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Wang T, Girgis S, Chang HJ, Assi A, Fagan-Garcia K, Cromarty T, Munday R, Goodman KJ, Veldhuyzen van Zanten S. Changes in Gastric Pathology after H. pylori Treatment in Community-Driven Research Aimed at Gastric Cancer Prevention. Cancers (Basel) 2023; 15:3950. [PMID: 37568765 PMCID: PMC10417032 DOI: 10.3390/cancers15153950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Community-driven projects have characterized Helicobacter pylori (Hp) infection in Indigenous communities in the Northwest Territories (NT) and Yukon (YT), Canada. These projects address concerns about the frequent diagnosis of Hp infection among community members and its relation to gastric cancer deaths, perceived to occur with alarming frequency in this region. Projects included breath-test screening for Hp infection, gastroscopy with gastric biopsies, and treatment to eliminate Hp infection. Previous project results showed a high prevalence of stomach pathologies associated with increased cancer risk among Hp-positive participants at baseline. This analysis describes changes in precancerous gastric pathologies in project participants who had gastroscopy before baseline treatment during 2008-2013 and again in 2017. Throughout the study period, the same pathologist graded Hp density, active gastritis, chronic gastritis, atrophic gastritis, and intestinal metaplasia using the updated Sydney System. Of 310 participants from three communities with baseline pathology data, 69 had follow-up pathology data. Relative to baseline, the prevalence of Hp infection and precancerous gastric pathology was substantially lower at follow-up; most participants who were Hp-positive at baseline and Hp-negative at follow-up had reduced severity of active, chronic, and/or atrophic gastritis at follow-up. Though follow-up numbers are small, these results yield evidence that successful Hp treatment has the potential to reduce the risk of gastric cancer in Arctic Indigenous communities.
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Affiliation(s)
- Ting Wang
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2X8, Canada (the CANHelp Working Group)
| | - Safwat Girgis
- Department of Lab Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2X8, Canada
| | - Hsiu-Ju Chang
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2X8, Canada (the CANHelp Working Group)
| | - Ali Assi
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2X8, Canada (the CANHelp Working Group)
| | - Katharine Fagan-Garcia
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2X8, Canada (the CANHelp Working Group)
| | - Taylor Cromarty
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2X8, Canada (the CANHelp Working Group)
| | - Rachel Munday
- Susie Husky Health Centre, Aklavik, NT X0E 0A0, Canada
| | - Karen J. Goodman
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2X8, Canada (the CANHelp Working Group)
| | - Sander Veldhuyzen van Zanten
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2X8, Canada (the CANHelp Working Group)
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Du N, Scherer C, Porto A. Assessment of Community Pediatric Providers' Approach to Children With Helicobacter pylori. JPGN REPORTS 2021; 2:e033. [PMID: 37206946 PMCID: PMC10191512 DOI: 10.1097/pg9.0000000000000033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/12/2020] [Indexed: 05/21/2023]
Abstract
In 2016, the European and North American Societies for Pediatric Gastroenterology, Hepatology, and Nutrition updated guidelines for management of Helicobacter pylori in children, adjusting the previous diagnostic and therapeutic approaches in response to changing epidemiology and antibiotic resistance patterns. In this study, we assessed knowledge, practice habits of H. pylori management, and adherence to new guideline recommendations among one state's community pediatric providers. The majority of the surveyed community pediatric providers are not following the new pediatric guidelines for H. pylori management. An evidence-practice gap for diagnosis and treatment of H. pylori disease can lead to poor resource utilization, inadequate antibiotic usage, increased antibiotic resistance, and prolonged symptoms in patients. By understanding pediatric provider practices, pediatric gastroenterologists can assist in addressing the gap through development of educational interventions for community pediatric providers.
