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Presence of Helicobacter pylori in a Sibling is Associated with a Long‐Term Increased Risk of H. pylori Infection in Israeli Arab Children
Author(s) -
Muhsen Khitam,
Athamna Abed,
Bialik Anya,
Alpert Gershon,
Cohen Dani
Publication year - 2010
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/j.1523-5378.2010.00746.x
Subject(s) - helicobacter pylori , medicine , helicobacter pylori infection , sibling , incidence (geometry) , population , immunology , gastroenterology , demography , environmental health , psychology , sociology , developmental psychology , physics , optics
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 .