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Lim B, Kim KS, Ahn JY, Na K. Overcoming antibiotic resistance caused by genetic mutations of Helicobacter pylori with mucin adhesive polymer-based therapeutics. Biomaterials 2024; 308:122541. [PMID: 38547832 DOI: 10.1016/j.biomaterials.2024.122541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/22/2024] [Accepted: 03/19/2024] [Indexed: 05/03/2024]
Abstract
Herein, we describe the 3'-sialyllactose-polyethyleneimine-chlorine e6 conjugate (3PC), meticulously engineered to effectively target Helicobacter bacteria (H. pylori) within the gastric environment. The composition of 3PC comprises polyethyleneimine, a cationic polymer, 3'-sialyllactose, which exhibits a specific binding affinity for H. pylori surface proteins, and a photosensitizer capable of generating oxygen radicals in response to specific wavelengths. The distinctive feature of 3PC lies in its capacity to enhance interaction with the anionic mucus layer facilitated by electrostatic forces. This interaction results in prolonged residence within the intestinal environment. The extended vacation in the intestinal milieu overcomes inherent limitations that have historically impeded conventional antibiotics from efficiently reaching and targeting H. pylori. 3PC can be harnessed as a potent tool for antibacterial photodynamic therapy, and its versatility extends to addressing the challenges posed by various antibiotic-resistant strains. The exceptional efficacy of 3PC in enhancing intestinal residence time and eradicating H. pylori has been robustly substantiated in animal models, particularly in mice. In summary, 3PC is a formidable agent capable of eradicating H. pylori, irrespective of its antibiotic resistance status, by efficiently penetrating and selectively targeting the mucus layer within the gastric environment.
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Affiliation(s)
- Byoungjun Lim
- Department of BioMedical-Chemical Engineering, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14662, Republic of Korea; Department of Biotechnology, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14662, Republic of Korea
| | - Kyoung Sub Kim
- Department of BioMedical-Chemical Engineering, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14662, Republic of Korea; Department of Biotechnology, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14662, Republic of Korea
| | - Ji Yong Ahn
- Department of Gastroenterology, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Kun Na
- Department of BioMedical-Chemical Engineering, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14662, Republic of Korea; Department of Biotechnology, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14662, Republic of Korea.
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Rysbekov K, Abrakhmanova S, Satybaeva R, Starosvetova Y, Kushugulova A. Helicobacter pylori eradication therapy for children. Drug Metab Pers Ther 2024; 39:59-67. [PMID: 38997154 DOI: 10.1515/dmpt-2024-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 06/17/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVES The research aims to investigate the effect of vitamin D supplementation on the efficacy of Helicobacter pylori eradication therapy and to find new drug combinations for the eradication of the bacterium. METHODS A total of 128 children participated in the research. They were distributed under the following criteria: group A were children who tested positive for H. pylori and were treated with the standard so-called triple therapy including vitamin D; group B were children who tested positive for H. pylori and received the standard triple therapy without including vitamin D in the treatment; and group C were children who tested negative for H. pylori. After endoscopic examination, additional venous blood samples were taken from the children to determine vitamin D levels. A controlled study was carried out 45 days after the initial treatment. RESULTS The overall success rate of eradication therapy was 84.1 %. In group A, the success rate of treatment was 93.5 %, contrary to group B, where the success rate was 75 %. Although there was a difference in the percentage of H. pylori eradication therapy in the main group compared to the control group, there was no significant difference in group B. The success rate of eradication is p=0.082. CONCLUSIONS Following the research results, the addition of vitamin D to the standard triple therapy regimen for H. pylori had no effect. It can therefore be concluded that vitamin D does not significantly increase the efficacy of eradication therapy.
