Published by : PROFESSIONAL MEDICAL PUBLICATIONS
|April - June 2007 (Part-II)||
Study of the risk factors related with helicobacter
pylori infections in children with peptic ulcer disease
Farid Imanzadeh1, Ali Akbar Sayyari2, Aziz Ighbali3, Hazhir Javaherizadeh4, Naser Valaie5
Objective: Helicobacter pylori is the cause of peptic ulcer and gastroduodenal disease in children and adults. The prevalence of H-pylori infection has increased during past decade. Most of evidence has shown the patients got infected child hood. This study was carried out for recognizing the risk factors of H-pylori in children with gastrointestinal problems who had undergon evaluation endoscopy in Mofid Children Hospital.
Methodology: In this case control study, the number of patients infection and control were 47 in each group. The patient and control groups were matched for age and sex. Demographic variable were registered in information forms. Positive urease test was considered as a patient and negative urease test was considered as control group. All of the risk factors for H-pylori infection were evaluated for both groups and CI in the samples was evaluated with 95% estimation.
Results: The number of family members were 4.1±1.2 in the control group and 5.7±1.2 in the patients group. Attitude were higher in the patients group toward low consumption of fruit, vegetables, liquid vegetables, seed oil, smoking in family, low level education of parents, blood group A and parents dyspepsia. In the all risk factors CI >1.0 and P<0.05.
Conclusion: The consumption of fruit, vegetables, liquid vegetable, seed oil, and negative history of smoking are the reasons for decreasing H-pylori infection in the children and adults.
KEYWORDS: Helicobacter Pylori, Infections, Peptic Ulcer.
Pak J Med Sci May - June 2007 Vol. 23 No. 3 446-448
1. Dr. Farid Imanzadeh
Asstt. Prof. of Pediatric Gastroenterology
2. Dr. Ali Akbar Sayyari
Prof. of Pediatric Gastroenterology
3. Dr. Aziz Ighbali
Resident Department of Pediatrics
4. Dr. Hazhir Javaherizadeh
Resident Department of Pediatrics
5. Dr. Naser Valaie
Department of Biostatistics
1-5: Mofid Children Hospital,
Shahid Behsehti University of Medical Sciences,
Tehran - Iran.
Dr. Hazhir Javaherizadeh,
* Received for Publication: July 17, 2006
* Accepted: December 27, 2006
Helicobacter pylori (H pylori) is a gram negative bacillus responsible for one of the most common infections found in human world wide.1 It is acquired early in life in developing countries and most of the population is infected by the age 10 years.2 More than 50% of children in our country were infected with H pylori.3 There have been some interesting reports published, which have highlighted rather unusual manifestations of H pylori infection in children like protein losing enteropathy,4 diarrhea and malnutrition,5 and iron deficiency anemia.6 This study was carried out to evaluate the risk factors for H pylori infection in children aged 4-14 years old who visited Mofid Children Hospital.
PATIENTS AND METHODS
This case- control study was carried out on the children aged 4-14 years who had gastrointestinal symptom such as epigastric pain, vomiting, heart burn. These children underwent Endoscopy after parent’s consent. The patients who have previous history of antibiotic therapy since last month and history of omeprazole since two weeks ago, and known history of H-pylori were excluded from our study. A total of 47 patients were included in this study and similar number of 47 age and sex matched control were selected. Patient’s data such as age, sex, risk factors were recorded in the questionnaire. Blood group was identified before endoscopy. The children who had positive urease test were classified as patients group and children without positive urease test were classified as control group. All patients had matched with control for age and sex. T-Test and Chi-square were used for data analysis. Odds ratio and Confidence interval with 95% were calculated. Data were analyzed with SPSS for windows.
This study was carried out in 47 patients and 47 controls. The mean age for patients and controls was 9.8±2.9 and 8.5±2.8 years respectively. Two groups were matched for age and sex. Twenty three boys and 24 girls were included in each group. The number of household in control and patients groups were 4.1±1.2 and 5.7±1.2 respectively (p<0.0001). The result of this study for the blood groups and risk factors are shown in Tables-I & II.
This study showed that children with gastrointestinal problem and positive H pylori test have a higher exposure rate for smoking in their family, poor liquid oil diet, poor vegetable and fruit diet, parents low educational level, positive history of dyspepsia in their parents, and blood group A. Hunt et al. reported that household size is a risk factor for H pylori infection.7 Indirect evidence from a number of studies has suggested that transmission may be from mother to child,8 whereas other studies have suggested that transmission is more likely from father to child. Walker et al. Showed that the most common route for H pylori transmission is a person to person route. Salivary secretion and oral contact are the factors for H pylori transmission. The major risk factor for infection is poor socioeconomic conditions in childhood.9-11 Hollander et al reported that unsaturated fatty acid in the daily diet can lower the rate of H. pylori infection via increased mucosal prostaglandin secretion. Some investigations showed that fresh vegetables and fruit has a protective effect against H. pylori infection.12 Kuarta et al reported that smoking related mucosal injury increase rate of H. pylori infection.13 In the current study, the children were the passive smoker and there is no available paper in this regard. Niv et al. Reported that H. pylori infection in person with O blood group has a higher rate than person with A blood group.14 The discrepancy seen in this study may be due to difference in hereditary and genetic specification in children. Smoking restriction and increasing vegetables and fruit consumption will decrease the rate of H. pylori infection.
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14. Niv Y, Fraser G, Delpre G, Neeman A, Leiser A, Samma Z, et al. Helicobacter pylori infection and blood groups. Am J Gasterolenterol 1996;91(1):101-4.
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