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A case-control study of risk factors for intussusception among infants in eastern France after the introduction of the rotavirus vaccine

Fotso Kamdem, Arnaud, Vidal, Chrystelle, Pazart, Lionel, Leroux, Franck, Pugin, Aurore, Savet, Caroline, Sainte-Claire Deville, Geoffroy, Guillemot, Didier, Massol, Jacques
Vaccine 2019 v.37 no.32 pp. 4587-4593
Rotavirus, breast feeding, case-control studies, confidence interval, gastroenteritis, hospitals, infant formulas, infants, odds ratio, risk factors, vaccination, vaccines, France
The objective of the present study was to investigate the risk factors for intussusception (IS) among infants, including vaccination against rotavirus.Case-control study with systematic inclusion of all infants aged <1 year with suspected IS admitted to emergency departments in the eastern region of France between 1 April 2008 and 31 March 2012. All cases classed level 1 according to the Brighton classification were matched to 4 hospital controls. Two exposure windows were examined; exposure to the first dose of rotavirus vaccine in the 7 and in the 14 days prior to the occurrence of IS.A total of 115 cases were matched with 457 controls. The average vaccination coverage rate over the 4 years of study was 8.6%. Rotavirus vaccine was not found to be significantly associated with the occurrence of IS in the 7 days (odds ratio (OR) not calculated; p = 0.99) and in the 14 days after administration of one dose vaccine (OR 1.33, 95% confidence interval (CI) 0.14–12.82). Infant formula alone or combined with breastfeeding was associated with an excess risk of IS (OR 2.74, 95% CI 1.10–6.79). A history of gastroenteritis within 2 weeks prior to hospitalisation was also associated with an increased risk (OR 2.24, 95% CI 1.07–4.67).Our study indicates that infant formula alone or combined with breastfeeding is a risk factor for IS. A small, non-significant increase in the risk of IS was observed after rotavirus vaccination, although the low vaccine coverage rate likely precluded detection of a significant increase in risk.