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Affiliation(s)
- Kairat Rysbekov
- Department of Pediatric Diseases with Courses Cardio-Rheumatology and Gastroenterology, 217968 Astana Medical University , Astana, Kazakhstan
| | - Sagira Abrakhmanova
- Department of Pediatric Diseases with Courses Cardio-Rheumatology and Gastroenterology, 217968 Astana Medical University , Astana, Kazakhstan
| | - Rashida Satybaeva
- Department of Pediatric Diseases with Courses Cardio-Rheumatology and Gastroenterology, 217968 Astana Medical University , Astana, Kazakhstan
| | - Yekaterina Starosvetova
- Department of Pediatric Diseases with Courses Cardio-Rheumatology and Gastroenterology, 217968 Astana Medical University , Astana, Kazakhstan
| | - Almagul Kushugulova
- Laboratory of Human Microbiome and Longevity, National Laboratory Astana, Astana, Kazakhstan
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Kendrick P, Kelly YO, Baumann MM, Compton K, Blacker BF, Daoud F, Li Z, Mouhanna F, Nassereldine H, Schmidt C, Sylte DO, Force LM, Hay SI, Rodriquez EJ, Mensah GA, Nápoles AM, Pérez-Stable EJ, Murray CJ, Mokdad AH, Dwyer-Lindgren L. The burden of stomach cancer mortality by county, race, and ethnicity in the USA, 2000-2019: a systematic analysis of health disparities. LANCET REGIONAL HEALTH. AMERICAS 2023; 24:100547. [PMID: 37600165 PMCID: PMC10435837 DOI: 10.1016/j.lana.2023.100547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 08/22/2023]
Abstract
Background There are persistent disparities in stomach cancer mortality among racial-ethnic groups in the USA, but the extent to which these patterns vary geographically is not well understood. This analysis estimated age-standardised mortality for five racial-ethnic groups, in 3110 USA counties over 20 years, to describe spatial-temporal variations in stomach cancer mortality and disparities between racial-ethnic groups. Methods Redistribution methods for insufficient cause of death codes and validated small area estimation methods were applied to death registration data from the US National Vital Statistics System and population data from the US National Center for Health Statistics to estimate annual stomach cancer mortality rates. Estimates were stratified by county and racial-ethnic group (non-Latino and non-Hispanic [NL] American Indian or Alaska Native [AIAN], NL Asian or Pacific Islander [Asian], NL Black [Black], Latino or Hispanic [Latino], and NL White [White]) from 2000 to 2019. Estimates were corrected for misreporting of racial-ethnic group on death certificates using published misclassification ratios. We masked (ie, did not display) estimates for county and racial-ethnic group combinations with a mean annual population of less than 1000; thus, we report estimates for 3079 (of 3110) counties for the total population, and 474, 667, 1488, 1478, and 3051 counties for the AIAN, Asian, Black, Latino, and White populations, respectively. Findings Between 2000 and 2019, national age-standardised stomach cancer mortality was lowest among the White population in every year. Nationally, stomach cancer mortality declined for all racial-ethnic groups across this time period, with the most rapid declines occurring among the Asian (percent decline 48.3% [45.1-51.1]) and Black populations (42.6% [40.2-44.6]). Mortality among the other racial-ethnic groups declined more moderately, decreasing by 36.7% (35.3-38.1), 35.1% (32.2-37.7), and 31.6% (23.9-38.0) among the White, Latino, and AIAN populations, respectively. Similar patterns were observed at the county level, although with wide geographic variation. In 2019, a majority of counties had higher mortality rates among minoritised racial-ethnic populations compared to the White population: 81.1% (377 of 465 counties with unmasked estimates for both racial-ethnic groups) among the AIAN population, 88.2% (1295 of 1469) among the Latino population, 99.4% (663 of 667) among the Asian population, and 99.9% (1484 of 1486) among the Black population. However, the size of these disparities ranged widely across counties, with the largest range from 0.3 to 17.1 among the AIAN population. Interpretation Stomach cancer mortality has decreased substantially across populations and geographies in the USA. However, disparities in stomach cancer mortality among racial-ethnic groups are widespread and have persisted over the last two decades. Local-level data are crucial to understanding the scope of this unequal burden among minoritised groups in the USA. Funding National Institute on Minority Health and Health Disparities; National Heart, Lung, and Blood Institute; National Cancer Institute; National Institute on Aging; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Office of Disease Prevention; and Office of Behavioral and Social Sciences Research, National Institutes of Health (contract #75N94019C00016).
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Is Helicobacter pylori Infection Prevalent in Middle East Countries? ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2023. [DOI: 10.5812/archcid-123364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Helicobacter pylori is a pathogenic bacteria found in the gastric mucosa of both children and adults. Our goal was to use an endoscopic method to look at the prevalence of H. pylori in children with gastrointestinal complaints. Methods: This cross-sectional research was conducted in 2022 on pediatric patients who received gastric or duodenal biopsies by endoscopy. We collected data from medical reports regarding patients' age, gender, location of residence, type of gastrointestinal problems, and frequency of H. pylori infection. Results: A total of 2030 pediatric patients participated in the study. Helicobacter pylori infection was found in 259 cases (12.76%). There were no significant differences between the two genders regarding the prevalence of H. pylori infection (P = 0.094). This infection was more common in patients aged > 10 years (P < 0.001) and in residents of the Isfahan suburb (P < 0.001). Conclusions: In comparison to other locations, we found a similar incidence rate of H. pylori infection in children. According to our findings, greater ages are associated with a higher detection rate of H. pylori infection.
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Setshedi M, Watermeyer G. The impact of Helicobacter pylori and intestinal helminth infections on gastric adenocarcinoma and inflammatory bowel disease in Sub-Saharan Africa. Front Med (Lausanne) 2022; 9:1013779. [PMID: 36569142 PMCID: PMC9780450 DOI: 10.3389/fmed.2022.1013779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
Gastric adenocarcinoma (GCA) is the 5th leading cancer globally with an estimated 1.1 million cases reported in 2020. Ninety percent of non-cardia GCAs are attributable to Helicobacter pylori (H. pylori), the most prevalent bacterial infection globally. Rates of H. pylori infection are highest in Sub-Saharan Africa (SSA), yet surprisingly low numbers of GCAs are reported in the region. A similar phenomenon is seen with the inflammatory bowel diseases (IBD), Crohn's disease, and ulcerative colitis. These disorders have risen dramatically over the past century in high income countries across the globe, with sharp increases noted more recently in newly industrialized regions. In contrast IBD is rare in most regions in SSA. For both diseases this may reflect under-reporting or limited access to diagnostic modalities, but an alternative explanation is the high burden of infection with gastrointestinal parasites endemic to SSA which may attenuate the risk of developing GCA and IBD. In this mini review we discuss the complex interplay between these microorganisms, GCA, and IBD, as well as a possible protective role of H. pylori and the development of IBD.
