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Al Ramahi R, Tumeh D. The prevalence and severity of upper gastrointestinal complications among patients with chronic diseases: a cross-sectional study from Palestine. BMC Gastroenterol 2024; 24:175. [PMID: 38773426 PMCID: PMC11106898 DOI: 10.1186/s12876-024-03267-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/15/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Many old people have at least one chronic disease. As a result, multiple drugs should be used. Gastrointestinal complications may occur because of the harmful effects of these chronic drugs on the stomach. The study aimed to assess the prevalence of upper gastrointestinal complications in patients taking chronic medications, the severity of these symptoms, and whether they take any gastro-protective drugs or not. METHODOLOGY This was a cross-sectional study through face-to-face questionnaires from internal outpatient clinics at a specialized hospital. Patients with chronic diseases who were taking at least one chronic medication were included in the study. Data Collection Form was used to gather information. The Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) was used to evaluate the severity of the upper gastrointestinal symptoms. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21. RESULTS A total of 400 patients with chronic diseases and using multiple medications were included. Among them, 53.8% were females and 56% were married, 58.5% were unemployed, 70% were not smokers, the mean age was 54.7 ± 17.5 years. The most common comorbid diseases among the patients were diabetes, hypertension, and arthritis, with percentages of 44.3%, 38%, and 27.3%, respectively. The mean number of chronic medications used was 3.36 ± 1.6 with a range of 1 to 9. The most commonly used was aspirin with a percentage of 50%, followed by atorvastatin, bisoprolol, and insulin with percentages of 29.5%, 25%, and 20.3%, respectively. Among the 400 participants, 362 (90.5%) suffered from upper gastrointestinal side effects like indigestion (65.8%), heartburn (78.3%), nausea (48.8%), and regurgitation (52.0%). Based on SF-LDQ scoring, of the 400 respondents, 235(58.8%), 109(27.3%) and 18(4.5%) suffered from mild, moderate and severe dyspepsia, respectively. A high percentage 325 (81.3%) of participants were prescribed gastro-protective medications. Proton pump inhibitors were the most prescribed group in 209 (52.3%) patients. Dyspepsia was significantly associated with older age (p-value = 0.001), being educated (p-value = 0.031), not being single (p-value < 0.001), having health insurance (p-value = 0.021), being a smoker (p-value = 0.003), and using ≥ 5 medications (p-value < 0.001). CONCLUSION Upper gastrointestinal complications among patients with chronic diseases were very common. Fortunately, the symptoms were mild in most cases. The risk increased with age and using a higher number of medications. It is important to review patients' medications and avoid overuse of them, in addition to use gastro-protective agents when needed.
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Affiliation(s)
- Rowa Al Ramahi
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O.Box 7, Nablus, Palestine.
| | - Deema Tumeh
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O.Box 7, Nablus, Palestine
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Socioeconomic disparities and household crowding in association with the fecal microbiome of school-age children. NPJ Biofilms Microbiomes 2022; 8:10. [PMID: 35241676 PMCID: PMC8894399 DOI: 10.1038/s41522-022-00271-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 01/28/2022] [Indexed: 11/08/2022] Open
Abstract
The development of the gut microbiome occurs mainly during the first years of life; however, little is known on the role of environmental and socioeconomic exposures, particularly within the household, in shaping the microbial ecology through childhood. We characterized differences in the gut microbiome of school-age healthy children, in association with socioeconomic disparities and household crowding. Stool samples were analyzed from 176 Israeli Arab children aged six to nine years from three villages of different socioeconomic status (SES). Sociodemographic data were collected through interviews with the mothers. We used 16 S rRNA gene sequencing to characterize the gut microbiome, including an inferred analysis of metabolic pathways. Differential analysis was performed using the analysis of the composition of microbiomes (ANCOM), with adjustment for covariates. An analysis of inferred metagenome functions was performed implementing PICRUSt2. Gut microbiome composition differed across the villages, with the largest difference attributed to socioeconomic disparities, with household crowding index being a significant explanatory variable. Living in a low SES village and high household crowding were associated with increased bacterial richness and compositional differences, including an over-representation of Prevotella copri and depleted Bifidobacterium. Secondary bile acid synthesis, d-glutamine and d-glutamate metabolism and Biotin metabolism were decreased in the lower SES village. In summary, residential SES is a strong determinant of the gut microbiome in healthy school-age children, mediated by household crowding and characterized by increased bacterial richness and substantial taxonomic and metabolic differences. Further research is necessary to explore possible implications of SES-related microbiome differences on children's health and development.
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Lapidot Y, Reshef L, Cohen D, Muhsen K. Helicobacter pylori and the intestinal microbiome among healthy school-age children. Helicobacter 2021; 26:e12854. [PMID: 34617641 DOI: 10.1111/hel.12854] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infection is acquired during childhood and causes chronic gastritis that remains asymptomatic in most infected people. H. pylori alters the gastric microbiota and causes peptic ulcer disease. Evidence on the relationship between asymptomatic H. pylori infection and children's gut microbiota remains elusive. AIM We characterized the relationship between H. pylori infection and the intestinal microbiome of healthy children, adjusting for known inter-personal and environmental exposures. MATERIALS AND METHODS This cross-sectional study included stool samples obtained from 163 Israeli Arab children aged 6-9 years from different socioeconomic strata. Sociodemographic information was collected through maternal interviews. H. pylori infection was determined using monoclonal antigen detection stool enzyme immunoassay. The gut microbiome was characterized by implementing 16S rRNA gene sequencing of the V4 region and a multivariate downstream analysis. RESULTS Overall, 57% of the participants were positive for H. pylori infection and it was significantly associated with low socioeconomic status. There was no significant association between H. pylori infection and bacterial richness of fecal microbiome. H. pylori infection was significantly associated with intestinal bacterial composition, including a strong association with Prevotella copri and Eubacterium biforme. Moreover, socioeconomic status was strongly associated with bacterial composition. DISCUSSION AND CONCLUSIONS H. pylori infection in healthy children was significantly associated with altered intestinal microbiome structure. Socioeconomic determinants exhibit a strong effect, related to both H. pylori infection and intestinal diversity and composition in childhood. These findings are clinically important to the understanding of the role of H. pylori infection and other intestinal microbes in health and disease.
