有消化道症状儿童幽门螺旋杆菌现症感染的调查

目的：了解有消化道症状的儿童幽门螺杆菌（H. pylori）现症感染状态,并调查H. pylori感染的危险因素。方法：选择有上消化道症状的376例患儿进行胃镜检查,同时取3块胃黏膜分别作快速尿素酶及病理组织学检查。部分患儿行13C-尿素呼气试验。上述3种方法中2项或2项以上阳性者诊断为H. pylori感染。同时对患儿居住环境、家庭经济状况、父母文化程度、消化道疾病家族史进行问卷调查。结果：376例患儿中,H. pylori现症感染率为44.9%（169例）。男女H. pylori感染率差异无统计学意义（P>0.05）。3岁~、8岁~、13~16岁年龄组H. pylori阳性率分别为39.5%（47/119）、41.0%（55/134）、54.5% (67/123）,不同年龄组间患儿H. pylori感染率差异有统计学意义（χ2=6.76,P<0.05）。儿童全托及中小学生寄宿、集体居住及用餐者H. pylori阳性率高于非集体居住及用餐者（53.6% vs 40.6%, P<0.05）。家庭经济收入高者H. pylori阳性率低于中低收入者（36.9% vs 48.3%,P<0.05）。父母文化程度高者H. pylori阳性率低于父母文化程度较低者（39.5% vs 50.8%,P<0.05）。有胃炎或消化性溃疡病家族史者H. pylori感染率高于无家族史者（52.9% vs 41.2%,P<0.05）。结论：随着年龄的增长,H. pylori感染率逐渐增加。集体居住、共同用餐、家庭低收入、父母受教育程度低以及有上消化道疾病家族史的患儿有较高的H. pylori感染率,因此以上因素是儿童感染H. pylori的危险因素。     

�й���ͯ�����ݸ˾���Ⱦ���в�ѧ��״���Ǩ

??The occurrence of Helicobacter pylori??H.pylori?? infection is significantly higher in developing countries when compared to developed nations. It is one of the most common chronic bacterial infections in China and significant geographic differences among regions are likely to present. The rates of
H.pylori infection and related diseases have been declining yearly in both developed and rapidly developing countries. A prospective??multicenter study performed recently in China indicates that H.pylori infection rate among Chinese asymptomatic children increases with age and is high after the age of ten. There is no overall regional difference among different cities. H.pylori infection rate in children has declined in Beijing in recent 20 years since 1991??which indicates that improvement in socioeconomic conditions might have helped to reduce the infection rate in children.     

Helicobacter pylori colonization among children up to 6 years: results of a community-based study from Northeastern Brazil

AIM: To determine the prevalence and risk factors associated with Helicobacter pylori infection among children up to 6 years. METHODS: Cross-sectional study carried out in a poor urban community in Fortaleza Northeast Brazil. A standardized questionnaire was applied. Helicobacter pylori status was evaluated by (13)C-urea breath test ((13)C-UBT) in children up to 48 months and by ELISA in the mothers. Sera were assayed by the Cobas Core anti-H. pylori IgG EIA. RESULTS: The overall prevalence of H. pylori infection was 40% (88/217), 41% (46/112) boys and 40% (42/105) girls were infected. The prevalence rate of infection by H. pylori increased significantly with age, from 29% (27/93) in the youngest group (3 months to 2 years) to 59% (35/59) in the oldest group (6 years), (p < 0.001). There was no significant difference in the prevalence of infection between gender, height and weight adjusted for age, history of breastfeeding, mother's education, number of people per room, number of people per bed, smoking habit of the mother and children's history of antibiotic intake. A significant difference was found in the prevalence of H. pylori infection and H. pylori status of mother (p = 0.02; odds ratio (OR) 2.98; 95% confidence interval (CI): 1.19-7.46) that remained significant after adjustment for covariates in multivariate analysis (p = 0.012; OR 4.65; 95%CI: 1.39-15.58). CONCLUSIONS: 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.     