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Oraijah AA, Shaqhan MH, Alhebshi FA, Alsuwat RW, Algethami AH, Alsofyani AH, Ozayzan A, Altowairqi SA, Alqurashi HH. Prevalence of Helicobacter pylori infection among patients with dyspepsia and other gastrointestinal diseases in King Abdulaziz Specialized Hospital in Taif. J Family Med Prim Care 2022; 11:6493-6498. [PMID: 36618210 PMCID: PMC9810908 DOI: 10.4103/jfmpc.jfmpc_1351_22] [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] [Received: 07/02/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction To estimate the prevalence of H. pylori in patients with dyspepsia as well as the prevalence of cancerous and precancerous nonmalignant lesions in patients with H. pylori. Methods A retrospective cohort study has been conducted at King Abdulaziz Specialist Hospital (KAASH), Ministry of Health (MOH) in Taif city in the Western province of Saudi Arabia among patients who underwent endoscopy between July 2019 and July 2021. Data were collected from the endoscopy log book and consisted of four sections; demographic data (age and gender), presenting symptoms and indications of endoscopy, endoscopic findings, and histopathological findings in endoscopic biopsies. Results The study included 680 patients. Their age ranged between 12 and 97 years with an arithmetic mean of 40.9 years and a standard deviation of 16.4 years. The prevalence of dyspepsia was 45.9% while that of H. pylori was 32.5%. The prevalence of H. pylori among patients with dyspepsia was 30.1% compared with 34.5% among those without dyspepsia, P > 0.05. The prevalence rates of H. pylori among male and female patients were 32.3% and 32.7%, respectively, P > 0.05. The prevalence rate of H. pylori was highest among patients aged between 41 and 60 years (38.7%) and lowest among those aged over 60 years (19.5%), P = 0.005. Active chronic gastritis was reported among almost two-thirds (65.6%) of patients with H. pylori compared with only 9.8% of those without H. pylori, P < 0.001. Conclusion The H. pylori was a common health problem among patients suffering from dyspepsia, however, its prevalence was relatively lower than other rates reported from other developing countries.
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Affiliation(s)
- Abrar A. Oraijah
- Internal Medicine Resident, Ministry of Health, Taif, Saudi Arabia,Address for correspondence: Dr. Abrar A. Oraijah, Internal Medicine Resident, Ministry of Health, Taif, Saudi Arabia. E-mail: a.a.oraijah@hotmail
| | - Mohammed H. Shaqhan
- Adult Gastroenterology and Endoscopy, Ministry of Health, Taif, Saudi Arabia
| | | | - Rawan W. Alsuwat
- Internal Medicine Resident, Ministry of Health, Taif, Saudi Arabia
| | | | - Afnan H. Alsofyani
- Adult Gastroenterology and Endoscopy, Ministry of Health, Taif, Saudi Arabia
| | - Angham Ozayzan
- Internal Medicine Resident, Ministry of Health, Taif, Saudi Arabia
| | | | - Hesham H. Alqurashi
- Adult Gastroenterology and Endoscopy, Ministry of Health, Taif, Saudi Arabia
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Tran V, Saad T, Tesfaye M, Walelign S, Wordofa M, Abera D, Desta K, Tsegaye A, Ay A, Taye B. Helicobacter pylori (H. pylori) risk factor analysis and prevalence prediction: a machine learning-based approach. BMC Infect Dis 2022; 22:655. [PMID: 35902812 PMCID: PMC9330977 DOI: 10.1186/s12879-022-07625-7] [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] [Received: 08/18/2021] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background Although previous epidemiological studies have examined the potential risk factors that increase the likelihood of acquiring Helicobacter pylori infections, most of these analyses have utilized conventional statistical models, including logistic regression, and have not benefited from advanced machine learning techniques. Objective We examined H. pylori infection risk factors among school children using machine learning algorithms to identify important risk factors as well as to determine whether machine learning can be used to predict H. pylori infection status. Methods We applied feature selection and classification algorithms to data from a school-based cross-sectional survey in Ethiopia. The data set included 954 school children with 27 sociodemographic and lifestyle variables. We conducted five runs of tenfold cross-validation on the data. We combined the results of these runs for each combination of feature selection (e.g., Information Gain) and classification (e.g., Support Vector Machines) algorithms. Results The XGBoost classifier had the highest accuracy in predicting H. pylori infection status with an accuracy of 77%—a 13% improvement from the baseline accuracy of guessing the most frequent class (64% of the samples were H. Pylori negative.) K-Nearest Neighbors showed the worst performance across all classifiers. A similar performance was observed using the F1-score and area under the receiver operating curve (AUROC) classifier evaluation metrics. Among all features, place of residence (with urban residence increasing risk) was the most common risk factor for H. pylori infection, regardless of the feature selection method choice. Additionally, our machine learning algorithms identified other important risk factors for H. pylori infection, such as; electricity usage in the home, toilet type, and waste disposal location. Using a 75% cutoff for robustness, machine learning identified five of the eight significant features found by traditional multivariate logistic regression. However, when a lower robustness threshold is used, machine learning approaches identified more H. pylori risk factors than multivariate logistic regression and suggested risk factors not detected by logistic regression. Conclusion This study provides evidence that machine learning approaches are positioned to uncover H. pylori infection risk factors and predict H. pylori infection status. These approaches identify similar risk factors and predict infection with comparable accuracy to logistic regression, thus they could be used as an alternative method. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07625-7.