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Affiliation(s)
- Nan Du
- From the Yale-New Haven Hospital, New Haven, CT
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Ma I, Guo M, Pillai DR, Church DL, Naugler C. Is the Utilization of Helicobacter pylori Stool Antigen Tests Appropriate in an Urban Canadian Population? Am J Clin Pathol 2020; 153:686-694. [PMID: 32145011 PMCID: PMC7159178 DOI: 10.1093/ajcp/aqz210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Helicobacter pylori stool antigen test (HpSAT) appropriateness was investigated by assessing its testing and positivity rates in Calgary, Canada. METHODS The laboratory information system was accessed for all patients who received an HpSAT in 2018. Testing volume, test results, age, and sex of patients were collected. Sociodemographic risk factors and geospatial analysis were performed by matching laboratory data to the 2016 census data. Testing appropriateness was defined as a concordance between testing and positivity rates for each sociodemographic variable. RESULTS In 2018, 25,518 H pylori stool antigen tests were performed in Calgary, with an overall positivity rate of 14.7%. Geospatial mapping demonstrated significant distribution variations of testing and positivity rates of HpSAT in the city. Certain sociodemographic groups studied (eg, recent immigrants) appeared to be appropriately tested (testing rate relative risk [RR] = 2.26, positivity rate RR = 4.32; P < .0001), while other groups (eg, male) may have been undertested (testing rate RR = 0.85, positivity rate RR = 1.14; P < .0001). CONCLUSIONS Determining concordance of testing and positivity rate of a laboratory test can be used for assessing testing appropriateness for other diseases in other jurisdictions. This study demonstrated some at-risk patients may be missed for H pylori testing.
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Affiliation(s)
- Irene Ma
- Calgary Laboratory Services, Calgary, Canada
| | - Maggie Guo
- Calgary Laboratory Services, Calgary, Canada
| | - Dylan R Pillai
- Departments of Pathology and La Medicine
- Calgary Laboratory Services, Calgary, Canada
- Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Deirdre L Church
- Departments of Pathology and La Medicine
- Calgary Laboratory Services, Calgary, Canada
- Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Christopher Naugler
- Departments of Pathology and La Medicine
- Calgary Laboratory Services, Calgary, Canada
- Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Msekandiana A, Msuya L, Philemon R, M'mbaga B, Kinabo G. Seroprevalence, risk factors and comorbidities associated with Helicobacter pylori infection amongst children receiving care at Kilimanjaro Christian Medical Center. Afr Health Sci 2019; 19:3208-3216. [PMID: 32127898 PMCID: PMC7040322 DOI: 10.4314/ahs.v19i4.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Helicobacter pylori frequently causes gastritis and peptic ulcers, and affected children are at risk of developing gastric carcinoma later in adulthood. METHODS This was a Hospital based cross sectional study. A total of 200 children aged 6 months to 14 years were enrolled. Study subjects were tested for H. pylori using a standard serology rapid test measuring immunoglobulin G for H. pylori. For risk factors, Chi-square tests were used to test for association and then, odds ratios and their corresponding 95% confidence intervals and p-values were computed using logistic regression. RESULTS The overall seroprevalence of H. pylori was 11.5%. The following factors were associated with H. pylori infection: Age group above 10 years, keeping a dog and household size. The independent predictors of H. pylori were: Fathers' occupation, keeping a dog, indoor tap water, age group, household size and diabetes mellitus type 1.. CONCLUSION The seroprevalence of H. pylori antibodies was lower compared to most developing countries. Keeping a dog, household size, indoor tap water, fathers' occupation and diabetes mellitus type 1 were found to be independent predictors of presence of H. pylori antibodies.
