HELICOBACTER PYLORI INFECTION IN PRESCHOOL CHILDREN IN CALI, COLOMBIA

Bravo LE1, Reina JC2, Correa P4, Alzate A3, Pradilla A3, Mera R4, Fontham E4

Dept. Pathology1, Pediatrics2, Public Health3, Universidad del Valle, Cali, Colombia, and Dept. Pathology4, Louisiana State University, New Orleans, USA

 

Introduction: Helicobacter pylori (Hp) is the most common chronic bacterial infection in humnas and is a well-stablished etiologic component of chronic gastritis, peptic ulcer, and gastric cancer. While these serious chronic diseases linked to Hp are predominantly of adult onset, this organism often infects young children in the first 10 years of life. In many populations, high prevalence has been found among preschool children, particularly those of low socioeconomic status living in crowded households. We are reporting the prevalence and transmission risk factors of Hp infection in a group of preschool children who attend 3 day-care centers of low socioeconomic status in Cali, Colombia.

Methods: Using the 13C-Urea Breath Test (13C-UBT) as a non-invasive means of detecting active Hp infection, we have studied a cohort of 608 preschool children under 5 years of age, at 4-month intervals since September 1997. Sociodemogrphic and anthropometric data, and stool Hp antigen have been collected in each child at the day-care centers. A special device was designed to emprove the efficiency of the sample collection in younger children, with very high yields.

Results: Hp infection increases with age, with a prevalence of 33.6% at age 2 years and 46% at age 5. Z-score values (mean¡ÀSD) for nutritional status parameters (height/age:-0.02¡À1.01 and weight/height:-0.08¡À0.93) were almost identical to the reference population. Several transmission risk factors were studied. There was a positive statistically significant correlation (p<0.05) between Hp infection and lactancy, regular attendance to the day-care center, frequent use of the swimming pool at home, who takes care of the child while at home and his age, regular hand washing of the person that takes the child to the toilet, frequent intake of boiled milk, washing fruits and vegetables, and intake of unboiled milk. There was no correlation with the number of persons per room at home, the number of persons sleeping with the child in the same bed or the presence of pets.

Conclusions: Our data confirm the observations of other investigators of increasing prevalence of Hp infection with age, and person-to-person and waterborne transmission.

 

 
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