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Affiliation(s)
- Van Tran
- Department of Mathematics, Colgate University, 13 Oak Dr., Hamilton, NY, USA
| | - Tazmilur Saad
- Department of Mathematics, Colgate University, 13 Oak Dr., Hamilton, NY, USA
| | - Mehret Tesfaye
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sosina Walelign
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Moges Wordofa
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dessie Abera
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassu Desta
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmet Ay
- Department of Mathematics, Colgate University, 13 Oak Dr., Hamilton, NY, USA. .,Department of Biology, Colgate University, 13 Oak Dr., Hamilton, NY, USA.
| | - Bineyam Taye
- Department of Biology, Colgate University, 13 Oak Dr., Hamilton, NY, USA.
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Chia SPS, Kong SLY, Pang JKS, Soh BS. 3D Human Organoids: The Next "Viral" Model for the Molecular Basis of Infectious Diseases. Biomedicines 2022; 10:1541. [PMID: 35884846 PMCID: PMC9312734 DOI: 10.3390/biomedicines10071541] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic has driven the scientific community to adopt an efficient and reliable model that could keep up with the infectious disease arms race. Coinciding with the pandemic, three dimensional (3D) human organoids technology has also gained traction in the field of infectious disease. An in vitro construct that can closely resemble the in vivo organ, organoid technology could bridge the gap between the traditional two-dimensional (2D) cell culture and animal models. By harnessing the multi-lineage characteristic of the organoid that allows for the recapitulation of the organotypic structure and functions, 3D human organoids have emerged as an essential tool in the field of infectious disease research. In this review, we will be providing a comparison between conventional systems and organoid models. We will also be highlighting how organoids played a role in modelling common infectious diseases and molecular mechanisms behind the pathogenesis of causative agents. Additionally, we present the limitations associated with the current organoid models and innovative strategies that could resolve these shortcomings.
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Affiliation(s)
- Shirley Pei Shan Chia
- Disease Modeling and Therapeutics Laboratory, ASTAR Institute of Molecular and Cell Biology, Singapore 138673, Singapore; (S.P.S.C.); (S.L.Y.K.); (J.K.S.P.)
- Department of Biological Sciences, National University of Singapore, 16 Science Drive 4, Singapore 117558, Singapore
| | - Sharleen Li Ying Kong
- Disease Modeling and Therapeutics Laboratory, ASTAR Institute of Molecular and Cell Biology, Singapore 138673, Singapore; (S.P.S.C.); (S.L.Y.K.); (J.K.S.P.)
- Department of Biological Sciences, National University of Singapore, 16 Science Drive 4, Singapore 117558, Singapore
| | - Jeremy Kah Sheng Pang
- Disease Modeling and Therapeutics Laboratory, ASTAR Institute of Molecular and Cell Biology, Singapore 138673, Singapore; (S.P.S.C.); (S.L.Y.K.); (J.K.S.P.)
- Department of Biological Sciences, National University of Singapore, 16 Science Drive 4, Singapore 117558, Singapore
| | - Boon-Seng Soh
- Disease Modeling and Therapeutics Laboratory, ASTAR Institute of Molecular and Cell Biology, Singapore 138673, Singapore; (S.P.S.C.); (S.L.Y.K.); (J.K.S.P.)
- Department of Biological Sciences, National University of Singapore, 16 Science Drive 4, Singapore 117558, Singapore
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Helicobacter pylori Infection in a Pediatric Population from Romania: Risk Factors, Clinical and Endoscopic Features and Treatment Compliance. J Clin Med 2022; 11:jcm11092432. [PMID: 35566557 PMCID: PMC9099726 DOI: 10.3390/jcm11092432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/17/2022] [Accepted: 04/22/2022] [Indexed: 12/18/2022] Open
Abstract
Background and Objectives: The aim of this study was to investigate the association between H. pylori positivity with specific symptoms, risk factors and endoscopic patterns among the pediatric population in northeastern Romania. Materials and Methods: A prospective study was performed in 18 months on 185 children aged 6−18 years with an indication for upper digestive endoscopy. Demographic, anamnestic, symptomatic, endoscopic and histologic data were recorded. Results: Of 116 H. pylori-positive children, the most affected group was 15−17 years. Most (65.5%) of them were girls, with a significant association (p < 0.001). The majority (66.4%) lived in a rural area and 47.4% of children had an unsafe source of water and lived in overcrowded houses with no basic sanitary comfort. The most frequent symptom was epigastric pain (56.9%), and the main endoscopic appearance was nodularity and hyperemia. Patients diagnosed with H. pylori started triple-therapy treatment for 14 days. Only 13.8% stopped the treatment, mainly because of a misunderstanding of the treatment protocol (9.5%). Conclusions: Romanian teen girls living in rural areas are at high risk for H. pylori infection. Epigastric pain and endoscopic nodularity of the gastric mucosa were associated with the infection. As the resistance of the bacteria is unknown in our country, future research is needed in order to improve the eradication rate.