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Affiliation(s)
- Amos Msekandiana
- Mzuzu Central Hospital, Pediatrics; Kilimanjaro Christian Medical University College, Pediatrics
| | - Levina Msuya
- Kilimanjaro Christian Medical University College, Pediatrics
| | - Rune Philemon
- Kilimanjaro Christian Medical University College, Pediatrics
| | - Blandina M'mbaga
- Kilimanjaro Christian Medical University College, Pediatrics; Kilimanjaro Research Institute
| | - Grace Kinabo
- Kilimanjaro Christian Medical University College, Pediatrics
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Colonic Abnormalities in Manitoban Children with Helicobacter pylori Gastritis. Gastroenterol Res Pract 2018; 2018:6840390. [PMID: 29805445 PMCID: PMC5902056 DOI: 10.1155/2018/6840390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/12/2018] [Indexed: 01/06/2023] Open
Abstract
Objectives Association between Helicobacter pylori (H. pylori) and colonic pathology is underinvestigated. The aim of this work was to examine the prevalence and nature of colonic changes in children diagnosed with H. pylori gastritis. Methods A comprehensive retrospective review of the medical records for all Manitoban children (≤17 years) diagnosed with H. pylori gastritis from January 1996 to May 2015 was conducted. Children with H. pylori gastritis who had colonoscopy were identified. Patients' demographics, indications for colonoscopy, laboratory and endoscopic findings, and colonic histopathological abnormalities were documented. Results A total of 231 children were found to have H. pylori gastritis. The mean age at diagnosis was 12.3 ± 4.1 years; 108 (46.6%) were girls. Of the 231 patients, 37 (16%) patients were found to have colonoscopy performed. Indications for colonoscopy included bleeding per rectum, significant weight loss, and hypoalbuminemia. Twenty-two (59%) of 37 children who had colonoscopy had significant endoscopic and histopathological findings on colonoscopy including polyposis and colitis. Boys with colonic changes were diagnosed at an earlier age compared to those without (11.5 ± 7.0 versus 15.0 ± 2.0, p < 0.049). Conclusions Our study may suggest a possible association between H. pylori and a subset of colonic changes in children.
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Ding Z, Zhao S, Gong S, Li Z, Mao M, Xu X, Zhou L. Prevalence and risk factors of Helicobacter pylori infection in asymptomatic Chinese children: a prospective, cross-sectional, population-based study. Aliment Pharmacol Ther 2015; 42:1019-26. [PMID: 26271484 DOI: 10.1111/apt.13364] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 07/07/2015] [Accepted: 07/23/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Limited research has been published on current Helicobacter pylori infection rate in asymptomatic children in China. AIM To assess current Helicobacter pylori infection rate, distribution characteristics and risk factors in Chinese asymptomatic children. METHODS A prospective, cross-sectional, population-based study was performed from 2009 to 2011 in three cities of China. Helicobacter pylori infection was diagnosed by a stool antigen test. Multi-stage cluster random sampling was used to select asymptomatic children including neonates. Socioeconomic details were obtained through a standardised questionnaire. RESULTS Among total of 3491 children (0-18 years), the global infection rate was 6.8% and there were no significant differences between genders. Age specific infection rate between regions was significantly different (P < 0.05). The infection rate significantly increased with age (P for trend <0.01). It was low during the newborn (0.6%) to preschool period and was significantly increased in high school students (13.5%) (P < 0.01). Multivariable regression indicated that hand sanitisation, individually served meals, higher education level of mother, above average living space and residence in urban areas were significantly protective against infection (OR 0.749, 0.698, 0.720, 0.838 and 0.770 respectively). Conversely, consuming meals in unsanitised conditions, sharing towels, receiving pre-chewed food from the mother, artificial feeding and family history of gastrointestinal disease were significantly associated with the risk of infection (OR 1.200, 1.965, 2.002, 1.071 and 2.093 respectively). CONCLUSIONS Helicobacter pylori infection rate increases with age in Chinese asymptomatic children and is common after 10 years of age. The rate of infection is related to socioeconomic status.