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Affiliation(s)
- Yelena Lapidot
- The Sackler Faculty of Medicine, Department of Epidemiology and Preventive Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Leah Reshef
- Faculty of Life Sciences, The Shmunis School of Biomedicine and Cancer Research, Tel Aviv University, Tel Aviv, Israel
| | - Dani Cohen
- The Sackler Faculty of Medicine, Department of Epidemiology and Preventive Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Khitam Muhsen
- The Sackler Faculty of Medicine, Department of Epidemiology and Preventive Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
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Naushad VA, Purayil NK, Badi A, Chandra P, Abuzaid HO, Abuhmaira MM, Lutf A, Paramba F, Varikkodan I, Elzouki ANY. Potential Predictors and Prevalence of Helicobacter pylori Infection Among Adult Patients With Dyspepsia: A Retrospective Study From Qatar. Cureus 2021; 13:e16216. [PMID: 34367816 PMCID: PMC8341225 DOI: 10.7759/cureus.16216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 12/04/2022] Open
Abstract
Aim To study the prevalence of Helicobacter pylori (H. pylori) infection among dyspeptic patients of various ethnic origins in Qatar and determine the association between H. pylori infection and various demographic factors and endoscopic findings. Methods A retrospective data review was carried at Alkhor Hospital, Hamad Medical Corporation, Qatar. Adult patients who underwent endoscopy for the evaluation of dyspepsia between January 2011 to December 2017 were included. Patients who underwent endoscopy for reasons other than dyspepsia and those with incomplete data were excluded. Results Of the 638 subjects included, 58.9% were males, and the mean age of the subjects was 42.2 years (range 18-79 years). Epigastric pain (80.6%) was the most common symptom, followed by heartburn (26.2%). Forty point nine percent (40.9%) had a positive Campylobacter-like organism (CLO) test for H. pylori. A higher prevalence of H. pylori infection was observed among subjects between 31-50 years of age (43.6%) and 18-30 years (40.5%), and in Asian (42.2%) and Middle East and North African nationals (MENA) nationals (40%). Among the endoscopic findings, esophagitis (P=0.002) and gastritis (P=0.001) showed a statistically significant correlation with H. pylori positivity. Univariate regression analysis revealed an increased risk for H. pylori infection among all age groups except above 65 years, with an odds ratio (OR) of more than 2 in all the three age groups. Among various ethnicities, patients from Asia and MENA countries showed an increased risk of getting H. pylori infection (OR 1.16, 95% CI; 0.77,1.75 and OR 1.06, 95% CI 0.70,-1.61 respectively). The multivariable logistic regression analysis showed that subjects with endoscopic findings of esophagitis (adjusted OR 1.67, 95%CI 1.19, 2.34; P=0.003), gastritis (adjusted OR 1.79, 95%CI 1.27, 2.57; P=0.001), and duodenal ulcer (adjusted OR 2.41, 95%CI 1.24, 4.70; P=0.010) remained significantly associated with an increased risk of having H. pylori infection. Conclusion The burden of H. pylori infection in patients with dyspepsia undergoing endoscopy is not low in Qatar. Less than 65 years of age, Asian nationals, and being from the MENA region were the demographic predictors for H. pylori infection. The finding of esophagitis, gastritis, and duodenal ulcer on endoscopy were independent endoscopic predictors for having H. pylori infection.
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Affiliation(s)
- Vamanjore A Naushad
- Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Clinical Department, College of Medicine, Qatar University, Doha, QAT.,Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT
| | - Nishan K Purayil
- Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT.,Clinical Department, College of Medicine, Qatar University, Doha, QAT
| | - Ahmad Badi
- Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Clinical Department, College of Medicine, Qatar University, Doha, QAT
| | - Prem Chandra
- Medical Research Center, Hamad Medical Corporation, Doha, QAT
| | - Hassan O Abuzaid
- Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT.,Clinical Department, College of Medicine, Qatar University, Doha, QAT
| | - Mohamed Milad Abuhmaira
- Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT.,Clinical Department, College of Medicine, Qatar University, Doha, QAT
| | - Abdo Lutf
- Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Clinical Department, College of Medicine, Qatar University, Doha, QAT
| | - Firjeeth Paramba
- Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT
| | | | - Abdel-Naser Y Elzouki
- Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Clinical Department, College of Medicine, Qatar University, Doha, QAT.,Clinical Medicine, Weill Cornell Medicine - Qatar, Doha, QAT
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Rakha M, Saleh O, Abdelgawad MS, El Baiomy A. Helicobacter pylori infection in patients with metabolic syndrome, with or without nonalcoholic fatty liver disease. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-020-00071-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Abstract
Background
Helicobacter pylori (HP) infection is considered a risk factor of GIT diseases, e.g., gastric and duodenal ulcers and gastric carcinomas. It is transmitted through feco/oral route and can be diagnosed by many methods, e.g., stool antigen test (SAT). Metabolic syndrome (MET S) is considered a circle of metabolic derangements that can cause some complications as ischemic changes and heart diseases. Metabolic syndrome may also cause nonalcoholic fatty liver disease (NAFLD) resulting in liver fibrosis, cirrhosis, and HCC.
Results
The study included 300 subjects recruited from Obesity Clinic and Diabetes & Endocrinology Unit, Specialized Medical Hospital, Mansoura University. Two hundred of metabolic syndrome patients were subdivided into two groups according to the presence or absence of NAFLD, in addition to 100 subjects not having metabolic syndrome and served as control group. We found that HP infection is more frequent in MET S with NAFLD patients (73%) than in MET S without NAFLD (47%) with (P value < 0.001) emphasizing that HP infection increases the risk of NAFLD development in patients with MET S.
