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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.