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Prevalence and determinants of Helicobacter pylori infection in preschool children: a population-based study from
D Rothenbacher1, G Bode, G Berg
1Department of Epidemiology, University of Ulm, Germany.
Insights
Helicobacter pylori infection prevalence in children varied significantly by nationality, with Turkish children showing higher rates. Early childhood living conditions are linked to infection risk, impacting long-term health outcomes.
Area of Science:
- Pediatric infectious diseases
- Epidemiology
- Public health
Background:
- Helicobacter pylori is a common human pathogen causing gastroduodenal diseases.
- Limited data exists on H. pylori prevalence and determinants in children.
- This study investigated H. pylori infection in preschool children in Southern Germany.
Purpose of the Study:
- To determine the prevalence of H. pylori infection in preschool children.
- To identify factors associated with H. pylori infection in this age group.
- To understand the impact of nationality and early life conditions on infection rates.
Main Methods:
- A population-based cross-sectional study was conducted in Ulm, Germany in 1996.
- Preschool children (aged 5-8) were screened for H. pylori using the 13C-urea breath test.
- Parental questionnaires collected data on nationality, residence history, and living conditions.
Main Results:
- A total of 945 children participated (79% response rate).
- The overall H. pylori prevalence was 13.4% (127 children).
- Infection rates varied dramatically by nationality, from 4.8% in German children to 66.7% in Turkish children, with early life residence being a key factor.
Conclusions:
- Nationality is a significant determinant of H. pylori prevalence in children, even within the same geographic area.
- Early childhood living conditions are strongly associated with H. pylori infection.
- H. pylori-related morbidity may differ substantially among population subgroups based on these factors.
Background:
Helicobacter pylori is among the most common infections in humans and has been recognized as major cause of various gastroduodenal diseases. There is limited knowledge, however, on the prevalence and determinants of this infection in children. We addressed these issues in a population-based cross-sectional study in Southern Germany.
Methods:
Study subjects were all preschool children in Ulm, a city in the South of Germany, who were screened for school fitness by physicians of the public health service in 1996. Infection status was determined by 13C-urea breath test. In addition, the parents of the children were asked to fill out a standardized questionnaire.
Results:
In total, 945 out of the 1201 eligible preschool children participated in the study (response rate = 79%). The children were aged 5-8 years. The majority were of German nationality (72.6%). Overall, 127 children (13.4%) were infected with H. pylori. Nationality, place of residence in the first year of life and duration of living in Germany were strongly associated with H. pylori infection status. The prevalence varied from 4.8% (95% confidence interval [CI]: 3.3-6.8%) in children with German nationality who were born in Germany or had lived in Germany since their first year of life to 66.7% (95% CI: 29.9-92.5%) in the children with Turkish nationality who came to Germany after the first year of life.
Conclusion:
Our results showed a large variation in prevalence of H. pylori infection in children living in the same geographical area according to nationality. They indicate an association between living conditions in early childhood and H. pylori infection and indicate that H. pylori associated morbidity may evolve very differently in population subgroups living in the same area.