无锡地区散居儿童幽门螺杆菌感染及相关因素流行病学调查

目的了解无锡地区儿童人群中幽门螺杆菌(H．pylori)感染率，探讨影响H．pylori感染的因素。方法采用酶联免疫分析法检测1126例0—12岁健康儿童及其父母粪便中的幽门螺杆菌抗原(HpSA)。并对每位人选者进行问卷调查，对其平时有无消化道症状、生活环境、生活习惯及家族史等情况进行了解。结果本地区儿童平均H．pylori感染率为19．1％，其中男性为19．6％，女性为18．5％，两者差异无显著性。有症状组阳性率为26．％，无症状组为10．6％。城区儿童H．pylori感染率为12．5％，城郊结合部儿童为19．3％，郊区、农村儿童为24．9％。结论无锡地区儿童中H．pylori感染率较高．有随年龄递增的趋势。幽门螺杆菌感染为引起无锡地区儿童胃十二指肠疾病的主要原因。     

深圳市宝安区儿童幽门螺旋杆菌感染及危险因素分析

目的 探讨深圳市宝安区儿童幽门螺旋杆菌(HP)感染状况及相关因素.方法 以深圳市宝安区1～14岁儿童为研究对象,采用血清酶联免疫吸附技术检测血清HP-IgG抗体及双夹心法检测粪便HP抗原.结果 感染阳性率为38.04%(124/326).随年龄增长,感染HP阳性率逐渐升高.父母有胃病史、家庭人均月收入低、不良生活习惯、与大人共用刷牙口杯、接受口嚼食物喂养史和经常食用街边小吃是造成本地区Hp感染的重要因素.结论 本地区儿童HP感染仍处于较高水平,随年龄增长,感染有增加趋势,并与个人卫生及生活习惯、家庭经济条件密切相关,呈现家庭内聚集现象.     

Helicobacter pylori infection in Turkish preschool and school children: role of socioeconomic factors and breast feeding

It has been shown that Helicobacter pylori (H. pylori) infection is rare among children in developed countries. In Turkey, the prevalence of H. pylori infection among adults is about 80-85%, which is close to the ratios reported in developing countries. There is limited knowledge, however, on the prevalence, determinants and associations of this infection, such as short stature, familial history of dyspepsia and abdominal pain, in children. The aims of this study were to estimate the prevalence, determinants and associations of H. pylori infection in a group of healthy school children using 13C-urea breath test (13C-UBT). The study subjects were selected from a kindergarten and an elementary school. The H. pylori status was determined by 13C-UBT. Standard questionnaires ascertaining sociodemographic data were completed for each child by questioning the mothers. Three hundred twenty-seven children aged 3-12 years participated in the study. Overall, 162 children (49.5%) were infected with H. pylori, and the prevalence increased with age: 18.2% under 4 years, 41% at 4-6 years, 48.6% at 6-8 years, 50% at 8-10 years, and 63% at 11-12 years of age. No association was determined between H. pylori infection and height and weight percentiles, history of abdominal pain or family history of dyspepsia in the study group. Investigation of the prevalence of H. pylori infection in our study group in relation to socioeconomic data in a logistic regression model revealed that low income, high household density of children, use of stove for heating, and no breast feeding were important risk factors for H. pylori infection. This study was done in a group of healthy Turkish children to estimate the age-related prevalence of H. pylori infection and to determine the factors predisposing to H. pylori infection during childhood. It was found that 1/5 of healthy Turkish children were infected with H. pylori before four years of age, and that every one child out of two under 11 years of age was infected with H. pylori. Low socioeconomic status, poor household living conditions and no breast feeding were determined as independent risk factors of H. pylori infection.     

Helicobacter pylori infection among children with gastrointestinal symptoms: a high prevalence of infection among patients with reflux oesophagitis

AIM: To investigate the link between H.pylori infection and dyspepsia in children, and association with reflux oesophagitis. PATIENTS AND METHODS: H.pylori status was detected by rapid urease test and/or culture in 130 consecutive symptomatic children coming for upper gastrointestinal endoscopy: 40 - aged 8-12 years (55% boys); 90 - aged 13-18 years (21% boys). Endoscopic findings were analyzed. H.pylori prevalence in the age group 8-12 years was compared to the prevalence among 55 asymptomatic children, aged 7-12 years (13C-urea breath test). Statistical analysis: chi(2) test, Fisher's test, and logistic regression analysis. RESULTS: The prevalence of H.pylori infection among patients with gastrointestinal symptoms was 54%. It was significantly higher among patients with reflux oesophagitis compared to patients with hyperaemic gastropathy: OR = 5.5; p = 0.03, 95% CI: 1.15-26.3. In logistic regression analysis, no significant difference between the prevalence of H.pylori infection between asymptomatic and symptomatic children could be demonstrated (OR = 1.8; 95% CI: 0.62-5.14). CONCLUSIONS: The prevalence of H.pylori was significantly higher among patients with reflux oesophagitis compared to patients with hyperaemic gastropathy alone. Adjusting for age the prevalence of H.pylori infection was not higher among symptomatic children compared to asymptomatic children of the same age.     