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Nasri P, Saneian H, Famouri F, Khademian M, Salehi F. Helicobacter pylori infection in pediatrics with gastrointestinal complaints. INTERNATIONAL JOURNAL OF PHYSIOLOGY, PATHOPHYSIOLOGY AND PHARMACOLOGY 2022; 14:118-123. [PMID: 35619660 PMCID: PMC9123471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Helicobacter pylori is one of the most important pathogenic bacteria in gastric mucosa both in adults and pediatrics. Here we aimed to investigate the prevalence of Helicobacter pylori in pediatrics with gastrointestinal complaints by the endoscopic method and using pathology reports. METHODS This is a cross-sectional study that was performed in 2019-2020 in Imam Hossein hospital affiliated to Isfahan University of Medical Sciences on medical documents of pediatrics that underwent gastric or duodenal biopsy via endoscopy. We collected data regarding patients' age, gender, place of residence, type of gastrointestinal complaints, and prevalence of Helicobacter pylori infection from the medical reports. We also investigated the possible correlation between the presence of Helicobacter pylori and the type of complaints among patients. RESULTS A total number of 400 pediatrics entered the study. Abdominal pain was the most common complaint (42%). Helicobacter pylori infection was found in 31 cases (7.8%). The prevalence of Helicobacter pylori infection in boys (10.7%) was significantly higher than in girls (4.6%) (P = 0.02) and was significantly related to the age group of children (P<0.001) in the way that Helicobacter pylori infection was more common in higher ages. There was no significant relationship between the prevalence of Helicobacter pylori infection and the type of complaint (P = 0.29). CONCLUSION We showed that the prevalence of Helicobacter pylori infection is low among pediatrics with gastrointestinal complaints and this issue could cast doubt on the high prevalence rates and importance of this infection in children.
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Affiliation(s)
- Peiman Nasri
- Metabolic Liver Disease Research Center, Isfahan University of Medical SciencesIsfahan, Iran
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical SciencesIsfahan, Iran
| | - Hossein Saneian
- Metabolic Liver Disease Research Center, Isfahan University of Medical SciencesIsfahan, Iran
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical SciencesIsfahan, Iran
| | - Fatemeh Famouri
- Metabolic Liver Disease Research Center, Isfahan University of Medical SciencesIsfahan, Iran
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical SciencesIsfahan, Iran
| | - Majid Khademian
- Metabolic Liver Disease Research Center, Isfahan University of Medical SciencesIsfahan, Iran
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical SciencesIsfahan, Iran
| | - Fatemeh Salehi
- School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
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Yuan C, Adeloye D, Luk TT, Huang L, He Y, Xu Y, Ye X, Yi Q, Song P, Rudan I. The global prevalence of and factors associated with Helicobacter pylori infection in children: a systematic review and meta-analysis. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:185-194. [PMID: 35085494 DOI: 10.1016/s2352-4642(21)00400-4] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Synthesised data on the prevalence of, and factors associated with, paediatric Helicobacter pylori infection at the global level remain scarce. We aimed to estimate the global prevalence of H pylori infection and its associated factors in children and adolescents. METHODS In this systematic review and meta-analysis, we searched PubMed, Embase, MEDLINE, and Scopus for observational population-based studies published between database inception and Oct 25, 2021, without language or geographical restrictions. We included studies that reported the prevalence of H pylori infection in children aged 18 years or younger. Records were screened and data were extracted using a standardised extraction form. We estimated the worldwide prevalence of H pylori infection in children (our main outcome) using multilevel mixed-effects meta-regression and then stratified prevalence by diagnostic method (serology vs urea breath tests or stool antigen tests). We analysed the significance of associated factors using a random-effects meta-analysis. This study is registered in PROSPERO, CRD42020209717. FINDINGS We identified 3181 records, of which 198 articles with 632 data points from 152 650 children were included. The overall global prevalence of H pylori infection in children was 32·3% (95% CI 27·3-37·8), which varied by diagnostic test (28·6% [23·0-35·0] for serology vs 35·9% [29·2-43·2] for urea breath tests or stool antigen tests). Regardless of diagnostic test, the prevalence of H pylori infection was significantly higher in low-income and middle-income countries than in high-income countries (43·2% [36·5-50·2] vs 21·7% [16·9-27·4]; p<0·0001) and in older children than in younger children (41·6% [35·6-47·8] in 13-18-year-olds vs 33·9% [28·6-39·7] in 7-12-year-olds vs 26·0% [21·4-31·0] in 0-6-year-olds; p<0·0001). Paediatric H pylori infection was significantly associated with lower economic status (odds ratio [OR] 1·63 [95% CI 1·46-1·82]), more siblings or children (1·84 [1·44-2·36]), room sharing (1·89 [1·49-2·40]), no access to a sewage system (1·60 [1·22-2·10]), having a mother infected with H pylori (3·31 [2·21-4·98]), having a sibling or siblings infected with H pylori (3·33 [1·53-7·26]), drinking unboiled or non-treated water (1·52 [1·32-1·76]), and older age (OR per year 1·27 [1·15-1·40]). INTERPRETATION H pylori infection is still highly prevalent in children and adolescents globally. Our findings can help to guide further research and the development and implementation of preventive and therapeutic measures to reduce H pylori infection in children. FUNDING None.
