title: Incidence and risk factors for intussusception among children in northern Israel from 1992 to 2009: a retrospective study.
abstract: BACKGROUND
  Determining the background incidence of intussusception is important in countries implementing rotavirus immunization. Rotavirus immunization was introduced into the routine infant immunization program in Israel during late 2010. Incidence and risk factors for intussusception were examined in children aged less than five years between 1992 and 2009.
  
  
  METHODS
  Data were collected from medical records of children hospitalized due to intussusception (N = 190), and from control children (N = 295), at Carmel and Hillel Yaffe hospitals in northern Israel.
  
  
  RESULTS
  The average annual incidence of intussusception in Jewish and Arab children aged less than five years was estimated at 36.1 (95% CI 17.0-76.5) vs. 23.2 per 100,000 (95% CI 9.3-57.9); for infants less than 12 months of age- 128.1 (95% CI 53.0-309.6) vs. 80.1 (95% CI 29.1-242.6) per 100,000. The risk of intussusception was higher in infants aged 3-5 months: OR 5.30 (95% CI 2.11-13.31) and 6-11 months: OR 2.53 (95% CI 1.13-5.62) when compared to infants aged less than 3 months; in those living in low vs high socioeconomic communities: OR 2.81 (95% CI 1.45-5.43), and in children with recent gastroenteritis: OR 19.90 (95% CI 2.35-168.32) vs children without recent gastroenteritis. Surgical reduction was required in 23.2%. The likelihood of surgery was significantly increased in patients presenting with bloody stool, in Arabs and those who were admitted to Hillel Yaffe Hospital.
  
  
  CONCLUSIONS
  The incidence of intussusception prior to universal rotavirus immunization was documented in northern Israel. Despite the lower incidence, Arab patients underwent surgery more often, suggesting delayed hospital admission of Arab as opposed to Jewish patients.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel. khitam15@yahoo.com.
authors.forename: Khitam
authors.initials: K
authors.lastname: Muhsen
authors.forename: Eias
authors.initials: E
authors.lastname: Kassem
authors.forename: Sigalit
authors.initials: S
authors.lastname: Efraim
authors.forename: Sophy
authors.initials: S
authors.lastname: Goren
authors.forename: Dani
authors.initials: D
authors.lastname: Cohen
authors.forename: Moshe
authors.initials: M
authors.lastname: Ephros
mesh_terms: D018912:Arabs; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007443:Intussusception / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D007557:Israel / Q000453:epidemiology; D007585:Jews; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D022243:Rotavirus Vaccines
chemical_list: D022243:Rotavirus Vaccines