Infekce Helicobacter pylori u souborusymptomatických a asymptomatických dětía dospívajících v České republice

Helicobacter pylori Infection in theGroup of Symptomatic and AsymptomaticChildren and Adolescents in the Czech Republic

Background.
There exist only inconsistent results of studies on the relationship between Helicobacter pylori (H.pylori) infection and functional dyspepsia and/or recurrent abdominal pain in children and adolescents. The answercould bring a comparison of the epidemiological features of H. pylori infection between children and adolescentswith dyspepsia and/or recurrent abdominal pain (symptomatic) and without these symptoms (asymptomatic), livingin the Czech republic.Methods and Results. Study includes children and adolescents (2–18 years) with upper gastrointestinal symptomsvisiting paediatric gastroenterology department between 1994 and 1999. Age, sex, socioeconomic level matchedcontrol (asymptomatic) group consisted of children and adolescents visiting the general paediatric service withsymptoms not related to the upper gastrointestinal tract.Demographic and socioeconomic factors, including parent(s)educational level, place of residence, living conditions, type of drinking water and pets in their household wereevaluated. Serum of the children and adolescents was tested for H. pylori IgG by enzyme linked immunosorbentassay. In addition, the symptomatic children and adolescents underwent endoscopic examination and biopsies fromgastric antrum and corpus were taken for the quick urease test, histology/histoscopy, and H. pylori cultivation. H.pylori infection in this group was stated when at least two testswere positive.Altogether 829 children and adolescentswere examined, 624 cases were symptomatic and 205 represented controls (asymptomatic). The prevalence ofinfection was 33 % among symptomatic children vs. 7,5 % among controls (OR = 6.2, p.001) and was similar amongboys and girls (32 % vs. 34,5 %, respectively). H. pylori prevalence increased with age among symptomatic children(10 % for children below 6 years and 37 % between 11 to 16 years) (p.001). In contrary, prevalence tended to fallwith age among asymptomatic children (11% in children below 6 years vs. 6 % in children over 10 years (OR=2.0,95 % CI=0.7-6.2). In both groups, an inverse correlation between H. pylori occurrence and mother’s educational levelwas observed. The H. pylori incidence was 10%among asymptomatic childrenwho drank water frommunicipalwater supply or from a well vs. 3% among those who drank bottled water (OR=4, 95 % CI = 1.1 to 18, p.05).Conclusions. H. pylori infection was more prevalent among symptomatic children and adolescents vs. asymptomaticchildren and adolescents within the same population. H. pylori incidence increased with age among symptomaticchildren and adolescents and tended to fall among controls, showing deep differences between the two groups.Withexception of the bottled water drinking, presence of any other factor studied represented significant risk for acquiringthe H. pylori infection.

Key words:
Helicobacter pylori infection, epidemiology, symptomatic, asymptomatic, children, adolescents. Se.