Seroprevalence of Helicobacter pylori Infection in Children in Northwest Region of Turkey: Relationship with Iron Deficiency Anemia

Abstract

Helicobacter pylori infection shows worldwide distribution, predominantly in countries or regions with poor socioeconomic conditions [1]. Recently, investigators focused on the role of H. pylori, in the development of extragastrointestinal diseases, including iron deficiency anemia (IDA) [2, 3]. IDA is common in the world and its frequency was reported as 37% in Duzce [4] and 6.5–33% [5] in other regions of Turkey, in children. Despite of studies supporting the role of H. pylori infection in the development of IDA [2, 6–10], some studies from developing countries failed to find such association [11–14] and the development of IDA was explained with malnutrition which leads inadequate iron intake besides reduces in the gastric acid barrier that allows bacterial colonization [15]. This study was designed with the aim of investigating H. pylori seroprevalence in children, in Duzce, the northwest region of Turkey and the association with IDA development. A total of 288 asymptomatic children (aged 6 months to 17 years), were screened for anti-H.pylori IgG with ELISA (IBL, Germany) and for IDA. Children were first applied a questionnaire and venous blood was drawn for antibody testing, complete blood count and biochemical tests. The subjects were divided into three groups based on their ages: Group A (6 months to 6 years, n ¼ 26), Group B (7–12 years, n ¼ 89) and Group C (13–17 years, n ¼ 56). Data was evaluated by � 2 test. From a total of 288 children (125 girls—43.4%, 163 boys—56.6%) with the mean age 11.06 years, overall seropositivity of anti-H. pylori IgG antibodies was 23.9%, increasing with age, 4.4%, 39.1%, 56.5% in Groups A, B and C, respectively (� 2 ¼ 16.27, p 0.05) and seropositivity was inversely related to economic status (p 0.05). H. pylori infection prevalences were increasing with age in both groups, 7.7%, 41.0% and 51.3% in Groups A, B, C, respectively, in IDA groups (� 2 ¼ 18.23, p < 0.001) and 0%, 36.7% and 63.3% Groups A, B, C, respectively in controls (� 2 ¼ 27.3, p < 0.001).