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Epidemiology of and Factors Associated with Helicobacter Pylori Infection and Proportion Requiring Treatment Among Symptomatic Children in Northwestern Tanzania

Received: 23 February 2024     Accepted: 19 March 2024     Published: 11 April 2024
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Abstract

Background: Helicobacter pylori infection has been reported to affect more than half of the global population. The persistence of H. pylori infection results to chronic gastritis and peptic ulcer disease. Despite this burden there is limited published studies regarding proportion of Helicobacter pylori infected children that require treatment in many settings in low and middle-income countries (LMICs). Therefore this study aimed to determine the epidemiology of and factors associated with Helicobacter pylori infection and proportion requiring treatment among symptomatic children in northwestern Tanzania. Methodology: This was a hospital based cross-sectional study conducted at BMC hospital in Northwestern Tanzania from December 2021 and April 2022 among outpatient children aged 1 to 15 years with gastrointestinal symptoms. The main study outcome (event) was presence of H. pylori infection as evidence by positive stool antigen test. Independent factors associated with H. pylori infection were determined by logistic regression model. The significance level was set at p-value of <0.05. Oesophagogastroduodenoscopy (OGD) was performed to the randomly serially selected representative sample of symptomatic children with positive H. pylori stool antigen test to determine the proportion of children requiring treatment. Results: A total of 422 symptomatic children were included in the study. The median age was 7 [IQR 3 – 10] years. The prevalence of H. pylori infection was 105 (24.9%). More than half of the participants (56.4%) were males. The risk of H. pylori infection was significantly associated with increase in age (OR= 1.09; 95%CI; 1.03 – 1.15; P= 0.002), and abdominal pain (OR=2.2; 95%CI 1.2 – 4.0; P= 0.01). About 55 participants were randomly selected for OGD among 100 children above or equal 2 years of age with positive stool antigen for H. pylori. The majority were found to have lesion warranting treatment. These lesions included gastritis 47 (85.5%), duodenal ulcers 2 (3.6%) and gastric ulcers 1 (1.8%). Conclusion: About a quarter of the enrolled children had H. pylori infection. Increase in age and abdominal pain were independently associated with H. pylori infection. Most H. pylori stool antigen test positive children had endoscopic lesions that warranted treatment. Therefore every H. pylori stool antigen test positive child needs eradication therapy.

Published in American Journal of Pediatrics (Volume 10, Issue 2)
DOI 10.11648/j.ajp.20241002.12
Page(s) 52-62
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Prevalence, Factors, Helicobacter Pylori Infection, Treatment, Symptomatic Children, Tanzania

References
[1] Aitila P, Mutyaba M, Okeny S, Ndawula Kasule M, Kasule R, Ssedyabane F, et al. Prevalence and Risk Factors of Helicobacter pylori Infection among Children Aged 1 to 15 Years at Holy Innocents Children’s Hospital, Mbarara, South Western Uganda. J Trop Med. 2019; 93(3): 1–7. eCollection 2019.
[2] Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017; 153(2): 420-429.
[3] Salih BA. Helicobacter pylori Infection in Developing Countries : The Burden for How Long ? Saudi J Gastroenterol. 2009; 15(3): 201–207.
[4] Bardhan PK. Epidemiological features of Helicobacter pylori infection in developing countries. Clin Infect Dis. 1997; 25(5): 973–8.
[5] Jaka H et al. Prevalence and risk factors associated with Helicobacter pylori infections in Tanzanian children. Catholic University of Health and Allied Sciences. 2016.
[6] Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, et al. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). JPGN. 2017; 64(6): 991–1003.
[7] Leslie Kish New York: John Wiley and Sons Inc. Survey Sampling. Am Polit Sci Rev. 1965; 59(4): 643.
[8] Shimoyama T. Stool antigen tests for the management of Helicobacter pylori infection. World J Gastroenterol. 2013; 19(45): 8188–91.
[9] Awuku YA, Simpong DL, Alhassan IK, Tuoyire DA, Afaa T, Adu P. Prevalence of Helicobacter pylori infection among children living in a rural setting in Sub-Saharan Africa. BMC Public Health. 2017; 17(360): 1–6.
[10] Kirdy FAL, Rajab M. Helicobacter pylori Infection : Clinical, Endoscopic, and Histological Findings in Lebanese Pediatric Patients. Int J Pediatr. 2020; 2020(4648167): 1–5. eCollection 2020.
[11] Galal YS, Ghobrial CM, Labib JR, Abou-zekri ME. Helicobacter pylori among symptomatic Egyptian children : prevalence, risk factors, and effect on growth. J Egypt Public Health Assoc. 2019; 94(17): 1–8.
[12] Hastings E V., Yasui Y, Hanington P, Goodman KJ. Community-driven research on environmental sources of H. pylori infection in arctic Canada. Gut Microbes. 2014; 5(5): 606–17.
[13] Hasosah M, Satti M, Shehzad A, Alsahafi A SG et al. Prevalence and Risk Factors of Helicobacter pylori Infection in Saudi Children: A Three-Year Prospective Controlled Study. Helicobacter. 2015; 20(1): 56–63.
[14] Spee LAA, Madderom MB, Pijpers M, Van Leeuwen Y, Berger MY. Association between Helicobacter pylori and gastrointestinal symptoms in children. Pediatrics. 2010; 125(3): 651–69.
[15] Llanes R, Escobar MP, Gala A, Capo V, Pe GI. Low Prevalence of Helicobacter pylori Among Symptomatic Children from a Hospital in Havana, Cuba. J Trop Pediatr Vol. 2012; 58(3): 231–4.
[16] Bagheri N, Salimzadeh L SH. Microbial Pathogenesis. The role of T helper 1-cell response in Helicobacter pylori -infection. Microb Pthogenes. 2018; 123: 1–8.
[17] Guidelines ACG. H. pylori Stool Antigen Testing Following the 2017 ACG Guidelines for H. pylori diagnosis. 2018; (1): 1–4.
Cite This Article
  • APA Style