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Affiliation(s)
- Z Ding
- Department of Gastroenterology, Beijing Children's Hospital of Capital Medical University, Beijing, China
| | - S Zhao
- Department of Gastroenterology, Beijing Children's Hospital of Capital Medical University, Beijing, China
| | - S Gong
- Department of Gastroenterology, Guangzhou Women and Children's Medical Center of Guangzhou Medical College, Guangzhou, China
| | - Z Li
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China
| | - M Mao
- Department of Pediatrics, West China Second Hospital of Sichuan University, Chengdu, China
| | - X Xu
- Department of Gastroenterology, Beijing Children's Hospital of Capital Medical University, Beijing, China
| | - L Zhou
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China
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Yahaghi E, Khamesipour F, Mashayekhi F, Safarpoor Dehkordi F, Sakhaei MH, Masoudimanesh M, Khameneie MK. Helicobacter pylori in vegetables and salads: genotyping and antimicrobial resistance properties. BIOMED RESEARCH INTERNATIONAL 2014; 2014:757941. [PMID: 25184146 PMCID: PMC4145543 DOI: 10.1155/2014/757941] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 05/18/2014] [Accepted: 06/09/2014] [Indexed: 02/08/2023]
Abstract
From a clinical and epidemiological perspective, it is important to know which genotypes and antibiotic resistance patterns are present in H. pylori strains isolated from salads and vegetables. Therefore, the present investigation was carried out to find this purpose. Three hundred eighty washed and unwashed vegetable samples and fifty commercial and traditional salad samples were collected from Isfahan, Iran. Samples were cultured and those found positive for H. pylori were analyzed using PCR. Antimicrobial susceptibility testing was performed using disk diffusion method. Seven out of 50 (14%) salad and 52 out of 380 (13.68%) vegetable samples harbored H. pylori. In addition, leek, lettuce, and cabbage were the most commonly contaminated samples (30%). The most prevalent virulence genes were oipA (86.44%) and cagA (57.625). VacA s1a (37.28%) and iceA1 (47.45%) were the most prevalent genotypes. Forty different genotypic combinations were recognized. S1a/cagA+/iceA1/oipA+ (33.89%), s1a/cagA+/iceA2/oipA (30.50%), and m1a/cagA+/iceA1/oipA+ (28.81%) were the most prevalent combined genotypes. Bacterial strains had the highest levels of resistance against metronidazole (77.96%), amoxicillin (67.79%), and ampicillin (61.01%). High similarity in the genotyping pattern of H. pylori among vegetable and salad samples and human specimens suggests that vegetable and salads may be the sources of the bacteria.
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Affiliation(s)
- Emad Yahaghi
- Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Faham Khamesipour
- Young Researchers and Elites Club, Islamic Azad University, Shahrekord Branch, P.O. Box 166, Shahrekord, Iran
| | - Fatemeh Mashayekhi
- Intensive and Critical Care Nursing, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Farhad Safarpoor Dehkordi
- Young Researchers and Elites Club, Islamic Azad University, Shahrekord Branch, P.O. Box 166, Shahrekord, Iran
| | - Mohammad Hossein Sakhaei
- Scientific Association of Veterinary Office, College of Veterinary Medicine, Islamic Azad University, Shahrekord Branch, P.O. Box 166, Shahrekord, Iran
| | - Mojtaba Masoudimanesh
- Scientific Association of Veterinary Office, College of Veterinary Medicine, Islamic Azad University, Shahrekord Branch, P.O. Box 166, Shahrekord, Iran
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Ghasemi-Kebria F, Ghaemi E, Azadfar S, Roshandel G. Epidemiology of Helicobacter pylori infection among Iranian children. Arab J Gastroenterol 2013; 14:169-72. [DOI: 10.1016/j.ajg.2013.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 08/14/2013] [Accepted: 11/19/2013] [Indexed: 12/18/2022]
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Ulanova M, Tsang R, Altman E. Neglected infectious diseases in Aboriginal communities: Haemophilus influenzae serotype a and Helicobacter pylori. Vaccine 2012; 30:6960-6. [DOI: 10.1016/j.vaccine.2012.09.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 07/04/2012] [Accepted: 09/25/2012] [Indexed: 12/17/2022]
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Helicobacter pylori in First Nations and recent immigrant populations in Canada. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2012; 26:97-103. [PMID: 22312609 DOI: 10.1155/2012/174529] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The diminishing prevalence of Helicobacter pylori infection among most segments of the Canadian population has led to changes in the etiologies and patterns of associated upper gastrointestinal diseases, including fewer peptic ulcers and their complications. Canadian Aboriginals and recent immigrants are among populations in which the prevalence of H pylori infection remains high and, therefore, the health risks imposed by H pylori remain a significant concern. Population-based strategies for H pylori eradication in groups with a low prevalence of infection are unlikely to be cost effective, but such measures are attractive in groups in which the prevalence rates of infection remain substantial. In addition to a lower prevalence of peptic ulcers and dyspepsia, the public health value of eradication may be particularly important if this leads to a reduction in the prevalence of gastric cancer in high prevalence groups. Therefore The Canadian Helicobacter Study Group held a conference that brought together experts in the field to address these issues, the results of which are reviewed in the present article. Canadians with the highest prevalence of H pylori infection are an appropriate focus for considering the health advantages of eradicating persistent infection. In Canadian communities with a high prevalence of both H pylori and gastric cancer, there remains an opportunity to test the hypothesis that H pylori infection is a treatable risk factor for malignancy.