The study proved that HP infection is associated with increased degree of fibrosis significantly (P value < 0.001) with progression to marked fibrosis which may complicate with NASH with over all predictive value of 75% especially in patients with hyperglycemia.
Conclusions
Our findings show that a circle of metabolic abnormalities seems to be attributed to HP infection in MET S patients increasing the risk of fatty liver and progression to marked fibrosis especially with coexistent hyperglycemia, dyslipidemia, and upper body obesity.
Diagnosis and early eradication of HP infection will help in decreasing metabolic disturbances and possibility of NAFLD, and protect against marked fibrosis progression.
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Belay AS, Abateneh DD, Yehualashet SS. <p>Seroprevalence of <em>Helicobacter pylori</em> Infection and Associated Factors Among Adult Dyspeptic Patients in Public Health Facilities, Mizan Aman Town, Southwest, Ethiopia: Institutional-Based Cross-Sectional Study</p>. Int J Gen Med 2020; 13:577-585. [PMID: 32982374 PMCID: PMC7490056 DOI: 10.2147/ijgm.s273523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 08/22/2020] [Indexed: 12/30/2022] Open
Abstract
Background Helicobacter pylori infection is a public health problem associated with chronic gastritis, peptic ulcer, and gastric cancer. It is endemic in developing countries like Ethiopia. This study was aimed to assess seroprevalence of H. pylori infection and associated factors among adults’ dyspeptic patients in public health facilities of Mizan Aman Town, Southwest Ethiopia. Methods Cross-sectional study was conducted in public health facilities of Mizan Aman Town, from April 1, 2018, to June 30, 2018. A total of 208 adult dyspeptic patients were included in the study. A structured questionnaire was used to collect data. Serum was tested for anti-H. pylori antibody using a commercial test strip. Data were entered using Epi info 6.04 and exported to SPSS 21 for analysis. Bivariate and multivariate logistic regression was employed and OR with 95% CI was retrieved. P-value of less than 0.05 was considered as statistically significant. Results A total of 208 participants were interviewed. The mean age of respondents was 31.70 (SD ±9.123) years. Seroprevalence of H. pylori infection was 89 (42.8%). Presence of domestic animals (AOR = 13.33, 95% CI = (2.203–80.692)), sources of drinking water (AOR = 0.011, 95% CI = (0.001–0.110)), toilet type (AOR = 11.236, 95% CI = (1.921–65.73)), shared beds with siblings (AOR = 7.775, 95% CI = (1.676–36.082)), family size (AOR = 0.015, 95% CI = (0.003, 0.089)), storing and reusing water (AOR =0.014, 95% CI = (0.002–0.103)) and occupational status (AOR = 23.33, 95% CI = (2.034–67.661)) were variables significantly associated with seroprevalence of H. pylori. Conclusion Seroprevalence of H. pylori infection is relatively high in Ethiopia. Family size, shared bed, presences of domestic animals, storage and reuse of water, toilet type, sources of drinking water, and occupation were significant factors associated with H. pylori infection. The possible identified modifiable risk factors should be addressed through effective health education.
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Affiliation(s)
- Alemayehu Sayih Belay
- Mizan Tepi University, College of Health Sciences, Department of Nursing, Mizan Aman, Ethiopia
- Correspondence: Alemayehu Sayih Belay Mizan Tepi University, College of Health Sciences, Department of Nursing, P.O. Box: 260, Mizan Teferi, EthiopiaTel +251-911669861 Email
| | - Dejene Derseh Abateneh
- Mizan Tepi University, College of Health Sciences, Department of Nursing, Mizan Aman, Ethiopia
- Kotebe Metropolitan University, Menelik II College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Addis Ababa, Ethiopia
| | - Sisay Shewasinad Yehualashet
- Mizan Tepi University, College of Health Sciences, Department of Nursing, Mizan Aman, Ethiopia
- Debre Berhan University, Institute of Health Sciences, Debre Berhan, Ethiopia
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Elias N, Nasrallah E, Khoury C, Mansour B, Abu Zuher L, Asato V, Muhsen K. Associations of Helicobacter pylori seropositivity and gastric inflammation with pediatric asthma. Pediatr Pulmonol 2020; 55:2236-2245. [PMID: 32543787 DOI: 10.1002/ppul.24905] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 06/13/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Controversy exists regarding an association between Helicobacter pylori infection and asthma in children. We examined the hypotheses of inverse associations of H. pylori seroprevalence and pepsinogen (PG) levels, as markers of gastric inflammation, with asthma in children. METHODS A hospital-based case-control study was conducted among children aged 4.8 to 17.3 years in Israel. Confirmed asthma cases (n = 75) were recruited through a pulmonary clinic, and controls (n = 160) without asthma were enrolled. Using enzyme-linked immunosorbent assays we measured the presence of H. pylori immunoglobulin G (IgG) antibodies, IgG antibodies to cytotoxin-associated gene A antigen (CagA) (virulent factor), serum PG levels and exposure to other enteric pathogens (Shigella flexneri). Multivariable logistic regression models were applied. RESULTS H. pylori IgG seropositivity was 25% and 40% among cases and controls, respectively (P = .03). H. pylori CagA IgG seropositivity was associated with reduced risk of asthma (adjusted odds ratio [OR], 0.33 [95% CI, 0.11-0.95] but not for the CagA negative serology (adjusted OR, 0.70 [95% CI, 0.32-1.54]). Children who were H. pylori seropositive with a PGI:PGII of ≤6.78 (severe gastric inflammation) had a lower likelihood of asthma (adjusted OR, 0.31 [95% CI, 0.10-0.89]) than did seronegative children. Exposure to Shigella flexneri did not differ between cases and controls, nor according to H. pylori seropositivity. Among the asthmatic children, pulmonary function did not differ according to H. pylori seropositivity. CONCLUSIONS H. pylori infection and its related gastric inflammation may have a protective role in the risk of pediatric asthma and further research into a potential causal pathway is required.
