A MULTIPLE-SITE INVESTIGATION OF SEROPOSITIVITY FOR HELICOBACTER PYLORI IN CHILDREN OF THE US.

Abstract

12 Aim: To determine the prevalence of H. pylori (Hp) IgG seropositivity in children of the US in relation to a number of hygiene and sociodemographic factors. Method: During the period from June 96 - September 97, serum Hp IgG was measured using EIA [EPI, NY] in 236 children(mean age 10.1 yr; range 1-18 yr) who had abdominal pain and/or vomiting and underwent upper GI endoscopy and 355 randomly selected asymptomatic children in 12 children's hospitals in the US and a questionnaire on risk factors and clinical history was completed. Results: The overall seropositivity rate is 10.7% in asymptomatic children and 19.5% in symptomatic children. There are no differences in Hp seropositivity rates in male (14.4%) and female children (14.3%). Hp seropositivity rates increased dramatically between ages of 13-17 years (26.4%) but remained almost unchanged in the ages of 0-12 years. The Hp seropositivity rate was higher in Hispanic and Black groups than in White and other groups. No associations were found between Hp seropositivity rates and the type of water supply, with or without pets in the house, being in day care facilities or not, or ever been fed with food chewed by adults or not. Hp seropositivity of children correlated with their parents' occupations, education levels, and family income. Children whose parents have occupations of higher social levels, more than 12 years of education, and higher annual incomes (>$36,000) have lower Hp seropositivity rate than those whose parents' have lower social level jobs, an education of 12 years or less, and less than $36,000 of annual incomes. Hp seropositivity rates were higher in those children who share a bed with a child or an adult (22.4%) than those who had their own bed or bedroom (13.0%), also those who live in a household with more rather than less persons (18.5% in houses with 5 or more persons and 10.8% in houses with less than 5 persons). These two factors indicate that close physical contact plays a role in the spread of Hp at home.Conclusion: In the US, Hp infection in early childhood occurs mainly within the house since family socioeconomic status plays a major role. In later childhood infection, society may play a big role. During the ages 12-18 years, along with the increase of social activities, teenagers pick up more Hp infection. We suspect high schools may be one of the major places for acquisition of Hp infection in the US.