Frequency of occurrence of H. pylori among children of preschool and school age and its impact on the development of clinical and morphological forms of gastritis

Abstract

The problem of diagnosis and treatment of Helicobacter pylori (Hp) infection in children in the modern world is relevant. Currently, endoscopic examinations such as video esophagogastroduodenoscopy are used not only for visualization of the mucous membranes of the esophagus and stomach, but also for cytological examination for the presence of H. pylori infection. The prevalence of H. pylori varies widely among different geographic areas and within specific regions, as well as depending on age and socioeconomic factors. In low- and middle-income countries or other disadvantaged populations, up to 75 percent of the population is infected, likely due to environmental factors including overcrowding and problems with water sanitation and transmission through the fecal-oral, oral-oral and gastro-oral routes. Among children (<18 years of age), the global prevalence of H. pylori infection rates is 32 to 36%; prevalence ranges from <5% (eg, in Scandinavian countries) to >70 % (eg, in several countries in Africa (Benin, Nigeria) and Latin America, with rates ranging from 30 to 40% in the United States, Canada, and the United Kingdom. When grouped by socioeconomic region (as defined by the World Bank), infection rates among children are approximately 22% in high-income countries and 43% in low- and middle-income countries. Prevalence of H. pylori infection is associated with lower socioeconomic status families in which the child is being raised, a large number of people living in the same household, coresidence, lack of access to a sewer system, unboiled or untreated drinking water, and the presence of household members with H. pylori. Lower prevalence among children compared to adults is likely related to socioeconomic improvements (eg, in infrastructure) rather than to new infections acquired in adulthood. Likewise, socioeconomic factors likely contribute to the decline in H. pylori levels over time in many regions. In some settings, H. pylori infection rates may also be influenced by earlier diagnosis and treatment of H. pylori among adults, due to the increasingly recognized relationship between H. pylori and gastric cancer. H. pylori infection occurs primarily in early childhood. Most infections occur before the age of 10 years, especially in resource-limited countries where infection often occurs before the age of three. For example, a study of Irish children found that the period of greatest risk of infection was before the age of three, and the risk of a new primary infection decreased after the age of five.

Children also have high rates of reinfection once the initial H. pylori infection is eradicated. Reinfection rates are approximately 20% or more in high prevalence populations. Risk factors for reinfection are similar to those for primary infection. For older children, a risk factor for re-infection is household contact with siblings under five years of age. Unlike children, re-infection after successful eradication in adults is rare. In this work, a statistical analysis of the influence of HP infection on the development of stomach diseases among school and preschool children in Astana was carried out.