Premium
First Detected Helicobacter pylori Infection in Infancy Modifies the Association Between Diarrheal Disease and Childhood Growth in Peru
Author(s) -
Jaganath Devan,
Saito Mayuko,
Gilman Robert H.,
Queiroz Dulciene M.M.,
Rocha Gifone A.,
Cama Vitaliano,
Cabrera Lilia,
Kelleher Dermot,
Windle Henry J.,
Crabtree Jean E.,
Checkley William
Publication year - 2014
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12130
Subject(s) - diarrheal disease , disease , helicobacter pylori , diarrheal diseases , medicine , helicobacter pylori infection , diarrhea , immunology
Background In endemic settings, H elicobacter pylori infection can occur shortly after birth and may be associated with a reduction in childhood growth. Materials and Methods This study investigated what factors promote earlier age of first H . pylori infection and evaluated the role of H . pylori infection in infancy (6–11 months) versus early childhood (12–23 months) on height. We included 183 children near birth from a peri‐urban shanty town outside of L ima, P eru. Field‐workers collected data on socioeconomic status ( SES ), daily diarrheal and breast‐feeding history, antibiotic use, anthropometrics, and H . pylori status via carbon 13‐labeled urea breath test up to 24 months after birth. We used a proportional hazards model to assess risk factors for earlier age at first detected infection and linear mixed‐effects models to evaluate the association of first detected H . pylori infection during infancy on attained height. Results One hundred and forty (77%) were infected before 12 months of age. Lower SES was associated with earlier age at first detected H . pylori infection (low vs middle‐to‐high SES H azard ratio ( HR ) 1.59, 95% CI 1.16, 2.19; p = .004), and greater exclusive breast‐feeding was associated with reduced likelihood ( HR 0.63, 95% CI 0.40, 0.98, p = .04). H . pylori infection in infancy was not independently associated with growth deficits ( p = .58). However, children who had their first detected H . pylori infection in infancy (6–11 months) versus early childhood (12–23 months) and who had an average number of diarrhea episodes per year (3.4) were significantly shorter at 24 months (−0.37 cm, 95% CI , −0.60, −0.15 cm; p = .001). Discussion Lower SES was associated with a higher risk of first detected H . pylori infection during infancy, which in turn augmented the adverse association of diarrheal disease on linear growth.