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Affiliation(s)
- Changzheng Yuan
- School of Public Health, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Centre for Child Health, Zhejiang University School of Medicine, Hangzhou, China; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Davies Adeloye
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Tzu Tsun Luk
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Liyan Huang
- School of Public Health, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Centre for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yusa He
- School of Public Health, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Centre for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunhan Xu
- Department of Maternal and Child health, School of Public Health, Peking University, Beijing, China
| | - Xinxin Ye
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Yi
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Mehata S, Parajuli KR, Pant ND, Rayamajhee B, Yadav UN, Mehta RK, Jha P, Mehta N, Dhimal M, Singh DR. Prevalence and correlates of Helicobacter pylori infection among under-five children, adolescent and non-pregnant women in Nepal: Further analysis of Nepal national micronutrient status survey 2016. PLoS Negl Trop Dis 2021; 15:e0009510. [PMID: 34153049 PMCID: PMC8263064 DOI: 10.1371/journal.pntd.0009510] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/07/2021] [Accepted: 05/27/2021] [Indexed: 12/11/2022] Open
Abstract
Most of the Helicobacter pylori infections occur in developing countries. The risk factors for H. pylori infections are poverty, overcrowding, and unhygienic conditions, which are common problems in under-privileged countries such as Nepal. Despite having a high risk of H. pylori infections, no national level study has been conducted to assess prevalence and correlates of H. pylori infection in Nepal. Therefore, we hypothesized that micronutrients such as iron, vitamin B12 deficiency, socio-economic status, and nutritional status correlate with the prevalence of H. pylori infection in Nepal. We studied prevalence and correlates of H. pylori infection among under-five children, adolescents aged 10–19 years and married non-pregnant women aged 20–49 years using data from the Nepal National Micronutrient Status Survey 2016 (NNMSS-2016). H. pylori infection was examined in stool of 6–59 months old children and 20–49 years old non-pregnant women whereas the rapid diagnostic kit using blood sample was used among adolescent boys and girls. Prevalence of H. pylori infection was 18.2% among 6–59 months old children, 14% among adolescent boys and 16% among adolescent girls aged 10–19 years; and 40% among 20–49 years non-pregnant women. Poor socioeconomic status, crowding, and unhygienic condition were found to be positively associated with higher incidence of H. pylori infections. No significant correlation was observed between nutritional and micronutrients status (iron or risk of folate deficiency) with H. pylori infection. Findings from this study suggest that poverty-associated markers are primary contributors of H. pylori infections in Nepalese communities. To control acquisition and persistence of H. pylori infection in Nepal, we suggest improved management of safe drinking water and implementation of sanitation and hygiene programs, with a focus on those of lower socioeconomic status. Helicobacter pylori is associated with a wide spectrum of gastrointestinal diseases and is a common problem in tropical region where inter-human contact is the primary mode of disease transmission. Poor socio-economic status is a crucial fueling factor of H. pylori infection. In this study, the authors present data from Nepal national micronutrient status survey 2016 (NNMSS-2016) and investigated the risk factors associated with H. pylori infections among under-five years old children, 10–19 years old adolescent boys and girls, and 20–49 years non-pregnant women nationwide. Study findings corroborate that poverty-associated markers are the key driving factor of H. pylori infections in Nepal, which can have a manifold effect on nutrition and subsequent child growth retardation. Management of safe drinking water and implementation of sanitation and hygiene practices to decrease acquisition of H. pylori infection is a pressing need in rural parts of Nepal and among marginalized communities. The findings of this study highlight the varied prevalence of H. pylori by age group, gender, place of residence, ethnic group, and ecological regions of the country. Moreover, no significant correlation was observed between nutritional and micronutrients status with H. pylori infection.
