Helicobacter pylori prevalences and risk factors among school beginners in a German urban center and its rural county.
In 1998, the Helicobacter pylori [(13)C]urea breath test was offered to all school beginners (birth cohort 1991/1992) in the city of Leipzig and in Leipzig County, Germany, to determine the colonization prevalence and potential transmission pathways of the bacterium. A total of 3,347 school beginners participated in the test, and 2,888 parents completed the detailed, self-administered questionnaire. The H. pylori prevalence was 6.5% [95% confidence interval (CI), 5.3-7.6] in the city and 5.7% (CI, 4.2-7.0) in the county. Using cluster analysis (WARD's method, Euclidean distances), we identified different sets of variables (confirmed by multivariate logistic regression analyses [odds ratios (ORs)] that are signficantly associated with H. pylori positivity. Among city children, the risk is significantly increased with contact to a pet hamster (OR = 2.4; 95% CI, 1.2-4.7; p < 0.015) and travels to Asian countries (OR = 3.7; 95% CI, 1.6-8.7; p < 0.002). Among county children, H. pylori positivity increased significantly with drinking of water from nonmunicipal sources (OR = 16.4; 95% CI, 3.1-88.5; p < 0.001), more than 3 children living in a household (OR = 4.2; 95% CI, 1.2-14.6; p < 0.02), and contact with pet hamsters (OR = 2.4; 95% CI, 1.0-5.7; p < 0.04). These data suggest that, in a general population sample, indirect fecal-oral transmission and living conditions are important risk factors in the spread of H. pylori infection. However, clinical symptoms do not necessarily indicate H. pylori positivity.
Herbarth
O
O
Department of Human Exposure Research and Epidemiology, UFZ-Centre for Environmental Research Leipzig-Halle, Leipzig, Germany. herbarth@expo.ufz.de
Krumbiegel
P
P
Fritz
G J
GJ
Richter
M
M
Schlink
U
U
Müller
D M
DM
Richter
T
T
D001944:Breath Tests; D002247:Carbon Isotopes / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012574:Schools; D014505:Urban Population; D014508:Urea / Q000032:analysis
D002247:Carbon Isotopes; D014508:Urea