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埃塞俄比亚锡达马地区部分医院儿科病房五岁以下儿童肠套叠的决定因素

Determinants of intussusception in children under five years old visiting paediatric ward in selected hospitals of Sidama region Ethiopia.

作者信息

Fetene Abraham, Nagarchi Khaleel, Getchew Tamiru

机构信息

Medical Education and Service Director, Department of Human Anatomy, Arbaminch University, Arba Minch, Ethiopia.

出版信息

Sci Rep. 2025 Jul 30;15(1):27758. doi: 10.1038/s41598-025-13245-3.

Abstract

Intussusception is a significant cause of child mortality in sub-Saharan Africa, yet its exact causes remain unclear. Two main theories suggest it may be linked to dietary factors or infections, highlighting the need for research to identify specific risk factors. Accordingly, this study aimed to investigate the factors associated with intussusception in children under five years of age. A hospital-based unmatched case-control study design was employed, using an interviewer-administered structured questionnaire and a review of medical records for data collection. Data were analysed using SPSS version 25, and both bivariate and multivariable logistic regression models were applied. Variables with a p-value < 0.25 in the bivariate analysis were included in the multivariable logistic regression model. Statistical significance was declared at a p-value of less than 0.05. The study included 52 cases and 156 controls. The average age of the cases was 11.5 months (SD ± 8.60), and that of the controls was 18.9 months (SD ± 15.4). Among the participants, males accounted for 65.4% of the cases and 53.8% of the controls, while females comprised 34.6% of the cases and 46.2% of the controls. Variables significantly associated with intussusception included age between 6 and 12 months [AOR = 3.13; 95% CI: 1.04-9.41], history of gastrointestinal infections [AOR = 5.07; 95% CI: 2.14-11.9], mixed feeding with breast milk and formula [AOR = 17.12; 95% CI: 5.42-54], and feeding with breast milk and homemade foods [AOR = 9.28; 95% CI: 2.52-34.2]. This study demonstrates that children aged 6 to 12 months, a history of gastrointestinal infections, previous medication use, and mixed feeding practices (breast milk combined with formula or homemade foods) are associated with an increased risk of intussusception. Educating mothers and caregivers on proper hygiene practices to reduce infections, and promoting awareness of the benefits of exclusive breastfeeding, are essential preventive strategies.

摘要

肠套叠是撒哈拉以南非洲儿童死亡的一个重要原因,但其确切病因仍不清楚。两种主要理论认为,它可能与饮食因素或感染有关,这突出了开展研究以确定具体风险因素的必要性。因此,本研究旨在调查五岁以下儿童肠套叠的相关因素。采用了基于医院的非匹配病例对照研究设计,通过访谈员实施的结构化问卷和查阅医疗记录来收集数据。使用SPSS 25版对数据进行分析,并应用了双变量和多变量逻辑回归模型。双变量分析中p值<0.25的变量被纳入多变量逻辑回归模型。p值小于0.05时具有统计学意义。该研究包括52例病例和156名对照。病例的平均年龄为11.5个月(标准差±8.60),对照的平均年龄为18.9个月(标准差±15.4)。在参与者中,男性占病例的65.4%和对照的53.8%,而女性占病例的34.6%和对照的46.2%。与肠套叠显著相关的变量包括6至12个月龄[AOR = 3.13;95%可信区间:1.04 - 9.41]、胃肠道感染史[AOR = 5.07;95%可信区间:2.14 - 11.9]、母乳与配方奶混合喂养[AOR = 17.12;95%可信区间:5.42 - 54]以及母乳与自制食品喂养[AOR = 9.28;95%可信区间:2.52 - 34.2]。本研究表明,6至12个月龄的儿童、胃肠道感染史、既往用药情况以及混合喂养方式(母乳与配方奶或自制食品混合)与肠套叠风险增加有关。教育母亲和照顾者采取适当的卫生习惯以减少感染,并提高对纯母乳喂养益处的认识,是至关重要的预防策略。

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