Rotavirus infection and intussusception in Tunisian children: implications for use of attenuated rotavirus vaccines

Anissa Chouikha, Imene Fodha, Kaies Maazoun, Mohamed Ben Brahim, Saida Hidouri, Abdellattif Nouri, Abdelhalim Trabelsi*, Andrew Duncan Steele

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Background: A licensed rotavirus vaccine was withdrawn from use because of an increased risk of intussusception. The association of rotavirus vaccination with intussusception raised concerns about a potential link between natural rotavirus disease and intussusception. The objectives of the present study were to determine whether an epidemiological association with natural rotavirus infection existed. Methods: From 1984 to 2003, all children younger than 5 years with intussusception were retrospectively identified by medical charts, and from 1995 to 2003, a prospective surveillance study of rotavirus infection in children younger than 5 years was independently conducted. Epidemiological characteristics of intussusception and rotavirus infection were then compared. Results: A total of 533 cases of intussusception and 146 cases of rotavirus infection were identified. The incidence of intussusception for infants younger than 1 year was 62/100,000 child-years. The age distributions of intussusception and rotavirus gastroenteritis overlapped, and a masculine predominance was noted in both cases. No significant association was observed between the monthly distribution of intussusception and rotavirus infection. Conclusion: The present study has not convincingly shown that rotavirus diarrhea plays a major role in intussusception. However, data about age and sex distributions supported the biologic plausibility of such an association.

Original languageEnglish
Pages (from-to)2133-2138
Number of pages6
JournalJournal of Pediatric Surgery
Issue number11
Publication statusPublished - Nov 2009
Externally publishedYes


  • Association
  • Intussusception
  • RRV-TV
  • Rotavirus


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