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Affiliation(s)
- Nael Elias
- Department of Pediatrics, Saint Vincent de Paul-French Hospital, Nazareth, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
| | - Elias Nasrallah
- Department of Pediatrics, Saint Vincent de Paul-French Hospital, Nazareth, Israel
| | - Camelia Khoury
- Department of Pediatrics, Saint Vincent de Paul-French Hospital, Nazareth, Israel
| | - Bshara Mansour
- Department of Pediatrics, Saint Vincent de Paul-French Hospital, Nazareth, Israel
| | - Layaly Abu Zuher
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
| | - Valeria Asato
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Tel Aviv, Israel
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de Sena-Reis JS, Bezerra DD, Figueiredo CA, Barreto ML, Alcântara-Neves NM, da Silva TM. Relationship between African Biogeographical Ancestry and Helicobacter pylori infection in children of a large Latin American urban center. Helicobacter 2019; 24:e12662. [PMID: 31571359 DOI: 10.1111/hel.12662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/05/2019] [Accepted: 08/25/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIM The relationship between race/ethnicity and H pylori infection has been extensively reported, with a higher prevalence of infection observed in black individuals. Whether such differences are due to genetic factors underlying African ancestry remains to be clarified. In the present study, we evaluated the association between the proportion of individual African ancestry and H pylori infection in a sample of 1046 children living in a large Latin American urban center. MATERIALS AND METHODS Estimation of individual biogeographical ancestry was based on 370,539 SNPs and performed using the ADMIXTURE software. Multivariate logistic regression models and mediation analysis considering the influence of previously recognized socioenvironmental risk factors to H pylori infection were performed. All analyses were conducted using the statistical package STATA v.14.0. RESULTS Each 10% increase in the proportion of individual African ancestry was positively and independently associated with H pylori infection in our population (adjusted OR = 1.22, 95% CI = 1.10-1.36, P < .001). Mediation analysis demonstrated that only 9.23% of the effect of the individual African ancestry on H pylori infection was explained by factors such as household income, the absence of street paving and crowding. CONCLUSIONS The results suggest that genetic variants that covariate with African ancestry may explain an important part of the racial differences observed for the prevalence of H pylori infection.
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Affiliation(s)
- Jucineide Silva de Sena-Reis
- Postgraduate Program in Genetics, Biodiversity and Conservation - PPGGBC, State University of Southwest of Bahia - UESB, Jequié, Bahia, Brazil
| | - Débora Diniz Bezerra
- Postgraduate Program in Genetics, Biodiversity and Conservation - PPGGBC, State University of Southwest of Bahia - UESB, Jequié, Bahia, Brazil
| | - Camila A Figueiredo
- Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Maurício Lima Barreto
- Center for Integration of Data and Knowledge for Health (CIDACS) / FIOCRUZ, Salvador, Bahia, Brazil
| | | | - Thiago Magalhães da Silva
- Laboratory of Biology and Human Genetics, Department of Biological Sciences - DCB, UESB, Jequié, Bahia, Brazil
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Correlates of infection with Helicobacter pylori positive and negative cytotoxin-associated gene A phenotypes among Arab and Jewish residents of Jerusalem. Epidemiol Infect 2019; 147:e276. [PMID: 31552815 PMCID: PMC6807302 DOI: 10.1017/s0950268819001456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
We examined the prevalence and correlates of Helicobacter pylori (H. pylori) infection according to cytotoxin-associated gene A (CagA) phenotype, a main virulence antigen, among the ethnically diverse population groups of Jerusalem. A cross-sectional study was undertaken in Arab (N = 959) and Jewish (N = 692) adults, randomly selected from Israel's national population registry in age-sex and population strata. Sera were tested for H. pylori immunoglobulin G (IgG) antibodies. Positive samples were tested for virulence IgG antibodies to recombinant CagA protein, by enzyme-linked immunosorbent assay. Multinomial regression models were fitted to examine associations of sociodemographic factors with H. pylori phenotypes. H. pylori IgG antibody sero-prevalence was 83.3% (95% confidence interval (CI) 80.0%–85.5%) and 61.4% (95% CI 57.7%–65.0%) among Arabs and Jews, respectively. Among H. pylori positives, the respective CagA IgG antibody sero-positivity was 42.3% (95% CI 38.9%–45.8%) and 32.5% (95% CI 28.2%–37.1%). Among Jews, being born in the Former Soviet Union, the Middle East and North Africa, vs. Israel and the Americas, was positively associated with CagA sero-positivity. In both populations, sibship size was positively associated with both CagA positive and negative phenotypes; and education was inversely associated. In conclusion, CagA positive and negative infection had similar correlates, suggesting shared sources of these two H. pylori phenotypes.
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10
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Muhsen K, Sinnreich R, Merom D, Nassar H, Cohen D, Kark JD. Helicobacter pylori infection, serum pepsinogens as markers of atrophic gastritis, and leukocyte telomere length: a population-based study. Hum Genomics 2019; 13:32. [PMID: 31331390 PMCID: PMC6647065 DOI: 10.1186/s40246-019-0217-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/03/2019] [Indexed: 01/16/2023] Open
Abstract
Background Persistent infections that induce prolonged inflammation might negatively affect the leukocyte telomere length (LTL); however, the role in LTL of Helicobacter pylori (H. pylori) infection, which persistently colonizes the stomach, remains unknown. The study objective was to examine associations of sero-prevalence of H. pylori immunoglobulin G (IgG) antibody and serum pepsinogens (PGs), as markers of atrophic gastritis, with LTL. A cross-sectional study was performed among 934 Arab residents of East Jerusalem, aged 27–78 years, randomly selected from Israel’s national population registry. Sera were tested for H. pylori IgG and PG levels by ELISA. LTL was measured by southern blots. Multiple linear regression models were fitted to adjust for sociodemographic and lifestyle factors. Results LTL decreased significantly with age (p < 0.001) and was shorter in men than women (p = 0.032). The mean LTL was longer in H. pylori sero-positive persons than negative ones: mean difference 0.13 kb (95% CI 0.02, 0.24), p = 0.016. Participants with atrophic gastritis (PGI < 30 μg/L or a PGI: PGII < 3.0) had shorter LTL than did those without: mean difference − 0.18 (95% CI − 0.32, − 0.04). The difference was of larger magnitude between persons who had past H. pylori infection (sero-negative to H. pylori IgG antibody) and atrophic gastritis, compared to those who were H. pylori sero-negative and did not have atrophic gastritis: mean difference − 0.32 kb (95% CI − 0.55, − 0.10). This association remained significant after adjustment for age, sex, and religiosity: beta coefficient − 0.21 kb (95% CI − 0.41, − 0.001), p = 0.049. The results were similar after further adjustment for lifestyle factors. In bivariate analysis, mean LTL was longer in physically active persons than non-active ones, and shorter in persons with than without obesity; however, these differences were diminished and were not significant in the multivariable model. Conclusions H. pylori IgG sero-positivity per se was not related to reduced LTL. However, persons with past H. pylori infection (i.e., lacking H. pylori IgG serum antibody) and with serological evidence of atrophic gastritis, had a significantly shorter LTL than did those without atrophic gastritis. Electronic supplementary material The online version of this article (10.1186/s40246-019-0217-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Ramat Aviv, 6139001, Tel Aviv, Israel.
