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

Praharaj, Ira; Reddy, Samarasimha Nusi; Nair, Nayana Prabhakaran; Tate, Jacqueline Elizabeth; Giri, Sidhartha; Thiyagarajan, Varunkumar; Mohan, Venkata Raghava; Revathi, Rajendiran; Maheshwari, Kalaivanan; Hemavathy, Priya; Kumar, Nirmal; Gupte, Mohan Digambar; Arora, Rashmi; Senthamizh, Sowmiya; Mekala, Suhasini; Goru, Krishna Babu; Pamu, Padmalatha; Badur, Manohar; Pradhan, Subal; Dash, Mrutunjay

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.

INTESTINAL infections; ROTAVIRUS vaccines; LOGISTIC regression analysis; SEROTYPES; ADENOVIRUSES; ROTAVIRUSES; ENTEROVIRUSES

Gut Pathogens, 2024, Vol 16, Issue 1, p1

1757-4749

Academic Journal

10.1186/s13099-024-00659-z