Juliana Rejane da Silva Roque1, Rodrigo Strehl Machado2, Douglas Rodrigues3, Patrícia Rech4, Elisabete Kawakami5. 1. MD, MSc. Postgraduate Student, Discipline of Pediatric Gastroenterology, Department of Pediatrics, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-Unifesp), São Paulo (SP), Brazil. 2. MD, PhD. Clinical Instructor, Discipline of Pediatric Gastroenterology, Department of Pediatrics, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-Unifesp), São Paulo (SP), Brazil. 3. MD, PhD. Clinical Instructor, Department of Preventive Medicine, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-Unifesp), São Paulo (SP), Brazil. 4. MSc. Postgraduate Student, Department of Preventive Medicine, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-Unifesp), São Paulo (SP), Brazil. 5. MD, PhD. Full Professor, Discipline of Pediatric Gastroenterology, Department of Pediatrics, Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-Unifesp), São Paulo (SP), Brazil.
Abstract
CONTEXT AND OBJECTIVE: : The prevalence of Helicobacter pylori infection is unevenly distributed among different populations. The aim here was to evaluate the factors associated with Helicobacter pylori infection among children up to five years of age living in a high-risk community. DESIGN AND SETTING: : Cross-sectional study in an indigenous community of Guarani Mbya ethnicity, Tekoa Ytu and Tekoa Pyau villages, Jaraguá district, city of São Paulo (SP), Brazil. METHODS: : 74 children aged 0.4 to 4.9 years (mean 2.9 ± 1.3 years; median 3.1), and 145 family members (86 siblings, 43 mothers and 16 fathers) were evaluated for Helicobacter pylori infection using the validated 13C-urea breath test. Clinical and demographic data were collected. RESULTS: : The prevalence was 8.3% among children aged 1-2 years and reached 64.3% among those aged 4-5 years (P = 0.018; overall 31.1%). The prevalence was 76.7% among siblings and 89.8% among parents. There was a negative association with previous use of antibiotics in multivariate analysis adjusted for age (odds ratio, OR: 0.07; 95% confidence interval, CI: 0.01 to 0.66; P = 0.02). The prevalence was higher among males (OR: 1.55), and was associated with maternal infection (OR: 1.81), infection of both parents (OR: 1.5), vomiting (OR: 1.28), intestinal parasitosis (OR: 2.25), previous hospitalization (OR: 0.69) and breastfeeding (OR: 1.87). CONCLUSIONS: : The prevalence was high among subjects older than three years of age, thus suggesting that the incidence of infection was higher over the first three years of life. Previous use of antibiotics was inversely associated with current Helicobacter pylori infection.
CONTEXT AND OBJECTIVE: : The prevalence of Helicobacter pyloriinfection is unevenly distributed among different populations. The aim here was to evaluate the factors associated with Helicobacter pyloriinfection among children up to five years of age living in a high-risk community. DESIGN AND SETTING: : Cross-sectional study in an indigenous community of Guarani Mbya ethnicity, Tekoa Ytu and Tekoa Pyau villages, Jaraguá district, city of São Paulo (SP), Brazil. METHODS: : 74 children aged 0.4 to 4.9 years (mean 2.9 ± 1.3 years; median 3.1), and 145 family members (86 siblings, 43 mothers and 16 fathers) were evaluated for Helicobacter pyloriinfection using the validated 13C-urea breath test. Clinical and demographic data were collected. RESULTS: : The prevalence was 8.3% among children aged 1-2 years and reached 64.3% among those aged 4-5 years (P = 0.018; overall 31.1%). The prevalence was 76.7% among siblings and 89.8% among parents. There was a negative association with previous use of antibiotics in multivariate analysis adjusted for age (odds ratio, OR: 0.07; 95% confidence interval, CI: 0.01 to 0.66; P = 0.02). The prevalence was higher among males (OR: 1.55), and was associated with maternal infection (OR: 1.81), infection of both parents (OR: 1.5), vomiting (OR: 1.28), intestinal parasitosis (OR: 2.25), previous hospitalization (OR: 0.69) and breastfeeding (OR: 1.87). CONCLUSIONS: : The prevalence was high among subjects older than three years of age, thus suggesting that the incidence of infection was higher over the first three years of life. Previous use of antibiotics was inversely associated with current Helicobacter pyloriinfection.