Seroprevalence of Helicobacter pylori infection among children of low socioeconomic level in São Paulo

Abstract

CONTEXT AND OBJECTIVE: Helicobacter pylori infection is mainly acquired during childhood, and is associated with significant morbidity in adults. The aim here was to evaluate the seroprevalence and risk factors of H. pylori infection among children of low socioeconomic level attended at a public hospital in São Paulo, Brazil. DESIGN AND SETTING:Cross-sectional study, among patients attended at an outpatient clinic.METHODS: 326 children were evaluated (150 boys and 176 girls; mean age 6.82 ± 4.07 years) in a cross-sectional study. Patients with chronic diseases or previous H. pylori treatment, and those whose participation was not permitted by the adult responsible for the child, were excluded. The adults answered a demographic questionnaire and blood samples were collected. The serological test used was Cobas Core II, a second-generation test. Titers > 5 U/ml were considered positive. RESULTS: H. pylori infection was diagnosed in 116 children (35.6%). Infected children were older than uninfected children (7.77 ± 4.08 years versus 5.59 ± 3.86 years; p < 0.0001). The seroprevalence increased from 20.8% among children aged two to four years, to 58.3% among those older than 12 years. There were no significant relationships between seropositivity and gender, color, breastfeeding, number of people in the home, number of rooms, bed sharing, living in a shantytown, maternal educational level, family income or nutritional status. In multivariate analysis, the only variable significantly associated with H. pylori seropositivity was age.CONCLUSION: Infection had intermediate prevalence in the study population, and age was associated with higher prevalence. RESUMO CONTEXTO E OBJETIVO:A infecção por Helicobacter pylori é adquirida principalmente na infância e é associada a morbidade significativa em adultos.O objetivo foi avaliar a soroprevalência de infecção por H. pylori bem como fatores de risco em crianças de baixo nível socioeconômico atendidas em um hospital público em São Paulo, Brasil. TIPO DE ESTUDO E LOCAL:Estudo transversal, realizado entre pacientes atendidos em ambulatório. MÉTODOS:Foram avaliadas 326 crianças (150 meninos e 176 meninas, idade: média 6,82 ± 4,07 anos) em estudo transversal. Foram excluídas aquelas com doenças crônicas, tratamento prévio de H. pylori e cujo responsável não consentiu participar do estudo. Os responsáveis responderam questionário demográfico e foi coletada uma amostra de sangue. O teste sorológico empregado foi o CobasCore II, exame de segunda geração, sendo considerados positivos títulos > 5 U/ml. RESULTADOS:Infecção por H. pylori foi diagnosticada em 116 (35,6%). A idade dos pacientes infectados foi maior que a dos demais (7,77 ± 4,08 anos versus 5,59 ± 3,86 anos; p < 0,0001). A prevalência aumenta de 20,8% entre dois e quatro anos de idade para 58,3% entre maiores de 12 anos. Não houve relação significativa entre soropositividade e sexo, raça, aleitamento materno, número de pessoas ou de cômodos na casa, compartilhamento de camas, domicílio em favela, escolaridade mat...

Helicobacter pylori infection is high in paediatric nonulcer dyspepsia but not associated with specific gastrointestinal symptoms

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Helicobacter pylori associated with breastfeeding, nutritional status and recurrent abdominal pain in healthy Nigerian children

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