| | - Ronit Sinnreich
- Hadassah School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel
| | - Dafna Merom
- Western Sydney University, Sydney, Australia
| | - Hisham Nassar
- St. Joseph Hospital, East Jerusalem and Department of Cardiology, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University Ramat Aviv, Ramat Aviv, 6139001, Tel Aviv, Israel
| | - Jeremy D Kark
- Hadassah School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel
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Eisdorfer I, Shalev V, Goren S, Chodick G, Muhsen K. Sex differences in urea breath test results for the diagnosis of Helicobacter pylori infection: a large cross-sectional study. Biol Sex Differ 2018; 9:1. [PMID: 29291751 PMCID: PMC5749022 DOI: 10.1186/s13293-017-0161-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/14/2017] [Indexed: 12/15/2022] Open
Abstract
Background Helicobacter pylori causes peptic ulcer disease and gastric cancer only in a subset of infected persons. Sex differences were shown in results of urea breath test (UBT), a commonly used test for the diagnosis of H. pylori infection. However, factors that might explain these differences, or affect UBT values, are not fully understood. We examined differences in UBT values between H. pylori-infected men and women while adjusting for background characteristics such as age, body mass index (BMI), and smoking. Methods A cross-sectional study was undertaken using coded data from the computerized database of Maccabi Health Services in Israel. Included were adults examined for UBT during 2002–2012 and were found H. pylori positive (UBT > 3.5‰). Multivariable linear mixed models were performed to assess the relationship between sex and UBT quantitative results, while adjusting for background characteristics. Results A total of 76,403 patients were included (52% of examined patients during the study period). Adjusted mean UBT value was significantly higher in women 33.8‰ (95% CI 33.4, 34.1) than in men 24.9‰ (95% CI 24.5, 25.3). A significant (P < 0.001) interaction was found between sex and smoking, showing diminished sex-differences in UBT results in smokers. Adjusted mean UBT values increased significantly with age and decreased with BMI, and it was higher in people who lived in low vs high socioeconomic status communities and lower in smokers vs non-smokers. Conclusions Systemic differences exist between men and women in quantitative UBT results. Host-related and environmental factors might affect UBT quantitative results. These findings have clinical implications regarding confirmation of the success of H. pylori eradication after treatment in various subgroups.
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Affiliation(s)
- Ido Eisdorfer
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
| | - Varda Shalev
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.,Medical Informatics Division, Maccabi Health Services, Tel Aviv, Israel
| | - Sophy Goren
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
| | - Gabriel Chodick
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.,Medical Informatics Division, Maccabi Health Services, Tel Aviv, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.
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12
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Abstract
BACKGROUND There are conflicting results regarding the role of H. pylori in children's growth. We examined differences in growth indices at school age according to H. pylori infection acquisition in preschool age. MATERIALS AND METHODS A prospective study was undertaken between 2004 and 2009, in which of healthy children (N = 139, ages 3-5 years at baseline) were tested for the presence of H. pylori antigen in their stool using enzyme-linked immunoassay and followed-up till age 6-9 years (median follow-up time 45 months). Height, weight, and hemoglobin levels were measured, and socioeconomic data were obtained. Z scores of height for age, weight for age, and body mass index for age at baseline and follow-up were calculated using the 2000 Center for Disease Control and Prevention growth reference curves. Growth velocity (cm/month) between preschool and school age was compared between H. pylori-infected and uninfected children using mixed models. RESULTS Fifty-three percent of the children were H. pylori positive at baseline, and all except one child tested positive at follow-up. The adjusted mean Z score of height for age at follow-up was significantly lower among H. pylori-infected children than uninfected ones: 0.15 (95% confidence intervals (CIs) 0.02, 0.29) and 0.45 (95% CI 0.29, 0.60), respectively (p = .002). Growth velocity was slower in the former group -0.0264 cm/month (95% CI -0.047, -0.005) (p = .014), after adjusting for baseline height and age. H. pylori infection was not associated with body weight. CONCLUSIONS Helicobacter pylori infection acquired in early childhood may have long-term adverse influence on linear growth at school age.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Sophy Goren
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
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Muhsen K, Cohen D, Levine MM. Can Giardia lamblia infection lower the risk of acute diarrhea among preschool children? J Trop Pediatr 2014; 60:99-103. [PMID: 24158113 DOI: 10.1093/tropej/fmt085] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
There are inconsistent findings concerning the role of Giardia lamblia in pediatric diarrhea. A prospective cohort study of the incidence of acute diarrhea among Israeli Arab preschool children offered the opportunity to examine the association between G. lamblia infection (at baseline) and subsequent diarrhea. Following baseline screening by light microscopy for the presence of Giardia in their stools, a cohort was assembled of 142 children who were followed between October 2003 and August 2004 for the incidence of diarrhea. Surveillance was performed through maternal interviews. At baseline, 21 children tested Giardia-positive. During the prospective surveillance, acute diarrhea occurred less often among Giardia-positive children (9.5%) than among children who were not infected with Giardia (26.5%). G. lamblia infection was associated with lower risk of acute diarrhea; adjusted odds ratio of 0.18 (95% confidence interval 0.04-0.93) (p = 0.041). This prospective study provides additional evidence that Giardia may lower the risk of subsequent acute diarrhea among preschool children.