    Mkwizu, M., Jaka, H., Mshana, S., Majinge, D., Nkandala, I., et al. (2024). Epidemiology of and Factors Associated with Helicobacter Pylori Infection and Proportion Requiring Treatment Among Symptomatic Children in Northwestern Tanzania. American Journal of Pediatrics, 10(2), 52-62. https://doi.org/10.11648/j.ajp.20241002.12

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    ACS Style

    Mkwizu, M.; Jaka, H.; Mshana, S.; Majinge, D.; Nkandala, I., et al. Epidemiology of and Factors Associated with Helicobacter Pylori Infection and Proportion Requiring Treatment Among Symptomatic Children in Northwestern Tanzania. Am. J. Pediatr. 2024, 10(2), 52-62. doi: 10.11648/j.ajp.20241002.12

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    AMA Style

    Mkwizu M, Jaka H, Mshana S, Majinge D, Nkandala I, et al. Epidemiology of and Factors Associated with Helicobacter Pylori Infection and Proportion Requiring Treatment Among Symptomatic Children in Northwestern Tanzania. Am J Pediatr. 2024;10(2):52-62. doi: 10.11648/j.ajp.20241002.12

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  • @article{10.11648/j.ajp.20241002.12,
      author = {Mwanaidi Mkwizu and Hyasinta Jaka and Stephen Mshana and David Majinge and Igembe Nkandala and Delfina Msanga and Tulla Masoza and Benson Kidenya and Elig Kimosso and Neema Kayange},
      title = {Epidemiology of and Factors Associated with Helicobacter Pylori Infection and Proportion Requiring Treatment Among Symptomatic Children in Northwestern Tanzania
    },
      journal = {American Journal of Pediatrics},
      volume = {10},
      number = {2},
      pages = {52-62},
      doi = {10.11648/j.ajp.20241002.12},
      url = {https://doi.org/10.11648/j.ajp.20241002.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20241002.12},
      abstract = {Background: Helicobacter pylori infection has been reported to affect more than half of the global population. The persistence of H. pylori infection results to chronic gastritis and peptic ulcer disease. Despite this burden there is limited published studies regarding proportion of Helicobacter pylori infected children that require treatment in many settings in low and middle-income countries (LMICs). Therefore this study aimed to determine the epidemiology of and factors associated with Helicobacter pylori infection and proportion requiring treatment among symptomatic children in northwestern Tanzania. Methodology: This was a hospital based cross-sectional study conducted at BMC hospital in Northwestern Tanzania from December 2021 and April 2022 among outpatient children aged 1 to 15 years with gastrointestinal symptoms. The main study outcome (event) was presence of H. pylori infection as evidence by positive stool antigen test. Independent factors associated with H. pylori infection were determined by logistic regression model. The significance level was set at p-value of H. pylori stool antigen test to determine the proportion of children requiring treatment. Results: A total of 422 symptomatic children were included in the study. The median age was 7 [IQR 3 – 10] years. The prevalence of H. pylori infection was 105 (24.9%). More than half of the participants (56.4%) were males. The risk of H. pylori infection was significantly associated with increase in age (OR= 1.09; 95%CI; 1.03 – 1.15; P= 0.002), and abdominal pain (OR=2.2; 95%CI 1.2 – 4.0; P= 0.01). About 55 participants were randomly selected for OGD among 100 children above or equal 2 years of age with positive stool antigen for H. pylori. The majority were found to have lesion warranting treatment. These lesions included gastritis 47 (85.5%), duodenal ulcers 2 (3.6%) and gastric ulcers 1 (1.8%). Conclusion: About a quarter of the enrolled children had H. pylori infection. Increase in age and abdominal pain were independently associated with H. pylori infection. Most H. pylori stool antigen test positive children had endoscopic lesions that warranted treatment. Therefore every H. pylori stool antigen test positive child needs eradication therapy.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Epidemiology of and Factors Associated with Helicobacter Pylori Infection and Proportion Requiring Treatment Among Symptomatic Children in Northwestern Tanzania
    
