Helicobacter pylori Prevalences and Risk Factors among School Beginners in a German Urban Center and Its Rural County

Environmental Health Perspectives, June, 2001 by Olf Herbarth, Peter Krumbiegel, Gisela J. Fritz, Matthias Richter, Uwe Schlink, Detlef M. Muller, Thomas Richter

The clinical predictors investigated did not seem to be significant in this population (Tables 3 and 5). No significant associations were found for "gastric/duodenal disease," "recurrent abdominal pain," or "recurrent heartburn" in children or in their families. Measurement errors associated with the low within- and between-population occurrence (Table 3) are balanced by the odds ratio analysis that is based on the total population (city and county) with 2,715 complete data sets. These odds ratios and confidence intervals suggest that the errors were minimized (Table 5). The role of clinical symptoms as indicators of H. pylori infection remains controversial (23), but similar findings have been reported indicating that "chronic abdominal pain" in childhood (24,25) may not necessarily indicate H. pylori positivity.

Conclusion

In this study we demonstrated that H. pylon. colonization in this preschool population is significantly related to risk factors such as "contact with pet hamsters," "travels to Asian countries," and "drinking of water from nonmunicipal sources." This suggests that indirect fecal--oral transmission may play a key role in the spread of this infection. These factors appear to be as important as household density, which was found to increase the risk of H. pylori infection when more than three children live in a household. However, relative to these risks, the clinical symptom indicators investigated do not seem to play the same significant role in predicting H. pylon, colonization.

Although, at present, the recommendations of the European Society for Primary Care Gastroenterology do not support a "test and treat" strategy (26), our goal was to show that epidemiologic screenings of population-based, nonsymptomatic children offer information about current prevalences and risk factors, thus, contributing to future recommendations.

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