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Affiliation(s)
- Suresh Mehata
- Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
- * E-mail:
| | - Kedar Raj Parajuli
- Nutrition Section, Family Welfare Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | | | - Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and health Sciences, UNSW, Sydney, Australia
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
- School of population Health, UNSW, Sydney, Australia
- Centre for Research Policy and Implementation, Biratnagar, Nepal
- Department of Public Health, Torrens University, Sydney, Australia
| | | | - Priya Jha
- Nepal Health Professional Council, Kathmandu, Nepal
| | - Neha Mehta
- Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | - Dipendra Raman Singh
- Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
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13
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Mezmale L, Polaka I, Rudzite D, Vangravs R, Kikuste I, Parshutin S, Daugule I, Tazhedinov A, Belikhina T, Igissinov N, Park JY, Herrero R, Leja M. Prevalence and Potential Risk Factors of Helicobacter pylori Infection among Asymptomatic Individuals in Kazakhstan. Asian Pac J Cancer Prev 2021; 22:597-602. [PMID: 33639679 PMCID: PMC8190350 DOI: 10.31557/apjcp.2021.22.2.597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/25/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infection is associated with several risk factors such as demographic, socioeconomic status and personal habits, which vary in different populations. This is the most up-to-date data on H. pylori prevalence and potential risk factors for H. pylori infection among asymptomatic middle-aged individuals in Kazakhstan. METHODS Apparently healthy individuals aged 40 to 64, who took part in the health control in the outpatient clinic, were invited to participate in the study; answered a questionnaire, donated a blood sample. The antibodies to H. pylori were analysed by latex agglutination method. The baseline characteristics of study subjects with or without H. pylori infection were compared using the Chi-square test. Odds ratio (OR) and 95% confidence intervals (CI) for the association between H. pylori infection and potential risk factors were estimated using multivariable logistic regression models. RESULTS Altogether 166 subjects (59% male; the median age - 51 years old) were included; 104 (62.7%) were H. pylori positive. There were no statistically significant differences between H. pylori positive and H. pylori negative groups in respect to the gender, anthropometric measurements, socioeconomic factors and personal habits. The multiple variable analysis showed that age (OR, 1.99; 95% CI, 1.03 - 3.86; P=0.04) and increased salt intake (OR, 2.21; 95% CI, 1.12 - 4.35; P=0.02) were associated with H. pylori infection. CONCLUSIONS More than half of the study subjects were infected with H. pylori in Kazakhstan. The prevalence of H. pylori infection was independently associated with older age and regular high salt consumption.
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Affiliation(s)
- Linda Mezmale
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
- Faculty of Medicine, University of Latvia, Riga, Latvia.
- Riga East University Hospital, Riga, Latvia.
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Reinis Vangravs
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
- Faculty of Medicine, University of Latvia, Riga, Latvia.
- Digestive Disease Centre GASTRO, Riga, Latvia.
| | - Sergei Parshutin
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
| | - Ilva Daugule
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
- Faculty of Medicine, University of Latvia, Riga, Latvia.
| | | | | | - Nurbek Igissinov
- Astana Medical University, Nur-Sultan, Kazakhstan.
- Central Asian Cancer Institute, Nur-Sultan, Kazakhstan.
- Eurasian Institute For Cancer Research, Bishkek, Kyrgyzstan.
| | - Jin Young Park
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France.
| | - Rolando Herrero
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France.
- Agencia Costarricense de Investigaciones Biomédicas, San José, Costa Rica.
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.
- Faculty of Medicine, University of Latvia, Riga, Latvia.
- Riga East University Hospital, Riga, Latvia.
- Digestive Disease Centre GASTRO, Riga, Latvia.
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Altamimi E, Alsharkhat N, AlJawarneh A, Abu Hamad MR, Assi AA, Alawneh S, Al-Ahmad M. Declining prevalence of Helicobacter pylori infection in Jordanian children, report from developing country. Heliyon 2020; 6:e04416. [PMID: 32715122 PMCID: PMC7378580 DOI: 10.1016/j.heliyon.2020.e04416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 04/20/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Helicobacter pylori (H. pylori) is a Gram-negative bacteria that is harbored in the stomach and linked to chronic gastritis, peptic ulcer disease, and gastric malignancy. Most Helicobacter infections are acquired during early infancy. This study aimed to establish the prevalence of H. pylori infection in Jordanian children using the 13C-urea breath test. MATERIALS AND METHODS We prospectively enrolled children between the ages of 4 and 17 years from April 2019 to July 2019. Enrolled children were patients with nongastrointestinal complaints at the pediatric clinics of two hospitals and at community centers caring for healthy children in Irbid, Jordan. Questionnaires obtaining data on sociodemographics, clinical symptomatology, and hygienic risk factors were completed. Recruited children underwent a urea breath test (UBT). RESULTS Of 340 children who were recruited, 328 (96.5%) were included in the final analysis. The mean age (±standard deviation) was 9.56 (±3.98) years (range, 4.0-17 years), and 168 (51.2%) were males. Only 48 children (14.6%) tested positive. There were no gender differences. Living in an urban area and a family history of previous H. pylori infection were risk factors for the acquisition of infection (P = 0.007 and 0.001, respectively). Although gastrointestinal symptoms were more common in H. pylori-infected children, only hiccups and constipation were statistically significant (P = 0.035 and 0.038, respectively). CONCLUSION H. pylori infects at least 15% of Jordanian children, suggesting a significant drop in infection rates in this group. Larger-scale studies combined with clinical evaluations will be important for further understanding the reasons for the observed decrease in H. pylori infections in Jordanian children.
