Prevalence of Helicobacter pylori infection in children from an urban community in north-east Brazil and risk factors for infection.

OBJECTIVES: To investigate the prevalence of Helicobacter pylori infection in a randomly selected population of children from a low income community in Brazil and the risk factors for infection.

DESIGN: A cross-sectional, randomised study of prevalence and risk factors.

SUBJECTS: Children living in an urban community in north-east Brazil.

METHODS: H. pylori infection was determined using the C-urea breath test. Risk factors were assessed using a structured interview schedule.

RESULTS: The overall prevalence of H. pylori was 56% (197/353). The infection was most common for those aged 12-14 years. In this group 75.4% (49/65) (95% CI, 63.1-85) of all children were positive for H. pylori, while in children less than 2 years of age 35.1% (13/37) (95% CI, 20.2-52.5) were positive. The prevalence of H. pylori increased significantly with age (P < 0.0001). In the bivariate analysis, a significant difference was found in the prevalence of H. pylori infection and age, number of persons per room, the number of children per household, cup sharing, and type of drinking water (P < 0.05). However, after logistic regression modelling only age (odds ratio (OR) = 1.3; 95% confidence interval (CI), 1.07-1.65), and number of persons per room (OR = 2.58; 95% CI, 1.4-4.6) were risk factors for H. pylori infection.

CONCLUSIONS: H. pylori is highly prevalent among children in a north-eastern Brazilian community characterised by poor living conditions, and this infection is largely acquired during early childhood. The infection increased with age, and domestic overcrowding. Further longitudinal studies must examine in depth the possible modes of transmission of the organism in young children.