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Review: Prevalence and dynamics of Helicobacter pylori infection during childhood
Author(s) -
Zabala Torrres Beatriz,
Lucero Yalda,
Lagomarcino Anne J.,
OrellanaManzano Andrea,
George Sergio,
Torres Juan P.,
O'Ryan Miguel
Publication year - 2017
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.12399
Subject(s) - medicine , seroprevalence , helicobacter pylori , helicobacter pylori infection , asymptomatic , meta analysis , cohort , cohort study , prevalence , disease , epidemiology , medline , pediatrics , immunology , serology , biology , antibody , biochemistry
Long‐term persistent Helicobacter pylori infection has been associated with ulceropeptic disease and gastric cancer. Although H. pylori is predominantly acquired early in life, a clear understanding of infection dynamics during childhood has been obfuscated by the diversity of populations evaluated, study designs, and methods used. Aim Update understanding of true prevalence of H. pylori infection during childhood, based on a critical analysis of the literature published in the past 5 years. Methods Comprehensive review and meta‐analysis of original studies published from 2011 to 2016. Results A MEDLINE ® /PubMed ® search on May 1, 2016, using the terms pylori and children, and subsequent exclusion, based on abstract review using predefined criteria, resulted in 261 citations. An Embase ® search with the same criteria added an additional 8 citations. In healthy children, meta‐analysis estimated an overall seroprevalence rate of 33% (95% CI: 27%‐38%). Seven healthy cohort studies using noninvasive direct detection methods showed infection prevalence estimates ranging from 20% to 50% in children ≤5 and 38% to 79% in children >5 years. The probability of infection persistence after a first positive sample ranged from 49% to 95%. Model estimates of cross‐sectional direct detection studies in asymptomatic children indicated a prevalence of 37% (95% CI: 30%‐44%). Seroprevalence, but not direct detection rates increased with age; both decreased with increasing income. The model estimate based on cross‐sectional studies in symptomatic children was 39% (95% CI: 35%‐43%). Conclusions The prevalence of H. pylori infection varied widely in the studies included here; nevertheless, model estimates by detection type were similar, suggesting that overall, one‐third of children worldwide are or have been infected. The few cohort and longitudinal studies available show variability, but most studies, show infection rates over 30%. Rather surprisingly, overall infection prevalence in symptomatic children was only slightly higher, around 40%. Studies including only one positive stool sample should be interpreted with caution as spontaneous clearance can occur.