1. Exploring the Infectious Contribution to Intussusception Causality Using the Effects of COVID-19 Lockdowns in Australia: An Ecological Study.
- Author
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Townley B, Akin D, Dimaguila GL, Sawires R, Sepulveda Kattan G, King S, Bines J, Wood N, Lambert S, and Buttery J
- Subjects
- Humans, Infant, Retrospective Studies, Child, Preschool, Child, Male, Female, Australia epidemiology, Adolescent, Infant, Newborn, Adult, Hospitalization statistics & numerical data, Middle Aged, Young Adult, Aged, New South Wales epidemiology, Queensland epidemiology, Victoria epidemiology, COVID-19 epidemiology, COVID-19 prevention & control, Intussusception epidemiology, Intussusception etiology, SARS-CoV-2
- Abstract
Background: Intussusception is the primary cause of acute bowel obstruction in infants. The majority of cases <2 years of age are classed as idiopathic, with viral infection implicated as one of the causes. Coronavirus disease 2019 (COVID-19) public health measures led to significant decreases in communicable disease prevalence. During these times, reductions in intussusception frequency were greater than would be expected with our previous understanding of its infectious etiology., Methods: We conducted a retrospective, multistate, ecological study over a 12-year period. Monthly case numbers of "intussusception"-coded admissions (code K56.1; International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification) were acquired from state-wide admissions data sets from New South Wales, Victoria, and Queensland, representing 77.62% of the eligible Australian population. These counts within differing jurisdictional lockdowns were compared with non-lockdown periods in order to investigate a correlation between intussusception frequency and lockdown periods., Results: We found a negative association between intussusception frequency and lockdown periods in both eligible states. The largest reductions were seen in the <2-year age groups, with Victoria experiencing a 62.7% reduction (rate ratio, 0.37; P < .001) and New South Wales a 40.1% reduction (0.599; P = .006) during lockdown times. Controls for variations in lockdown restrictions between both regional and metropolitan areas also showed expected decreases., Conclusions: Our ecological study demonstrates significant decreases in the frequency of pediatric intussusception admissions during the COVID-19 lockdown periods. The unexpected magnitude of the reductions suggests that the true proportion of infectious disease-caused idiopathic intussusception is greatly underestimated., Competing Interests: Potential conflicts of interest. B. T. and J. Buttery report grants from the Bill & Melinda Gates Foundation, PATH US, the Australian government Department of Health, GSK, the World Health Organization (WHO), and the University of Melbourne (research grant from Partnership in Research Indonesia and Melbourne [PRIME]); support for travel and/or meetings from the WHO Advisory Committee for Vaccines Against AMR and the Australian Government Department for Foreign Affairs and Trade; and participation on a data and safety monitoring board for Vakzine Project Management and on the WHO Advisory Committee for Vaccines Against AMR. N. W. reports funding from Australia's Medical Research Future Fund for a coronavirus disease 2019 (COVID-19) vaccine trial and participated on data and safety monitoring board for a clinical vaccine trial of a COVID-19 vaccine manufactured by Bionet Asia. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
- Published
- 2024
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