Abstract
The prevalence of Helicobacter pylori infection is unevenly distributed among different populations. The aim here was to evaluate the factors associated with Helicobacter pylori infection among children up to five years of age living in a high-risk community. Cross-sectional study in an indigenous community of Guarani Mbya ethnicity, Tekoa Ytu and Tekoa Pyau villages, Jaraguá district, city of São Paulo (SP), Brazil. 74 children aged 0.4 to 4.9 years (mean 2.9 ± 1.3 years; median 3.1), and 145 family members (86 siblings, 43 mothers and 16 fathers) were evaluated for Helicobacter pylori infection using the validated 13C-urea breath test. Clinical and demographic data were collected. The prevalence was 8.3% among children aged 1-2 years and reached 64.3% among those aged 4-5 years (P = 0.018; overall 31.1%). The prevalence was 76.7% among siblings and 89.8% among parents. There was a negative association with previous use of antibiotics in multivariate analysis adjusted for age (odds ratio, OR: 0.07; 95% confidence interval, CI: 0.01 to 0.66; P = 0.02). The prevalence was higher among males (OR: 1.55), and was associated with maternal infection (OR: 1.81), infection of both parents (OR: 1.5), vomiting (OR: 1.28), intestinal parasitosis (OR: 2.25), previous hospitalization (OR: 0.69) and breastfeeding (OR: 1.87). The prevalence was high among subjects older than three years of age, thus suggesting that the incidence of infection was higher over the first three years of life. Previous use of antibiotics was inversely associated with current Helicobacter pylori infection.
Highlights
Helicobacter pylori infection is ubiquitous among humans, its prevalence is unevenly distributed among different populations
The present study aimed to evaluate factors associated with Helicobacter pylori infection among children up to five years of age in an urban indigenous community of Guarani ethnicity in the city of São Paulo, Brazil
There was no compliance with the study protocol among these 63 children, in spite of multiple requests made by the study staff
Summary
Helicobacter pylori infection is ubiquitous among humans, its prevalence is unevenly distributed among different populations. The incidence of this infection has declined sharply over the past few decades. Prevalence of under 10% among children has been reported. In Brazil, the prevalence of Helicobacter pylori remains high among deprived urban settlements, rural communities and indigenous communities. Occurrences of Helicobacter pylori are probably due to poor sanitation, allied with poverty.[1,2,3,4,5,6]. We reported that there was high prevalence (73.5%) of this infection among children in six indigenous communities in the Amazon Forest.[6] there is no study evaluating indigenous communities located in urban areas
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