Mansour Adel M, El Koutby Montasser, El Barbary Mohamed M, Mohamed Wissam, Shehata Sameh, El Mohammady Hanan, Mostafa Manal, Riddle Mark S, Sebeny Peter J, Young Sylvia Y N, Abdel-Messih Ibrahim
US Naval Medical Research Unit No. 3, Bacteriology and Parasitology Diseases Research Program, Cairo, Egypt.
J Infect Dev Ctries. 2013 Jan 15;7(1):28-35. doi: 10.3855/jidc.2321.
We aimed to identify potential risk factors for intussusception (ISS) among children presenting to two pediatric hospitals in Egypt.
In this case-control study, enrolled children < 3 years old with ISS (confirmed radiologically and/or surgically) were matched by age and gender to controls admitted with acute non-abdominal surgical illnesses. Stool samples were collected and tested for various enteric bacteria, rotavirus, enteric adenoviruses (EA, 40 and 41) and astroviruses using commercially available ELISA diagnostic kits.
From December 2004 to May 2009, 158 cases and 425 matched controls were enrolled. A history of diarrhoea and cough over the preceding four weeks of interview were more common in cases than controls, respectively. Children with mothers who had secondary education and above were 2.2 times more likely to have ISS than those whose mothers had a lower level of education. In spite of the low detection rate of EA infection (regardless of diarrhoea history) and asymptomatic rotavirus infection, they were detected in higher frequencies in cases than controls; however, infection with astrovirus and bacterial pathogens did not appear to be associated with increased risk of ISS.
History of diarrhoea and cough over the four weeks preceding the study and maternal education above secondary level were potential risk factors for ISS. EA and asymptomatic rotavirus infection were detected in higher frequencies among cases than controls; however, association with ISS cannot be confirmed. Additional research is needed to confirm these findings and evaluate the pathogenesis which may link such infections with ISS.
我们旨在确定埃及两家儿科医院收治的儿童发生肠套叠（ISS）的潜在风险因素。
在这项病例对照研究中，纳入年龄小于3岁、经放射学和/或手术确诊为ISS的儿童，按年龄和性别与因急性非腹部外科疾病入院的对照儿童进行匹配。收集粪便样本，使用市售ELISA诊断试剂盒检测各种肠道细菌、轮状病毒、肠道腺病毒（EA，40型和41型）和星状病毒。
2004年12月至2009年5月，共纳入158例病例和425例匹配对照。在访谈前四周有腹泻和咳嗽病史的病例分别比对照更为常见。母亲受过中等及以上教育的儿童患ISS的可能性是母亲教育程度较低的儿童的2.2倍。尽管EA感染（无论腹泻病史如何）和无症状轮状病毒感染的检出率较低，但在病例中的检出频率高于对照；然而，星状病毒和细菌病原体感染似乎与ISS风险增加无关。
研究前四周的腹泻和咳嗽病史以及母亲中等以上教育程度是ISS的潜在风险因素。病例中EA和无症状轮状病毒感染的检出频率高于对照；然而，不能证实其与ISS有关。需要进一步研究以证实这些发现并评估可能将此类感染与ISS联系起来的发病机制。
