HELICOBACTER
PYLORI INFECTION IN PRESCHOOL CHILDREN IN
CALI, COLOMBIA
Bravo LE1, Reina JC2, Correa P4,
Alzate A3, Pradilla A3, Mera R4, Fontham E4
Dept. Pathology1,
Pediatrics2, Public Health3, Universidad del Valle,
Cali, Colombia, and Dept. Pathology4, Louisiana State
University, New Orleans, USA
Introduction: Helicobacter pylori (Hp) is the most
common chronic bacterial infection in humnas and is a well-stablished
etiologic component of chronic gastritis, peptic ulcer, and gastric cancer.
While these serious chronic diseases linked to Hp are predominantly of
adult onset, this organism often infects young children in the first 10
years of life. In many populations, high prevalence has been found among
preschool children, particularly those of low socioeconomic status living
in crowded households. We are reporting the prevalence and transmission
risk factors of Hp infection in a group of preschool children who attend 3
day-care centers of low socioeconomic status in Cali, Colombia.
Methods: Using the 13C-Urea Breath Test (13C-UBT)
as a non-invasive means of detecting active Hp infection, we have studied a
cohort of 608 preschool children under 5 years of age, at 4-month intervals
since September 1997. Sociodemogrphic and anthropometric data, and stool Hp
antigen have been collected in each child at the day-care centers. A
special device was designed to emprove the efficiency of the sample
collection in younger children, with very high yields.
Results: Hp infection increases with age, with a
prevalence of 33.6% at age 2 years and 46% at age 5. Z-score values (mean��SD) for nutritional
status parameters (height/age:-0.02��1.01 and
weight/height:-0.08��0.93) were almost identical to the reference
population. Several transmission risk factors were studied. There was a
positive statistically significant correlation (p<0.05) between Hp
infection and lactancy, regular attendance to the day-care center, frequent
use of the swimming pool at home, who takes care of the child while at home
and his age, regular hand washing of the person that takes the child to the
toilet, frequent intake of boiled milk, washing fruits and vegetables, and
intake of unboiled milk. There was no correlation with the number of
persons per room at home, the number of persons sleeping with the child in
the same bed or the presence of pets.
Conclusions: Our data confirm the observations of
other investigators of increasing prevalence of Hp infection with age, and
person-to-person and waterborne transmission.