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Affiliation(s)
- Khitam Muhsen
- Department of Medicine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
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Khedmat H, Karbasi-Afshar R, Agah S, Taheri S. Helicobacter pylori Infection in the general population: A Middle Eastern perspective. CASPIAN JOURNAL OF INTERNAL MEDICINE 2013; 4:745-753. [PMID: 24294467 PMCID: PMC3841773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 08/19/2013] [Accepted: 08/25/2013] [Indexed: 06/02/2023]
Abstract
Helicobacter pylori (H.pylori) infection is probably the most important factor that has been associated with the development of gastric cancers in human populations. However, there are no reliable data on the prevalence of this infection in the Middle East. In this article, based on a comprehensive literature review, we aimed to evaluate the situation in this region. The literature has been searched for the incidence and prevalence of H.pylori infection by Pubmed and Google Scholar. Search was repeated for each of the Middle Eastern countries, and to empower the method, citations of each found article were searched for the related studies. Seventy seven reports from the countries of the Middle East region had been reviewed and they all indicated a high rate of infection either in the general population or in the dyspeptic patients, the rate seemed to be higher in patients with dyspepsia, in patients with histologically confirmed gastritis and in patients of older age groups.
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Affiliation(s)
- Hossein Khedmat
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Reza Karbasi-Afshar
- Cardiovascular Research Center; Baqiyatallah University of Medical Sciences; Tehran, Iran
| | - Shahram Agah
- Colorectal Research Center; Iran University of Medical Sciences, Tehran, Iran
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Muhsen K, Jurban M, Goren S, Cohen D. Incidence, age of acquisition and risk factors of Helicobacter pylori infection among Israeli Arab infants. J Trop Pediatr 2012; 58:208-13. [PMID: 21908868 DOI: 10.1093/tropej/fmr068] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We examined the age of acquisition of Helicobacter pylori infection in a prospective study that was conducted among 231 Israeli Arab children. Helicobacter pylori was identified in stool specimens collected at ages 2, 4, 6, 8, 12 and 18 months, using a monoclonal stool antigen immunoassay. Information on household characteristics, breastfeeding, antibiotic use and hygiene practices was obtained. The incidence of H. pylori infection was 33.3%. The estimated mean age of H. pylori infection acquisition was 14 months. The determinants of H. pylori infection were living in a low socioeconomic status (SES) village: OR 9.60 (95% CI 2.91-31.68, p < 0.001); low paternal education: OR 3.35 (95% CI 1.21-9.29, p = 0.02); and boiling feeding bottles and nipples at low frequency: OR 7.12 (95% CI 1.82-27.86, p = 0.005). In conclusion, H. pylori infection is acquired at a higher rate in low SES settings. Parental education and hygiene play an important role in H. pylori acquisition in infancy.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
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Interaction among ethnicity, socioeconomic status, and Helicobacter pylori seroprevalence in Israeli children and adolescents. J Pediatr Gastroenterol Nutr 2011; 53:524-7. [PMID: 21637128 DOI: 10.1097/mpg.0b013e31822676ca] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The aim of the study was to examine the prevalence of Helicobacter pylori infection among Israeli children from different backgrounds and to assess potential interactions between ethnicity, socioeconomic status (SES), and H pylori seroprevalence. PATIENTS AND METHODS The present sero-epidemiologic study was conducted among 0- to 20-year-old children seeking medical attention, not specifically gastrointestinal symptoms, using sera collected between 2000 and 2001 from 575 Israeli Arab children, 584 Jewish children from the general population, and sera that were obtained between 1997 and 2007 from 464 children of an ultraorthodox Jewish community. An enzyme-linked immunosorbent assay was used to measure H pylori serum immunoglobulin G antibodies and seropositivity to H pylori CagA strains. RESULTS H pylori seropositivity was 22.9% (95% confidence interval [CI] 19.7-26.5) among Jewish children from the general population, 25.2% (95% CI 21.5-29.4) among ultraorthodox Jewish children, and 45.6% (95% CI 41.5-49.7) among Arab children. H pylori seroprevalence increased significantly with age in the 3 study groups, but it was consistently higher in Arab children. Compared with Jewish participants from high SES and controlling for age and sex, the odds ratio for H pylori seropositivity was 2.03 (95% CI 1.31-3.12) in Jewish children from intermediate SES, 2.42 (95% CI 1.29-4.53) in Arab children from intermediate SES, 2.26 (95% CI 1.52-3.36) in Jewish children from low SES, and 5.72 (95% CI 3.89-8.42) in Arab children from low SES. CagA seropositivity was 40.8% and 45.0% among Jewish and Arab children, respectively (P =0.59), and it was highest among subjects of lower SES. CONCLUSIONS Socioeconomic factors may not totally explain the ethnic differences in H pylori prevalence.
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Seroprevalence, correlates and trends of Helicobacter pylori infection in the Israeli population. Epidemiol Infect 2011; 140:1207-14. [PMID: 22014090 DOI: 10.1017/s0950268811002081] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We examined the prevalence, correlates and trends of H. pylori infection in Israel using residual sera obtained in 2007-2008 from 1466 Jewish subjects aged 0-77 years and 897 Arabs aged 0-19 years, and in 2000-2001 from 627 Jewish and 575 Arab subjects aged 0-19 years. H. pylori IgG antibodies were measured by ELISA. The age-adjusted H. pylori seroprevalence was 45.2% in Jewish participants. Seropositivity increased with age, reaching 60% at age ≥ 50 years and ranged from 24.3% in subjects originating from North America/Western Europe/Australia, to 63.2% in those from Asia/Africa/South America. Among Arabs, H. pylori seroprevalence was 42.1% and reached 65% in adolescents. There was no significant change in seroprevalence between 2000-2001 and 2007-2008. High prevalence of H. pylori was found in Arabs, and in Jews originating from countries of high H. pylori endemicity. These findings are characteristic of countries of diverse ethnic structure and recent immigration.