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Liu G, Xu X, He L, Ding Z, Gu Y, Zhang J, Zhou L. Primary antibiotic resistance of Helicobacter pylori isolated from Beijing children. Helicobacter 2011; 16:356-62. [PMID: 21923681 DOI: 10.1111/j.1523-5378.2011.00856.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The antimicrobials resistance of Helicobacter pylori (H. pylori) was able to sharply decline the eradication rate of H. pylori both in adults and children, but there are limited studies about the primary antibiotic resistance and the related gene mutations, specifically in China. MATERIALS AND METHODS The primary resistance to 9 antibiotics of 73 H. pylori strains isolated from gastric biopsies of children recruited at Beijing Children's Hospital was assessed, and the mutations in 23S rRNA gene of 65 macrolide-resistant strains and in gyrA and gyrB of 12 quinolone-resistant strains were investigated. RESULTS The resistance rate to clarithromycin, azithromycin, metronidazole, levofloxacin, moxifloxacin, and rifampicin was 84.9%, 87.7%, 61.6%, 13.7%, 15.1%, and 6.8%, respectively. No resistance to amoxicillin, gentamicin, and tetracycline was observed. Dual, triple, and quadruple antibacterial resistant percentage was 46.6% (34/73), 15.1% (11/73), and 2.7% (2/73), respectively. The gene mutation rate of A2142C, A2142G, and A2143G in 23S rRNA gene was 1.5% (1/65), 6.2% (4/65), and 84.6% (55/65), respectively. The detection rate of mutations of Asn87, Asp91, and Met191 in GyrA was 41.7% (5/12), 25% (3/12), and 25% (3/12), respectively. CONCLUSION The high prevalence of primary antibiotic resistance was out of expectation in H. pylori strains isolated from the children in Beijing. Antibiotic susceptibility should be made clear before the antibiotic was used in the anti-H. pylori therapy in this population. The A2143G was the most populated mutation in macrolide-resistant strains, and Asn87 and Asp91 of GyrA were the most common mutation points in quinolone resistance strains.
