CI) 1.06-2.87) and enteroviruses (aOR = 1.77; 95% CI 1.05-2.97) than controls. Rotavirus was not associated with increased intussusception risk. Adenovirus C (PAF = 16.9%; 95% CI 4.7% - 27.6%) and enteroviruses (PAF = 14.7%; 95% CI 4.2% - 24.1%) had the highest population attributable fraction for intussusception.

Conclusion: Adenovirus C serotypes and enteroviruses were significantly associated with intussusception in Indian children. Rotavirus was not associated with risk of intussusception.

Keywords: Adenovirus; Case-control; Intussusception; PAF; Viral pathogens.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Prevalence of enteropathogens in intussusception cases and matched controls
Fig. 2
Fig. 2
Enteropathogen presence and matched odds ratio (± 95% CI) of intussusception (Cq 35 cycles)
Fig. 3
Fig. 3
Adenovirus C quantity (Cq values) and matched odds ratio (± 95% CI) for intussusception
See this image and copyright information in PMC

References

    1. Bines JE, Kohl KS, 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;22(5):569–74. - PubMed
    1. Satter SM, Aliabadi N, Yen C, Gastañaduy PA, Ahmed M, Mamun A, et al. Epidemiology of childhood intussusception in Bangladesh: findings from an active national hospital based surveillance system, 2012–2016. Vaccine. 2018;36(51):7805–10. - PMC - PubMed
    1. Clark AD, Hasso-Agopsowicz M, Kraus MW, Stockdale LK, Sanderson CFB, Parashar UD, et al. Update on the global epidemiology of intussusception: a systematic review of incidence rates, age distributions and case-fatality ratios among children aged < 5 years, before the introduction of rotavirus vaccination. Int J Epidemiol. 2019;48(4):1316–26. - PMC - PubMed
    1. Patel MM, Lopez-Collada VR, Bulhões MM, de Oliveira LH, Márquez AB, Flannery B, et al. Intussusception Risk and Health benefits of Rotavirus Vaccination in Mexico and Brazil. N Engl J Med. 2011;364(24):2283–92. - PubMed
    1. Yih WK, Lieu TA, Kulldorff M, Martin D, McMahill-Walraven CN, Platt R et al. Intussusception Risk after Rotavirus Vaccination in U.S. Infants. N Engl J Med New England Journal of Medicine; 1/14/2014: Massachusetts Medical Society; 2014. pp. 503 – 12. - PubMed

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