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Affiliation(s)
- Eyad Altamimi
- Pediatric Department, Jordan University of Science and Technology, Irbid, Jordan
- Pediatric Department, King Abdullah University Hospital, Irbid, Jordan
| | | | | | | | - Anas Abu Assi
- King Hussein Cancer Foundation and Center, Amman, Jordan
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15
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Miyamoto R, Okuda M, Lin Y, Murotani K, Okumura A, Kikuchi S. Rapidly decreasing prevalence of Helicobacter pylori among Japanese children and adolescents. J Infect Chemother 2019; 25:526-530. [DOI: 10.1016/j.jiac.2019.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/24/2019] [Accepted: 02/21/2019] [Indexed: 12/17/2022]
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16
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Boyanova L, Hadzhiyski P, Markovska R, Yaneva P, Yordanov D, Gergova G, Mitov I. Prevalence of Helicobacter pylori is still high among symptomatic Bulgarian children. Acta Microbiol Immunol Hung 2019; 66:255-260. [PMID: 30585499 DOI: 10.1556/030.65.2018.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Helicobacter pylori positivity was assessed among 656 symptomatic children in 2010-2017. Overall infection prevalence was 24.5% and a significantly higher rate was detected in girls (28.5%) compared to boys (20.0%). Moreover, in children with duodenal ulcer, H. pylori prevalence was higher (47.4%) compared with the rest (23.9%). On the contrary, the infection was detected 1.9-fold less frequently in patients with GERD (14.5%) compared with the other (27.0%) patients and 2.1-fold less often in the presence of duodenogastric reflux (bile) reflux (13.0%) compared with the absence of the reflux (27.0%). No significant difference was observed between the younger (aged ≤7 years, 20.0%) and the older (aged 8-18 years, 25.5%) patients. H. pylori infection rate in Bulgarian pediatric patients between 2010 and 2017 was 2.5-fold lower than that in 1996-2006. In conclusion, H. pylori infection is still an important concern for Bulgarian children, although having decreased by about 1.8%/yearly over 21 years. This study reveals the importance of H. pylori diagnostics even in the youngest symptomatic children and demonstrates an inverse association between either GERD or bile reflux and H. pylori infection.
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Affiliation(s)
- Lyudmila Boyanova
- 1 Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | - Petyo Hadzhiyski
- 2 Specialized Hospital for Active Pediatric Treatment, Medical University of Sofia, Sofia, Bulgaria
| | - Rumyana Markovska
- 1 Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | - Penka Yaneva
- 2 Specialized Hospital for Active Pediatric Treatment, Medical University of Sofia, Sofia, Bulgaria
| | - Daniel Yordanov
- 1 Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | - Galina Gergova
- 1 Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | - Ivan Mitov
- 1 Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
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Maxim R, Pleşa A, Stanciu C, Gîrleanu I, Moraru E, Trifan A. Helicobacter pylori prevalence and risk factors among children with celiac disease. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2019; 30:284-289. [PMID: 30460898 PMCID: PMC6428505 DOI: 10.5152/tjg.2018.18181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND/AIMS The relationship between Helicobacter pylori and celiac disease (CD) remains controversial. The aim of this study was to assess the prevalence and risk factors for H. pylori infection among children diagnosed with CD. MATERIALS AND METHODS This study included 70 patients diagnosed with CD at a tertiary referral center in Romania. Age, gender, and indicators of environmental conditions were evaluated via interviews with the children's caretakers. A multivariable logistic regression analysis was performed to identify the independent predictors for H. pylori infection. RESULTS Of the 70 patients, 37 (52.9%) were females, and the mean age was 4.04±3.26 years. H. pylori infection was diagnosed in 23 (32.8%) patients, of whom 12 (52.1%) were females, and the mean age was 6.2±4.5 years. Of the total number of children with CD and H. pylori infection, 18 (78.2%) had milder forms of enteropathy (Marsh I-II), whereas the remaining 5 (21.7%) had villous atrophy compared to the other 47 (67.2%) patients who were negative for H. pylori-infection and showed more severe intestinal damage. The development of H. pylori infection was independently related to children with one parent only [odd ratio (OR), 9.04; 95% confidence interval (CI), 1.29-62.89; p<0.001], living in houses without sanitary facilities (OR, 3.88; 95% CI, 1.27-14.22; p=0.016), belonging to low-income families (OR, 8.52; 95% CI, 2.52-71.39; p=0.002), and of parents with a prior history of gastritis (OR, 2.68; 95% CI, 1.49-14.50; p=0.004). CONCLUSION Children with CD and H. pylori infection had milder forms of enteropathy compared to children who are negative for H. pylori, suggesting that H. pylori infection may confer some protection against the development of severe degrees of villous atrophy.
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Affiliation(s)
- Roxana Maxim
- Institute of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Alina Pleşa
- Institute of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Carol Stanciu
- Institute of Gastroenterology and Hepatology, FRCP, Iasi, Romania
| | - Irina Gîrleanu
- Institute of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Evelina Moraru
- Institute of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Anca Trifan
- Institute of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
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