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Affiliation(s)
- Guodong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Low prevalence of iron-deficiency anaemia among Inuit preschool children: Nunavut Inuit Child Health Survey, 2007–2008. Public Health Nutr 2010; 14:1415-23. [DOI: 10.1017/s1368980010002429] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractObjectiveTo report the prevalence rates and correlates for anaemia, iron deficiency (ID) and iron-deficiency anaemia (IDA) among Inuit preschool-aged children.DesignA cross-sectional study assessed iron intake, demographic information, medical history, anthropometrics, Hb, ferritin, C-reactive protein and antibodies toHelicobacter pylori.SettingSixteen selected Inuit communities in Nunavut Territory, Canada.SubjectsInuit (n388) aged 3–5 years randomly recruited from communities.ResultsAnaemia (3–4 years: Hb < 110 g/l; 5 years: Hb < 115 g/l) was prevalent in 16·8 % of children. The prevalence of ID (ferritin < 12 μg/l) was 18·0 % and that of IDA was 5·4 %. When ID was defined as ferritin <10 μg/l, 10·8 % of children were iron deficient and 3·3 % had IDA. In multiple logistic regression, boys were more likely to be iron deficient (OR = 2·28, 95 % CI 1·17, 8·25), but no other risk factor emerged for ID. Three- to 4-year-olds were less likely than 5-year-olds to have anaemia from causes other than ID (OR = 0·11, 95 % CI 0·08, 0·58). Anaemia from other causes was more common among children residing in crowded homes (OR = 2·30, 95 % CI 1·37, 12·31) and those treated for past-year ear infection (OR = 1·35, 95 % CI 1·05, 7·21).ConclusionsThe low prevalence of ID and IDA is encouraging, but efforts are still needed to reduce rates as they continue to be higher than general population rates. Household crowding and infections may contribute to anaemia and warrant further research.
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Saadah OI. Helicobacter pylori infection in Saudi children; clinical, endoscopic and pathological findings. Arab J Gastroenterol 2010. [DOI: 10.1016/j.ajg.2010.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Gastric cancer is the second most common cause of cancer death worldwide. A large body of evidence supports a causal role of Helicobacter pylori in the majority of gastric malignancies. Great strides have been made in understanding the pathogenesis of this relationship, but much remains to be learned. Moreover, because of the high prevalence of infection, the lack of definitive trials, and the challenges of H. pylori treatment, there remains no consensus on the role of routine screening and treatment of this infection to prevent cancer. This article reviews the current knowledge on H. pylori and gastric cancer and presents some of the clinical and public health challenges associated with this pathogen.
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Affiliation(s)
- V Herrera
- Division of Infectious Diseases, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Abstract
his review summarizes the articles published on Helicobacter pylori infection in children between April 2008 and March 2009. Recent evidence highlights the decreasing prevalence trend of H. pylori infection and supports both intrafamilial and extrafamilial transmission. The association with various symptoms is still being debated. Interestingly, H. pylori infection seems inversely associated with allergic diseases. Monoclonal stool antigen tests are widely used and accurate for the diagnosis of H. pylori infection, but less accurate in young children. The new biprobe real-time PCR assay applied to stools showed a poor sensitivity in children. Using the urea hydrolysis rate next to the delta over baseline values, the (13)C-urea breath test provides excellent results for all age children, even for young children. Treatment of H. pylori infection remains a challenge, considering suboptimal efficacy of current therapy. Among emerging alternatives, sequential treatment appears promising. The adjunction of probiotics to conventional regimens, although eliciting great interest, has shown limited therapeutic benefit.
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Affiliation(s)
- Angelika Kindermann
- Department of Pediatric Gastroenterology, Emma's Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
PUD affects both the East and the West. The magnitude of the problem, however, varies within these regions. The study of peptic ulcer epidemiology is impeded by the paucity of general population-based data, invasiveness of diagnostic tests, and variable access to testing facilities. As such, direct comparisons of PUD epidemiology between the East and the West are difficult. The prevalence rates of H pylori are highly variable and depend greatly on the local sanitation conditions. The use of NSAIDs and aspirin is ubiquitous and increasing especially for the antiplatelet activity of aspirin in the prophylaxis of cardiovascular events. There is evidence that pharmacogenetics play a role in susceptibility to the ulcerogenic properties of NSAIDs. The prevalence of PUD parallels the risk factors, but emerging in both the East and the West is idiopathic PUD, now a substantial proportion of ulcers in areas of declining H pylori infection. Genetic polymorphisms affect the efficacy of treatment using PPIs. Local H pylori resistance rates also influence the eradication success rates.
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Affiliation(s)
- Rupert W Leong
- Concord Hospital, Ambulatory Care Endoscopy Unit, Level 1 West, Hospital Road, Concord, Sydney NSW 2139, Australia.
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