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Muhsen K, Ornoy A, Akawi A, Alpert G, Cohen D. An association between Helicobacter pylori infection and cognitive function in children at early school age: a community-based study. BMC Pediatr 2011; 11:43. [PMID: 21612616 PMCID: PMC3121602 DOI: 10.1186/1471-2431-11-43] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 05/25/2011] [Indexed: 12/13/2022] Open
Abstract
Background H. pylori infection has been linked to iron deficiency anemia, a risk factor of diminished cognitive development. The hypothesis on an association between H. pylori infection and cognitive function was examined in healthy children, independently of socioeconomic and nutritional factors. Methods A community-based study was conducted among 200 children aged 6-9 years, from different socioeconomic background. H. pylori infection was examined by an ELISA kit for detection of H. pylori antigen in stool samples. Cognitive function of the children was blindly assessed using Stanford-Benit test 5th edition, yielding IQ scores. Data on socioeconomic factors and nutritional covariates were collected through maternal interviews and from medical records. Multivariate linear regression analysis was performed to obtain adjusted beta coefficients. Results H. pylori infection was associated with lower IQ scores only in children from a relatively higher socioeconomic community; adjusted beta coefficient -6.1 (95% CI -11.4, -0.8) (P = 0.02) for full-scale IQ score, -6.0 (95% CI -11.1, -0.2) (P = 0.04) for non-verbal IQ score and -5.7 (95% CI -10.8, -0.6) (P = 0.02) for verbal IQ score, after controlling for potential confounders. Conclusions H. pylori infection might be negatively involved in cognitive development at early school age. Further studies in other populations with larger samples are needed to confirm this novel finding.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
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Muhsen K, Barak M, Henig C, Alpert G, Ornoy A, Cohen D. Is the association between Helicobacter pylori infection and anemia age dependent? Helicobacter 2010; 15:467-72. [PMID: 21083753 DOI: 10.1111/j.1523-5378.2010.00793.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The relationship between H. pylori infection and anemia in childhood is still unclear. The aim of the study was to examine the association between H. pylori infection and anemia or iron deficiency in school-age children and in infants. MATERIALS AND METHODS Six- to 9-year-old Israeli Arab children (N = 202) and infants (N = 197) were examined for hemoglobin and ferritin levels. ELISA was used to detect H. pylori antigens in stool specimens collected from the participants. Household characteristics were obtained through personal interviews with the mothers. RESULTS The prevalence of anemia was 15.5 versus 5.5% in H. pylori-positive and -negative school-age children, respectively and 34.5 versus 29.8% in H. pylori-positive and -negative infants, respectively. The Mantel-Haenszel age-adjusted prevalence ratio (PR) and 95% confidence intervals (CIs) were 1.6 (95%CI 1.0, 2.6). In multivariate analysis controlling for socioeconomic variables, H. pylori infection was associated with 2.8 higher prevalence of anemia only in school-age children: adjusted PR 2.8 (95% CI 0.9, 9.3). The adjusted mean difference in hemoglobin levels between H. pylori infected school-age children and uninfected ones was -0.372 gr/dL (95% CI -0.704, -0.039) (p = .04). The respective mean ferritin difference was -6.74 μg/L (95% CI -13.38, -.011) (p = .04). Such differences were not found in infants. CONCLUSIONS H. pylori infection is associated with higher prevalence of anemia in school-age children independently of socioeconomic variables. Such association was not observed in infants. These findings are of clinical and public health importance.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel
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Muhsen K, Athamna A, Bialik A, Alpert G, Cohen D. Presence of Helicobacter pylori in a sibling is associated with a long-term increased risk of H. pylori infection in Israeli Arab children. Helicobacter 2010; 15:108-13. [PMID: 20402813 DOI: 10.1111/j.1523-5378.2010.00746.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES We examined the dynamics of Helicobacter pylori infection between pre-school and school ages and compared the determinants of late acquisition of H. pylori infection with determinants of early and persistent H. pylori infection. METHODS ELISA was used to detect H. pylori antigens in stool specimens collected from children at preschool age (3-5 years) and from their mothers and siblings in 2004. The children were tested again for H. pylori at school age (6-9 years) in 2007-2009. Household and socioeconomic characteristics were obtained by interviews. RESULTS The prevalence of H. pylori infection increased from 49.7% (95% CI 42.8, 56.7) in 2004 to 58.9% (95% CI 51.8, 65.6) in 2007-2009. Among children tested in both examinations, 69 (49.3%) had persistent infection, 14 (10.0%) were new cases, 56 (40.0%) remained uninfected, and one (0.7%) had lost H. pylori infection. The approximate annual incidence of infection during 2004-2009 was 5%. Sibling's H. pylori positivity at baseline increased the risk for late acquisition of H. pylori infection; adjusted prevalence ratio (PR) 4.62 (95% CI 0.76, 28.23) (p = .09), while maternal education lowered the risk; adjusted PR 0.84 (95% CI 0.69, 1.01) (p = .06). Sibling's H. pylori positivity was the only significant variable associated with early and persistent H. pylori infection in multivariate analysis. CONCLUSIONS Most H. pylori infections are acquired at preschool age and transient infection beyond this age is uncommon in this population. Helicobacter pylori-infected siblings are the major reservoir of H. pylori in early and late childhood demonstrating sustained intra-familial transmission of H. pylori.