    AU  - Mwanaidi Mkwizu
    AU  - Hyasinta Jaka
    AU  - Stephen Mshana
    AU  - David Majinge
    AU  - Igembe Nkandala
    AU  - Delfina Msanga
    AU  - Tulla Masoza
    AU  - Benson Kidenya
    AU  - Elig Kimosso
    AU  - Neema Kayange
    Y1  - 2024/04/11
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ajp.20241002.12
    DO  - 10.11648/j.ajp.20241002.12
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 52
    EP  - 62
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20241002.12
    AB  - Background: Helicobacter pylori infection has been reported to affect more than half of the global population. The persistence of H. pylori infection results to chronic gastritis and peptic ulcer disease. Despite this burden there is limited published studies regarding proportion of Helicobacter pylori infected children that require treatment in many settings in low and middle-income countries (LMICs). Therefore this study aimed to determine the epidemiology of and factors associated with Helicobacter pylori infection and proportion requiring treatment among symptomatic children in northwestern Tanzania. Methodology: This was a hospital based cross-sectional study conducted at BMC hospital in Northwestern Tanzania from December 2021 and April 2022 among outpatient children aged 1 to 15 years with gastrointestinal symptoms. The main study outcome (event) was presence of H. pylori infection as evidence by positive stool antigen test. Independent factors associated with H. pylori infection were determined by logistic regression model. The significance level was set at p-value of H. pylori stool antigen test to determine the proportion of children requiring treatment. Results: A total of 422 symptomatic children were included in the study. The median age was 7 [IQR 3 – 10] years. The prevalence of H. pylori infection was 105 (24.9%). More than half of the participants (56.4%) were males. The risk of H. pylori infection was significantly associated with increase in age (OR= 1.09; 95%CI; 1.03 – 1.15; P= 0.002), and abdominal pain (OR=2.2; 95%CI 1.2 – 4.0; P= 0.01). About 55 participants were randomly selected for OGD among 100 children above or equal 2 years of age with positive stool antigen for H. pylori. The majority were found to have lesion warranting treatment. These lesions included gastritis 47 (85.5%), duodenal ulcers 2 (3.6%) and gastric ulcers 1 (1.8%). Conclusion: About a quarter of the enrolled children had H. pylori infection. Increase in age and abdominal pain were independently associated with H. pylori infection. Most H. pylori stool antigen test positive children had endoscopic lesions that warranted treatment. Therefore every H. pylori stool antigen test positive child needs eradication therapy.
    
    VL  - 10
    IS  - 2
    ER  - 

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Author Information
  • Department of Pediatrics and Child Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; Singida Regional Referral Hospital, Singida, Tanzania

  • Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania

  • Department of Clinical Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania

  • Department of Internal Medicine, Bugando Medical Center, Mwanza, Tanzania

  • Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; Department of Internal Medicine, Bugando Medical Center, Mwanza, Tanzania

  • Department of Pediatrics and Child Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania

  • Department of Pediatrics and Child Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania

  • Department of Clinical Biochemistry, Catholic University of Health and Allied Sciences, Mwanza, Tanzania

  • Department of Clinical Laboratory, Bugando Medical Center, Mwanza, Tanzania

  • Department of Pediatrics and Child Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania

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