Helicobacter pylori Colonization Among Children up to 6 Years: Results of a Community-based Study from Northeastern Brazil

Braga, Andréa B. C.; Fialho, Andre; Marzano‐Rodrigues, Maria Noel; Queiroz, Dulciene Maria Magalhães; Rocha, Andréia Maria Camargos; Braga, Lúcia Libanez Bessa Campelo

doi:10.1093/tropej/fmm051

Cited by 31 publications

(31 citation statements)

References 27 publications

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“…The primary risk factors for acquiring H pylori in Brazil are related to unfavorable living conditions experienced during childhood, including low family income, low education levels of the children's parents, lack of proper household sanitary facilities, household crowding or high density housing or in institutions; improper personal hygiene habits, presence of an infected family member, especially the mother, and deficient basic public health services such as supply of piped drinking water, household garbage collection and sewerage with treatment plants for collected waste (9,36,55,56,79,110) .…”

Section: Group 5 Epidemiology Of Infection and Proposals For Action mentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

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Section: Group 5 Epidemiology Of Infection and Proposals For Action mentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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“…Poucos estudos sobre a prevalência do H. pylori foram realizados com uma amostra grande o suficiente e com métodos diagnósticos não invasivos validados localmente em crianças de comunidades indígenas 10,11 . Portanto, é de vital importância que obtenhamos uma melhor compressão da epidemiologia da infecção por H. pylori em crianças das chamadas comunidades primitivas.…”

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Prevalence of Helicobacter pylori infection and intestinal parasitosis in children of the Xingu Indian Reservation

Escobar-Pardo¹,

Godoy²,

Machado³

et al. 2011

J Pediatr (Rio J)

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Objective: To evaluate the prevalence of Helicobacter pylori infection and its association with intestinal parasitoses in children from indigenous communities of the Xingu Indian Reservation, in Brazil.Methods: A total of 245 Native Brazilian children between 2 and 9 years of age, from six villages of the Xingu River region, a tributary of the Amazon River, were assessed. H. pylori was detected using the 13 C-urea breath test. Breath samples were collected at baseline and 30 minutes after ingestion of 50 mg of 13 C-urea diluted with 100 mL of water flavored with passion fruit juice and sweetener. Stool samples were collected for the stool ova and parasites exam for 202/245 (82.4%) children. Results:The overall prevalence of H. pylori was 73.5%. A significant association of H. pylori with increased age was observed among the different villages and ethnic groups. Positive results for the presence of parasites -97.5% (198/202) -from the stool samples collected showed no association with H. pylori. Giardia showed an association with H. pylori in the multivariate analysis. Risk factors for H. pylori infection were observed in Kisêjê and Kaibi ethnic groups (OR [odds ratio] = 3.36 and 4.00, respectively), as well as in Tuiararé, Ngojwere, Capivara, Diauarum, and Pavuru villages (OR = 8.10, 4.10, 4.88, 1.85, and 1.40, respectively). Conclusions:H. pylori infection is highly prevalent in these communities, as well as intestinal parasitoses. However, there were significant differences in the prevalence of H. pylori among the diverse villages studied. Giardia was closely associated with H. pylori infection. J Pediatr (Rio J). 2011;87(5):393-8: Epidemiology, prevalence,Helicobacter pylori, giardia. ResumoObjetivo: Avaliar a prevalência da infecção por Helicobacter pylori e sua associação com parasitoses intestinais em crianças da comunidade indígena do Parque Indígena do Xingu. Métodos:Foram incluídas 245 crianças indígenas entre 2 e 9 anos, de seis aldeias da região do rio Xingu, afluente do Amazonas. H. pylori foi detectado pelo teste respiratório com ureia-13 C. Foram coletadas amostras de ar expirado, em jejum e 30 minutos após a ingestão de 50 mg de ureia-13 C diluída em 100 mL de água aromatizada com suco de maracujá. Foram coletadas amostras de fezes de 202/245 (82,4%) crianças para exame protoparasitológico. Conclusões: Foi encontrada alta prevalência de H. pylori e de parasitose intestinal em crianças nas comunidades presentemente investigadas. No entanto, houve diferença significativa na prevalência do H. pylori entre as diversas aldeias estudadas. Verificou-se associação entre a presença de giárdia e a infecção por H. pylori.