Helicobacter pylori infection in children of Texas

BACKGROUND: Acquisition of the Helicobacter pylori infection usually occurs in childhood. The prevalence of infection differs among ethnic groups and in adults is inversely related to the socioeconomic status of the individual's family during childhood. This study investigates the seroprevalence of H. pylori infection in children of different ethnic groups in relation to socioeconomic class and investigates the prevalence of acute H. pylori infection among children who have had recent onset of abdominal pain. METHODS: Serum samples were collected from 797 children, aged 6 months to 18 years, of various socioeconomic and ethnic backgrounds, at a large urban children's hospital. H. pylori status was determined by an anti-H. pylori immunoglobulin (Ig)G enzyme-linked immunosorbent assay (ELISA) validated for pediatric use. To determine the prevalence of acute H. pylori infection, children brought to the emergency center with abdominal symptoms without diarrhea and overt signs of acute abdomen were evaluated with both serology and the 13C-urea breath test. Acute H. pylori was defined as a positive 13C-urea breath test result and negative IgG serology for H. pylori. RESULTS: The overall seroprevalence of H. pylori was 12.2% and increased with age (e.g., 8.3% at 6-11.9 months and 17.9% at 13 years). The prevalence was inversely related to socioeconomic status (6.6%, moderate to high vs. 15%, low socioeconomic status). The difference in seroprevalence among blacks (16.8%), Hispanics (13.3%), and whites (8.3%; P < 0.01) could be accounted for by differences in socioeconomic status. Eighteen percent of children who were evaluated at the emergency center for recent-onset abdominal pain had acute H. pylori infections. CONCLUSIONS: Socioeconomic status, not ethnic group, is the more important risk factor for acquisition of H. pylori infection during childhood. Acute H. pylori infection was a relatively common cause of recent-onset, nonsurgical abdominal pain.     

Seroprevalence of Helicobacter pylori in a pediatric population.

Helicobacter pylori (H. pylori) is one of the common bacterial infections in humans. In this study, seroprevalence of H. pylori infection in a pediatric population in Izmir and its relationship with different variables were investigated. Two hundred twenty-six children (115 boys, 111 girls, age range: 1-18) were tested for anti-H. pylori IgG. Socioeconomic conditions, living area (urban or rural), and number of people living in the same house were noted for each subject. H. pylori antibodies were determined by an enzyme immunoassay. Overall, 120 (53%) subjects were seropositive for H. pylori. The seroprevalence of H. pylori increased significantly with age and poor socioeconomic conditions. Seroprevalence did not differ according to sex, number of people living in the same house or living area.     

Evaluation of stool antigen test for Helicobacter pylori infection in asymptomatic children from a developing country using 13C-urea breath test as a standard

OBJECTIVE: Prevalence of asymptomatic Helicobacter pylori infection is very high in infants and children in developing countries. C urea breath test (UBT) is a reliable non-invasive diagnostic test for H. pylori infection in children that avoids invasive endoscopy. We compared a newly introduced H. pylori stool antigen test (with a high sensitivity and specificity in symptomatic children) with UBT in asymptomatic children mostly 1-5 years old, from a population with a high prevalence of infection. METHOD: Eighty six asymptomatic children (42 boys and 44 girls) were tested for H. pylori infection using the UBT and a stool antigen test (HpSA) based on a sandwich enzyme immunoassay for antigen detection. RESULTS: Forty five of the eighty-six (52.3%) children tested positive for H. pylori using the breath test. In 34 of these forty-five children, H. pylori antigen was detected in stool (sensitivity = 75.6%, 95% CI = 63 to 88%). Of the 50 of 86 (58%) children positive by HpSA test, 34 were positive for breath test. Of the 41 children with negative UBT test 25 were negative for stool antigen test (specificity = 61%, 95% CI = 46 to 76%). CONCLUSION: The sensitivity and specificity of the new stool antigen test are lower in asymptomatic children with high H. pylori prevalence rate compared to those reported for children with gastrointestinal symptoms. Its usefulness is limited for diagnosis in an asymptomatic child with H. pylori infection.