Risk factors and serological diagnosis of Helicobacter pylori infection in children with abdominal pain and vomiting

Ranjit K. Chourashia; Farhana Bayes; Fahmida B. Kakan; Rezina Parveen; Mohammad S. Ahtesam; Sanjida Ahmed; Sarbari Saha

doi:10.18203/2349-3291.ijcp20253774

Authors

Ranjit K. Chourashia Department of Pediatric Gastroenterology, National Medical College and Teaching Hospital, Birgunj, Parsa, Nepal
Farhana Bayes Department of Pediatric Gastroenterology and Nutrition, Bangladesh Medical University, Dhaka, Bangladesh
Fahmida B. Kakan Department of Obstetrics and Gynaecology, Kuwait Bangladesh Friendships Hospital, Uttara, Dhaka, Bangladesh
Rezina Parveen National Gastro Liver Institute and Hospital, Mohakhali, Dhaka, Bangladesh
Mohammad S. Ahtesam Department of Neurology, National Institute of Neurosciences, Agargaon, Dhaka, Bangladesh
Sanjida Ahmed Department of Pediatric Neurology, Bangladesh Medical University, Dhaka, Bangladesh
Sarbari Saha Department of Neonatology, Bangladesh Medical University, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20253774

Keywords:

Helicobacter pylori, Abdominal pain, Socioeconomic status, Crowded living conditions, Unsafe drinking water

Abstract

Background: Helicobacter pylori is a Gram-negative bacterium that ranks among the most prevalent chronic infections around the globe. It's closely associated with conditions like gastritis, peptic ulcers, gastric cancer, and mucosa-assisted lymphoid tissue (MALT) lymphoma. Most people get infected during childhood, especially in developing nations, where factors like overcrowding, inadequate sanitation, and unsafe drinking water play a significant role. In Bangladesh, for instance, more than 60% of children are infected by the time they turn two. Getting an accurate diagnosis is essential to minimize complications and enhance the management of gastrointestinal disorders in kids. Objectives of the study were to assess prevalence, risk factors, and diagnostic accuracy of serological testing for Helicobacter pylori infection in symptomatic Bangladeshi children.

Methods: This case control study was conducted at the Pediatric Gastroenterology and Nutrition Department, BSMMU, Dhaka from April 2021 to October 2022. A total of 98 children aged 1–18 years with abdominal pain and/or vomiting were enrolled by purposive sampling. Cases were defined by positive anti-H. pylori IgG serology, and controls were seronegative. Data collection included demographic, socioeconomic, clinical, and laboratory variables. Statistical analysis employed statistical package for the social sciences (SPSS) v20, with logistic regression for adjusted associations.

Results: Among 96 children, 48 were H. pylori IgG positive. Significant risk factors included low socioeconomic status (50% versus 4.2%, p<0.001), low parental education (27.1% versus 0%, p<0.001), and living in a joint family (52.1% versus 14.6%, p<0.001). Key symptoms in positive patients were dyspepsia (78%), loss of appetite (64%), and pallor (66%, p<0.001). Stool antigen was positive in 82% of seropositive cases, and chronic gastritis was the predominant histological finding (92%).

Conclusions: H. pylori infection is common in children with abdominal pain strongly linked to poor socioeconomic, environmental, and vomiting children.

Metrics

Metrics Loading ...

Author Biography

Ranjit K. Chourashia, Department of Pediatric Gastroenterology, National Medical College and Teaching Hospital, Birgunj, Parsa, Nepal

Assistant Professor, Department of Pediatrics, City Medical College, Gazipur, Bangladesh

References

Malaty HM. Epidemiology of Helicobacter pylori infection. Best Pract Res Clin Gastroenterol. 2007;21(2):205-14. DOI: https://doi.org/10.1016/j.bpg.2006.10.005

Marshall B, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. The Lancet. 1984;323(8390):1311-5. DOI: https://doi.org/10.1016/S0140-6736(84)91816-6

Warren JR, Marshall B. Helicobacter pylori as the etiologic agent of peptic ulcer disease. Clin Med. 1983;7:437-9.

