Helicobacter pylori and the birth cohort effect: evidence of a continuous decrease of infection rates in childhood.
OBJECTIVE
To investigate whether the decrease in rate of Helicobacter pylori infection in subsequent birth cohorts has continued during the last decades.


METHODS
Determination by ELISA of IgG H. pylori antibodies in 314 serum samples from Dutch children (age 6-8 yr, n = 154) and young adolescents (age 12-15 yr, n = 160), collected in 1978 and 1993.


RESULTS
The prevalence of H. pylori declined from 19% to 9% at age 6-8 yr and from 23% to 11% at age 12-15 yr. For the whole study population, a decline from 21% to 10% (p = 0.01) was observed between 1978 and 1993. On the basis of these data and an incidence of infection with H. pylori of 0.3% per year during the same period, a model for both past and future prevalence rates of H. pylori in the Dutch population was calculated. The outcome demonstrates a decrease from more than 50% around World War II to less than 20% for the whole population around year 2040.


CONCLUSIONS
H. pylori infection rates in childhood have continued to decline until recent decades, demonstrating a persistent birth cohort effect. This decline will result in a very low prevalence of H. pylori infection in the Dutch population during the next decades, becoming even lower as the observed decline in children and young adolescents continues.
Roosendaal
R
R
Department of Clinical Microbiology and Infection Control, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Kuipers
E J
EJ
Buitenwerf
J
J
van Uffelen
C
C
Meuwissen
S G
SG
van Kamp
G J
GJ
Vandenbroucke-Grauls
C M
CM
D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D015988:Cohort Effect; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005544:Forecasting; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011159:Population Surveillance; D015995:Prevalence
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G