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

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

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, Rot...

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Main Authors: Ira Praharaj, Samarasimha Nusi Reddy, Nayana Prabhakaran Nair, Jacqueline Elizabeth Tate, Sidhartha Giri, Varunkumar Thiyagarajan, Venkata Raghava Mohan, Rajendiran Revathi, Kalaivanan Maheshwari, Priya Hemavathy, Nirmal Kumar, Mohan Digambar Gupte, Rashmi Arora, Sowmiya Senthamizh, Suhasini Mekala, Krishna Babu Goru, Padmalatha Pamu, Manohar Badur, Subal Pradhan, Mrutunjay Dash, Nirmal Kumar Mohakud, Rajib Kumar Ray, Geetha Gathwala, Madhu Gupta, Ravi Kanojia, Rajkumar Gupta, Suresh Goyal, Pramod Sharma, Mannancheril Abraham Mathew, Tarun John Kochukaleekal Jacob, Balasubramanian Sundaram, Chethrapilly Purusothaman Girish Kumar, Priyadarshini Dorairaj, Ramasubramaniam Pitchumani, Raghul Maniam, Sambandan Kumaravel, Hemant Jain, Jayanta Kumar Goswami, Ashish Wakhlu, Vineeta Gupta, Jie Liu, Eric R. Houpt, Umesh D. Parashar, Gagandeep Kang
Format: Article
Language:English
Published: BMC 2024-10-01
Series:Gut Pathogens
Subjects:
Intussusception
Case-control
Adenovirus
Viral pathogens
PAF
Online Access:https://doi.org/10.1186/s13099-024-00659-z
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Summary: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.
ISSN:1757-4749

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