Brown LM. Helicobacter pylori: Epidemiology and routes of transmission. Epidemiol Rev. 2000;22(2):283-97. DOI: https://doi.org/10.1093/oxfordjournals.epirev.a018040

Eusebi LH, Zagari RM, Bazzoli F. Epidemiology ofHelicobacter pyloriInfection. Helicobacter. 2014;19(s1):1-5. DOI: https://doi.org/10.1111/hel.12165

Smith GV, Moran AP, Bajaj‐Elliott M, Farthing MJG. Induction of Cyclooxygenase 2 by Escherichia coli but not Helicobacter pylori lipopolysaccharide in gastric epithelial cells in vitro. Helicobacter. 2003;8(5):513-20. DOI: https://doi.org/10.1046/j.1523-5378.2003.00170.x

Kusters JG, Van Vliet AHM, Kuipers EJ. Pathogenesis of Helicobacter Pylori Infection. Clin Microbiol Rev. 2006;19(3):449-90. DOI: https://doi.org/10.1128/CMR.00054-05

Rowland M, Daly L, Vaughan M, Higgins A, Bourke B, Drumm B. Age-specific acquisition of Helicobacter pylori in childhood. Helicobacter. 2006;11(4):328-32.

Sarker SA, Rahman MM, Mahalanabis D, Bardhan PK, Hildebrand P, Beglinger C, et al. Prevalence of Helicobacter pylori infection in infants and young children in Bangladesh. J Clin Microbiol. 1995;33(2):559-61.

Nahar S. Epidemiology of H. pylori infection in Bangladeshi children: association with socioeconomic and environmental factors. Epidemiol Infect. 2009;137(8):1237-49.

Megraud F. Helicobacter pylori infection: persistence and reinfection. Gut. 2007;56(12):1652-3. DOI: https://doi.org/10.1136/gut.2007.132514

Blaser MJ, Atherton JC. Helicobacter pylori persistence: biology and disease. J Clin Investig. 2004;113(3):321-33. DOI: https://doi.org/10.1172/JCI20925

McColl KEL. Helicobacter PyloriInfection. N Engl J Med. 2010;362(17):1597-604. DOI: https://doi.org/10.1056/NEJMcp1001110

Nakashima S, Arai S, Mizuno Y, Yoshino K, Ando S, Nakamura Y, et al. A clinical study of Japanese patients with ulcer induced by low‐dose aspirin and other non‐steroidal anti‐inflammatory drugs. Aliment Pharmacol Therap. 2005;21(s2):60-6. DOI: https://doi.org/10.1111/j.1365-2036.2005.02476.x

Zhao Y. Association of H. pylori infection with anemia in children: a meta-analysis. World J Pediatr. 2012;8(2):119-24.

IARC Working Group. Schistosomes, liver flukes and Helicobacter pylori. IARC Monogr Eval Carcinog Risks Hum. 1994;61:1-241.

Kivi M, Tindberg Y. H. pylori occurrence and transmission: a family affair? Scand J Infect Dis. 2006;38(6-7):407-17. DOI: https://doi.org/10.1080/00365540600585131

Hopkins RJ, Vial PA, Ferreccio C, Ovalle J, Prado P, Sotomayor V, et al. Seroprevalence of Helicobacter pylori in Chile: risk factors for infection. Epidemiol Infect. 1993;111(2):309-17.

Weyermann M, Rothenbacher D, Brenner H. Acquisition of Helicobacter pylori infection in early childhood: independent contributions of infected mothers, fathers and siblings. Am J Gastroenterol. 2008;104(1):182-9. DOI: https://doi.org/10.1038/ajg.2008.61

Goodman KJ, Cockburn M. The role of socioeconomic status in Helicobacter pylori infection. Am J Public Health. 2001;91(7):1119-23.

Nabwera HM, Logan RP. Epidemiology of Helicobacter pylori: transmission, host factors, and public health implications. Helicobacter. 2000;5(1):S12-7.