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Affiliation(s)
- Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel
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Helicobacter pylori infection is associated with low serum ferritin levels in Israeli Arab children: a seroepidemiologic study. J Pediatr Gastroenterol Nutr 2009; 49:262-4. [PMID: 19525869 DOI: 10.1097/mpg.0b013e31818f0a0d] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We examined the association between Helicobacter pylori seropositivity and low ferritin levels in sera of 509 Israeli Arab children aged 1 to 19 years. Serum ferritin levels were measured using the immunoturbidity assay. ELISA was used to detect serum IgG antibodies to H pylori and IgG antibodies to H pylori CagA strains. Low ferritin level was found between 14.5% and 8.6% of the H pylori seropositive and seronegative participants, respectively (P = 0.035). A trend for a higher frequency of low ferritin was detected among H pylori-CagA seropositive children. Multivariate analysis showed an increased frequency of low ferritin only among children younger than or equal to 5 years: adjusted OR 4.62 (95% CI 1.53-13.99) P = 0.007.
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Abstract
The prevalence of Helicobacter pylori infection in young children attending day care facilities was studied using a monoclonal stool antigen test. Of 316 samples, 78 (24.7%) were positive. Only 7/98 (7.1%) of the 3- to 12-month-old infants tested positive compared with 71/218 (32.5%) of the 13- to 60-month-old group. We conclude that approximately 30% of infants may become infected with H. pylori after the first year of life.
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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 2009; 104:182-9. [PMID: 19098867 DOI: 10.1038/ajg.2008.61] [Citation(s) in RCA: 126] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Infected siblings, mothers, and fathers have all been suggested to be major sources for Helicobacter pylori acquisition among children, but few studies have addressed the potential role of various family members simultaneously. METHODS A systematic review was performed on studies investigating intrafamilial transmission of childhood H. pylori infection. Within the Ulm Birth Cohort Study, which consists of 1,066 healthy newborns, born between November 2000 and November 2001 and followed up to age 4, and their siblings and parents, the independent role of the infection status of parents and siblings in transmission of H. pylori among children at age 4 was assessed. RESULTS Among four studies reporting infected mothers and siblings as independent risk factors for childhood H. pylori infection, odds ratios (ORs) for childhood infection given an infected sibling decreased meaningfully after adjustment for maternal infection status. Within the Ulm Birth Cohort Study, the prevalence of infection was 3.0% among index children at age 4. In bivariate analyses, maternal, paternal, and sibling infection were all strongly and significantly related to infection of the child. However, after multivariate adjustment, only maternal infection persisted as the single strong and significant risk factor (OR 13.0, 95% confidence interval 3.0-55.2). CONCLUSIONS These patterns suggest that mutual control for H. pylori status of other family members is crucial for estimating the role of mothers, fathers, and siblings in the transmission of childhood H. pylori infection. In populations with low H. pylori prevalence the infected mother is likely to be the main source for childhood H. pylori infection.
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Affiliation(s)
- Maria Weyermann
- Department of Clinical Epidemiology and Aging Research, The German Cancer Research Center, Heidelberg, Germany
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Siai K, Ghozzi M, Ezzine H, Medjahed N, Azzouz M. Prevalence and risk factors of Helicobacter pylori infection in Tunisian children: 1055 children in Cap-Bon (northeastern Tunisia). ACTA ACUST UNITED AC 2008; 32:881-6. [DOI: 10.1016/j.gcb.2008.03.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2007] [Revised: 03/21/2008] [Accepted: 03/26/2008] [Indexed: 11/26/2022]
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Yilmaz O. Progress in developing accurate tests for the diagnosis of Helicobacter pylori infection. EXPERT OPINION ON MEDICAL DIAGNOSTICS 2007; 1:531-540. [PMID: 23496359 DOI: 10.1517/17530059.1.4.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Helicobacter pylori is a chronic infectious agent as defined the major pathogen causing gastritis, gastric and duodenal ulcer, gastric carcinoma and mucosa-associated lymphoid tissue lymphoma, however little is known about its role in functional dyspepsia. H. pylori is the only microorganism known to inhabit the human stomach and the gastric mucosal cells. Chronic H. pylori infection of the stomach is increasingly recognized as a major risk factor for the development of gastroduodenal disease. H. pylori can be detected by non-invasive and invasive methods, the latter requiring endoscopy.
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Affiliation(s)
- Ozlem Yilmaz
- Dokuz Eylül University, Faculty of Medicine, Department of Microbiology and Clinical Microbiology, 35340, Inciralti, ˙Izmir, Turkey +90 232 412 45 06 ; +90 232 259 05 41 ;
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Abstract
Helicobacter pylori infection is typically acquired in early childhood in both low- and high-income regions of the world and, once established, commonly persists lifelong unless treated. Social and economic development decreases the prevalence both within and between countries. The epidemiology of H. pylori infection highlights the geographic, ethnic, and racial differences throughout the world.
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Delport W, van der Merwe SW. The transmission of Helicobacter pylori: the effects of analysis method and study population on inference. Best Pract Res Clin Gastroenterol 2007; 21:215-36. [PMID: 17382274 DOI: 10.1016/j.bpg.2006.10.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Although much is known about the virulence of Helicobacter pylori, the transmission pathways for this bacterium are still unresolved. Transmission has been addressed through: (1) prevalence within families; (2) detection in fecal/oral environments; (3) detection in the abiotic/biotic environment; and (4) direct inference from strain similarity. Here, we review the molecular and biochemical methods used and discuss the relative merits of each. Furthermore, as there are differences between developing and developed nations, we discuss the results obtained from transmission studies in light of the study population. We conclude that H. pylori is probably transmitted person-to-person, facilitated by fecal-oral transmission during episodes of diarrhea or gastro-oral contact during periods of vomiting. The persistence of H. pylori in abiotic and biotic environments remains unproven but possible reactivation from viable, non-culturable coccoid forms should be further investigated. Finally, we speculate on the effect of host-pathogen interactions in confounding the inference of transmission.
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Affiliation(s)
- Wayne Delport
- DST-NRF Centre of Excellence at the Percy FitzPatrick Institute, University of Cape Town, Rondebosch 7701, South Africa
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