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Trend of Helicobacter pylori Infection in Childhood: A Single-Center Experience
Abdulkerim Elmas1, Mustafa Akçam1
1Department of Pediatrics, Süleyman Demirel University, School of Medicine, Isparta, Turkey.
Insights
Helicobacter pylori (HP) infection prevalence in children and adolescents significantly decreased between 2007 and 2022. Positivity rates were higher in older children and linked to duodenal ulcers.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Epidemiology
Background:
- Helicobacter pylori (HP) is a common bacterial infection, with prevalence increasing with age.
- HP infection rates in Turkish children range from 30% to 56.6%, varying regionally.
Purpose of the Study:
- To determine the frequency of HP infection in pediatric patients undergoing upper gastrointestinal endoscopy.
- To analyze trends in HP infection rates over time in a specific region.
- To compare HP prevalence across different age groups and its association with duodenal ulcers.
Main Methods:
- Retrospective analysis of clinical and endoscopic data from 1737 pediatric cases (2007-2022).
- Diagnosis confirmed via histopathologic examination of gastric biopsy specimens for HP presence.
- Statistical analysis to assess trends and associations.
Main Results:
- Overall HP positivity was 29% (504/1737 cases).
- HP positivity increased with age: 14.5% (0-6 yrs), 26.9% (7-12 yrs), 33.6% (13-18 yrs).
- Significant association between HP positivity and duodenal ulcers (65.7% of duodenal ulcer patients were HP positive).
- HP positivity rates decreased significantly over the study period: 44% (2007-2012), 28.6% (2013-2017), 24.2% (2018-2022).
Conclusions:
- The frequency of Helicobacter pylori infection in children and adolescents has decreased in the studied region over 15 years.
- Higher HP prevalence in older children suggests age-related risk factors.
- Decreasing trends may correlate with increased awareness and socioeconomic development.
Abstract:
Helicobacter pylori (HP) is the most common bacterial infection in humans. Helicobacter pylori infection, which frequently increases with age, is seen in 30%-56.6% of children in Turkey, although it varies by region. In this study, we aimed to determine the frequency of HP in children and adolescents who underwent upper gastrointestinal endoscopy and gastric biopsy in our region and to compare the changes over the years. Cases who underwent upper gastrointestinal endoscopy for various indications between 2007 and 2022 in our pediatric gastroenterology unit were included in the study. The clinical and endoscopic characteristics of 1737 cases whose histopathologic specimens were obtained, have been retrospectively analyzed from their records. The diagnosis of HP infection was based on the presence of HP on histopathologic examination of gastric biopsy specimens. Of 1737 cases, 504 (29%) were HP positive. The HP positive case rates were 14.5%, 26.9%, and 33.6% in the 0-6, 7-12, and 13-18 age groups, respectively. H. pylori positivity was detected in 65.7% of patients with duodenal ulcers, and the relationship between duodenal ulcers and HP positivity was significant (P < .001). The average HP positivity rates were 44%, 28.6%, and 24.2% in 2007-2012 (group 1), 2013-2017 (group 2), and 2018-2022 (group 3). H. pylori positivity rates significantly decreased in years (P = .001/P = .056/P < .001). We found that the frequency of HP infection in children decreased in our region over the years. Helicobacter pylori positivity was higher in older than younger children. A decrease in HP frequency prevalence may be possible in parallel with awareness and socioeconomic development.
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