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Helicobacter pylori and the birth cohort effect: evidence of a continuous decrease of infection rates in childhood
R Roosendaal1, E J Kuipers, J Buitenwerf
1Department of Clinical Microbiology and Infection Control, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Insights
Helicobacter pylori (H. pylori) infection rates in Dutch children and adolescents have significantly declined over recent decades. This trend indicates a continued birth cohort effect, projecting a very low prevalence of H. pylori in the future.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- The prevalence of Helicobacter pylori (H. pylori) infection has shown a declining trend in successive birth cohorts.
- Understanding the continuation of this trend is crucial for public health strategies.
Purpose of the Study:
- To investigate the ongoing decline in Helicobacter pylori infection rates in recent birth cohorts.
- To model future H. pylori prevalence in the Dutch population based on observed trends.
Main Methods:
- ELISA determination of IgG H. pylori antibodies in serum samples from Dutch children and adolescents.
- Analysis of samples collected in 1978 and 1993, covering age groups 6-8 and 12-15 years.
Main Results:
- H. pylori prevalence decreased from 19% to 9% in 6-8 year olds and 23% to 11% in 12-15 year olds between 1978 and 1993.
- Overall prevalence in the study population dropped from 21% to 10% (p=0.01).
- Modeling predicted a decline from over 50% post-WWII to under 20% by 2040.
Conclusions:
- Childhood H. pylori infection rates continue to decline, supporting a persistent birth cohort effect.
- A very low prevalence of H. pylori infection is anticipated in the Dutch population in the coming decades.
- The observed decline in younger age groups suggests even lower future prevalence rates.
Objective:
To investigate whether the decrease in rate of Helicobacter pylori infection in subsequent birth cohorts has continued during the last decades.
Methods:
Determination by ELISA of IgG H. pylori antibodies in 314 serum samples from Dutch children (age 6-8 yr, n = 154) and young adolescents (age 12-15 yr, n = 160), collected in 1978 and 1993.
Results:
The prevalence of H. pylori declined from 19% to 9% at age 6-8 yr and from 23% to 11% at age 12-15 yr. For the whole study population, a decline from 21% to 10% (p = 0.01) was observed between 1978 and 1993. On the basis of these data and an incidence of infection with H. pylori of 0.3% per year during the same period, a model for both past and future prevalence rates of H. pylori in the Dutch population was calculated. The outcome demonstrates a decrease from more than 50% around World War II to less than 20% for the whole population around year 2040.
Conclusions:
H. pylori infection rates in childhood have continued to decline until recent decades, demonstrating a persistent birth cohort effect. This decline will result in a very low prevalence of H. pylori infection in the Dutch population during the next decades, becoming even lower as the observed decline in children and young adolescents continues.