Study On Risk Factors Of Helicobacter Pylori Infection And The Effect Of Helicobacter Pylori Infection On Iron Status And Growth Among Preschool Children

Helicobacter pylori is one of the most prevalent human infections in the world and in most children infection with this organism is asymptomatic. So examining the risk factors of H.pylori infection among asymptomatic children would contribute to determine the truth. But there is no large seroepidemiologic data on risk factors of H.pylori infection in children in China.Objective To identify risk factors of Helicobacter pylori infection in asymptomatic preschool children, and then provide effective measures for intervention against Hpylori infection in children.Methods By cluster sampling, we recruited 501 healthy asymptomatic children aged 2 to 7 years who lived in Pucheng, a city located in northern Fujian Province through child health care and physical examination. The subjects were from the sameregion and had no much difference in socioeconomic level. A structured questionnaire was sent to the parents of these healthy children to obtain related information about the living conditions and the environment. The questionnaire consisted of personal and parents hygiene practices, living habits, parental history of gastritis or peptic ulcer, socioeconomic, and other demographic data. Of the 501 questionnaires sent out, 487(97.2%) were returned. There had 7 children who refused drawing blood. Therefore, a case-control study was carried out among 480 preschool children (269 boys and 211 girls) aged 2.33 to 7.83 years in fact. After collecting blooding samples from participants, serum IgG antibodies to H. pylori were measured. H. pylori infection was defined as a positive ELISA result. The effects of risk factors were analysed using univariate factor analysis and unconditional logistic regression analysis. All the data were managed by EPI Info S.Ola and analyzed by SAS(Version6.12).Results Among 480 preschool children, 172(35.8%) were diagnosed as H.pylori-positive. Univariate factor analysis showed H.pylori infection was significantly associated with the following factors, mother's eating on time(P=0.013); father's partiality for food(P=0.004); mother's history of gastritis or peptic ulcer(P=0.030); the history of gastroduodenal trouble of the adults who looked after the child(P=0.002); eating with the adults who had a history of gastritis or peptic ulcer(P=0.033); the bad habits of gnawing fingers or toys(P=0.007); tooth cup-sharing with other family members in the home(P=0.003); breast feeding in infancy less than 6 months(P=0.033); nibbing between meals(P=0.044); crowding(P=0.009). Logistic regression analysis demonstrated significant independent relationships between seropositivity and the following factors: the bad habits of gnawing fingers or toys(odds ratio[OR]=2.42, P=0.010); stomach trouble of the adults who looked after the child(OR=2.43, P=0.017); toothcup-sharing with other family members in the home(OR=1.99, P=0.007); crowding(OR=1.79, P=0.028);father's partiality for food(OR=1.66, P=0.034). And breast feeding in infancy by mothers who had no history of gastritis or peptic ulcer is a protective factor of H.pylori infect-ion(OR=0.58, P=0.035). Infection with H.pylori was not positively associated with4other factors such as education level of parents,expenses in child every month, numbers of persons in family,contact with pets. Also,breast feeding in infant and mother's history of gastritis or peptic ulcer had a interaction, so did the family history of stomach trouble and toothcup-sharing with other family members.Conclusion The findings support the current view that H.pylori infection clusters within families and H.pylori infection is often acquired in childhood by oral-oral and fecal-oral person to person spread. Parents and personal hygiene practices are also involved in the transmission of H.pylori to children.