Publication:

Risk factors and serological diagnosis of Helicobacter pylori infection in children with abdominal pain and vomiting

Background Helicobacter pylori is a Gram-negative bacterium that ranks among the most prevalent chronic infections around the globe. It's closely associated with conditions like gastritis, peptic ulcers, gastric cancer, and mucosa-assisted lymphoid tissue (MALT) lymphoma. Most people get infected during childhood, especially in developing nations, where factors like overcrowding, inadequate sanitation, and unsafe drinking water play a significant role. In Bangladesh, for instance, more than 60% of children are infected by the time they turn two. Getting an accurate diagnosis is essential to minimize complications and enhance the management of gastrointestinal disorders in kids. Objectives of the study were to assess prevalence, risk factors, and diagnostic accuracy of serological testing for Helicobacter pylori infection in symptomatic Bangladeshi children.

Methods This case control study was conducted at the Pediatric Gastroenterology and Nutrition Department, BSMMU, Dhaka from April 2021 to October 2022. A total of 98 children aged 1–18 years with abdominal pain and/or vomiting were enrolled by purposive sampling. Cases were defined by positive anti-H. pylori IgG serology, and controls were seronegative. Data collection included demographic, socioeconomic, clinical, and laboratory variables. Statistical analysis employed statistical package for the social sciences (SPSS) v20, with logistic regression for adjusted associations.

Results Among 96 children, 48 were H. pylori IgG positive. Significant risk factors included low socioeconomic status (50% versus 4.2%, p<0.001), low parental education (27.1% versus 0%, p<0.001), and living in a joint family (52.1% versus 14.6%, p<0.001). Key symptoms in positive patients were dyspepsia (78%), loss of appetite (64%), and pallor (66%, p<0.001). Stool antigen was positive in 82% of seropositive cases, and chronic gastritis was the predominant histological finding (92%).

Conclusions H. pylori infection is common in children with abdominal pain strongly linked to poor socioeconomic, environmental, and vomiting children.