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“…Previous epidemiological studies have shown a high prevalence of H. pylori infection in Brazil (2,20,24). H. pylori infection, generally acquired in childhood, persists asymptomatically for decades in most individuals.…”

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confidence: 98%

High Prevalence of Clarithromycin Resistance and cagA , vacA , iceA2 , and babA2 Genotypes of Helicobacter pylori in Brazilian Children

Garcia¹,

Aranda²,

Gonçalves

et al. 2010

J Clin Microbiol

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We isolated 45 Helicobacter pylori strains from 217 child patients. Resistance to clarithromycin, metronidazole, amoxicillin, and tetracycline was detected in 27%, 13%, 4%, and 0% of strains, respectively. The A2143G mutation was the most prevalent (67%) among clarithromycin-resistant strains. In addition, strain genotyping revealed a significant association between gastritis severity and the simultaneous presence of cagA, vacA s1m1, iceA2, and babA2 genes.Helicobacter pylori infection is found worldwide and constitutes a public health concern in many countries. Previous epidemiological studies have shown a high prevalence of H. pylori infection in Brazil (2,20,24). H. pylori infection, generally acquired in childhood, persists asymptomatically for decades in most individuals.Amoxicillin, tetracycline, metronidazole, and clarithromycin are frequently used, combined with proton pump inhibitors or bismuth salts, for the treatment of H. pylori infections (25). However, antibiotic resistance is frequently associated with eradication failure (3, 16). Resistance to metronidazole and clarithromycin is population dependent, and several studies suggest that clarithromycin resistance is higher in strains isolated from children than in strains isolated from adults (10). In Brazil, the prevalence of clarithromycin-resistant strains in adults is reported to be from 7 to 10% (15, 18). However, little is known about the prevalence of clarithromycin-resistant H. pylori infection in Brazilian children.The primary aims of this study were to determine the prevalence of clarithromycin-resistant H. pylori strains in children, to identify those isolates via rapid methodology, and to examine the severity of gastritis caused by the antibiotic-resistant H. pylori isolates. Metronidazole, amoxicillin, and tetracycline resistance was also studied. Furthermore, the study aimed to genotype the vacA and iceA genes and to detect the cagA gene in gastric biopsy specimens, since recent studies found a high frequency of cagA-positive and iceA2-positive strains as well as a strain with the vacA signal region genotype s1 and middle region sequence m1 among pediatric H. pylori isolates in Brazil (6,7,11,23). This is also the first investigation of babA2 gene prevalence in Brazilian children.A total of 217 consecutive child patients, aged 1 to 18 years (mean age, 10 years) (105 girls and 112 boys), who underwent Gastric biopsy specimens were processed for histological examination and evaluated according to the updated Sydney system of classification and grading of gastritis (4).Antral gastric specimens were transported in sodium thioglycolate broth (Difco, Detroit, MI) in an ice bath and ground before submission to DNA extraction and PCR-restriction fragment length polymorphism (PCR-RFLP) analysis with primers specific to the H. pylori 23S rRNA gene (17). The QIAmp tissue kit (Qiagen) was used for DNA extraction. Point mutations related to clarithromycin resistance in the 23S rRNA amplicon were investigated in all H. pylori isolates by PCR-RFLP usin...

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Helicobacter pylori Colonization Among Children up to 6 Years: Results of a Community-based Study from Northeastern Brazil

Abstract: This study shows that children living in low socioeconomic status and poor hygienic conditions are infected very early in childhood. It identifies age and H. pylori positive mother as independent risk factors for infection.

Cited by 31 publications

References 27 publications

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Prevalence of Helicobacter pylori infection and intestinal parasitosis in children of the Xingu Indian Reservation

High Prevalence of Clarithromycin Resistance and cagA , vacA , iceA2 , and babA2 Genotypes of Helicobacter pylori in Brazilian Children

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