Helicobacter pylori infection in children of Texas.
BACKGROUND
Acquisition of the Helicobacter pylori infection usually occurs in childhood. The prevalence of infection differs among ethnic groups and in adults is inversely related to the socioeconomic status of the individual's family during childhood. This study investigates the seroprevalence of H. pylori infection in children of different ethnic groups in relation to socioeconomic class and investigates the prevalence of acute H. pylori infection among children who have had recent onset of abdominal pain.


METHODS
Serum samples were collected from 797 children, aged 6 months to 18 years, of various socioeconomic and ethnic backgrounds, at a large urban children's hospital. H. pylori status was determined by an anti-H. pylori immunoglobulin (Ig)G enzyme-linked immunosorbent assay (ELISA) validated for pediatric use. To determine the prevalence of acute H. pylori infection, children brought to the emergency center with abdominal symptoms without diarrhea and overt signs of acute abdomen were evaluated with both serology and the 13C-urea breath test. Acute H. pylori was defined as a positive 13C-urea breath test result and negative IgG serology for H. pylori.


RESULTS
The overall seroprevalence of H. pylori was 12.2% and increased with age (e.g., 8.3% at 6-11.9 months and 17.9% at 13 years). The prevalence was inversely related to socioeconomic status (6.6%, moderate to high vs. 15%, low socioeconomic status). The difference in seroprevalence among blacks (16.8%), Hispanics (13.3%), and whites (8.3%; P < 0.01) could be accounted for by differences in socioeconomic status. Eighteen percent of children who were evaluated at the emergency center for recent-onset abdominal pain had acute H. pylori infections.


CONCLUSIONS
Socioeconomic status, not ethnic group, is the more important risk factor for acquisition of H. pylori infection during childhood. Acute H. pylori infection was a relatively common cause of recent-onset, nonsurgical abdominal pain.
Opekun
A R
AR
Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital and Veterans Affairs Medical Center, Houston 77030-2399, USA. aopekun@bcm.tmc.edu
Gilger
M A
MA
Denyes
S M
SM
Nirken
M H
MH
Philip
S P
SP
Osato
M S
MS
Malaty
H M
HM
Hicks
J
J
Graham
D Y
DY
D015746:Abdominal Pain / Q000209:etiology*; D000208:Acute Disease; D000367:Age Factors; D000907:Antibodies, Bacterial / Q000097:blood; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007223:Infant; D008297:Male; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D013781:Texas / Q000453:epidemiology
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G