Klein PD, Graham DY, Gaillour A, Opekun AR, Smith EO. Water sources as a risk factor for H. pylori transmission. Lancet. 1991;337(8756):1503-6. doi:10.1016/0140-6736(91)93169-i. DOI: https://doi.org/10.1016/0140-6736(91)93196-G

Abadi ATB, Mobarez AM, Taghvaei T, Wolfram L. Invasive tests for diagnosis of Helicobacter pylori infection. World J Gastroenterol. 2018;24(31):3366-81.

Gisbert JP, Pajares JM. Stool antigen test for the diagnosis of Helicobacter pylori infection: a systematic review. Helicobacter. 2004;9(4):347-68. DOI: https://doi.org/10.1111/j.1083-4389.2004.00235.x

Leal YA, Flores LL, García-Cortés LB, Cedillo-Rivera R, Torres J. Antibody-Based Detection Tests for the Diagnosis of Helicobacter pylori Infection in Children: A Meta-Analysis. PLoS One. 2008;3(11):e3751. DOI: https://doi.org/10.1371/journal.pone.0003751

Yoshihisa Y. Diagnostic accuracy of ELISA for H. pylori antibodies. Helicobacter. 2004;9(4):342-6.

Korotkaya Y, Shores D. Helicobacter pyloriin Pediatric Patients. Pediatr Rev. 2020;41(11):585-92. DOI: https://doi.org/10.1542/pir.2019-0048

Brown LM, Thomas TL, Ma JL, Chang YS, You WC, Liu WD, et al. Helicobacter pylori infection in rural China: demographic, lifestyle and environmental factors. Int J Epidemiol. 2002;31(3):638-45. DOI: https://doi.org/10.1093/ije/31.3.638

Oyen N, Skjaerven R, Irgens LM. Population-based Recurrence Risk of Sudden Infant Death Syndrome Compared with Other Infant and Fetal Deaths. Am J Epidemiol. 1996;144(3):300-5. DOI: https://doi.org/10.1093/oxfordjournals.aje.a008925

Gold BD, Colletti RB, Abbott M, Czinn SJ, Elitsur Y, Hassall E, et al. Helicobacter pylori Infection in Children: Recommendations for Diagnosis and Treatment. J Pediatr Gastroenterol Nutr. 2000;31(5):490-7. DOI: https://doi.org/10.1002/j.1536-4801.2000.tb07169.x

Pacifico L. Consequences of Helicobacter pylori infection in children. World J Gastroenterol. 2010;16(41):5181. DOI: https://doi.org/10.3748/wjg.v16.i41.5181

Queiroz DMM, Harris PR, Sanderson IR, Windle HJ, Walker MM, Rocha AMC, et al. Iron Status and Helicobacter pylori Infection in Symptomatic Children: An International Multi-Centered Study. PLoS One. 2013;8(7):e68833. DOI: https://doi.org/10.1371/journal.pone.0068833

Wenzhen Y, Yumin L, Kehu Y, Bin M, Quanlin G, Donghai W, et al. Iron deficiency anemia in Helicobacter pylori infection: meta-analysis of randomized controlled trials. Scand J Gastroenterol. 2010;45(6):665-76. DOI: https://doi.org/10.3109/00365521003663670

Gosciniak G, Iwanczak B, Przondo-Mordarska A. Correlation between endoscopic and histological findings in different forms of Helicobacter pylori gastritis in children. Adv Clin Exp Med. 2004;13(2):241-8.

Dohil R, Hassall E, Jevon G, Dimmick J. Gastritis and gastropathy of childhood. J Pediatr Gastroenterol Nutr. 1999;29(4):378-94. DOI: https://doi.org/10.1002/j.1536-4801.1999.tb02439.x

Malaty HM, El-Kasabany A, Graham DY, Miller CC, Reddy SG, Srinivasan SR, et al. Age at acquisition of Helicobacter pylori infection: a follow-up study from infancy to adulthood. Lancet. 2002;359(9310):931-5. DOI: https://doi.org/10.1016/S0140-6736(02)08025-X