Risk Factors Associated with Helicobacter Pylori Infection in Children with Gastrointestinal Symptoms

Abstract

Background: The main cause of peptic ulcer disease in children is H. pylori, which has also been proven as a carcinogen in human. With an estimated high prevalence and its chronic nature, it is important to determine the risk factors for H. pylori infection. Studies in adults have shown association of H. pylori infection with several risk factors, but research in children is still scarce. Objective: To determine the risk factors associated with H. pylori infection in children with gastrointestinal symptoms. Methods: This was a case-control study in children with gastrointestinal symptoms treated at H. Adam Malik General Hospital in Medan from September 2019 - June 2020. Diagnosis of H. pylori infection was made if one of the diagnostic tests was positive. Data was then collected from parents with a questionnaire guidance and was analysed to determine the association between the risk factors with the incidence of H. pylori infection. Result: A total of 68 children (34 cases and 34 controls) met the criteria as sample. Age range of subjects was between 2-17 years with a median of 12.5 years. Routine hand washing (before eating, after defecation, and when hands were dirty) decreases the risk of H. pylori infection (P = 0.040; OR 0.2; 95%CI 0.4-1.04). History of bottle feeding until more than 2 years old increases the risk of H. pylori infection (P = 0.041; OR 3.59; 95% CI 1.01-12.73). Conclusion: Routine hand washing and a history of bottle feeding until more than 2 years old were associated with the incidence of H. pylori infection.