Acute Helicobacter pylori infection is followed by an increase in diarrheal disease among Peruvian children.
BACKGROUND
Cohort and case-crossover studies were conducted to evaluate whether new Helicobacter pylori infections are followed by increased diarrhea.


METHODS
Participants were 6-month-old to 12-year-old shantytown residents living near Lima, Peru. Baseline data were collected from community households. Health interviews were completed daily, and sera, drawn every 4 months, were tested for H pylori immunoglobulin G. Diarrhea rates among newly H pylori-infected (seroconverting) children were compared with rates among persistently uninfected and infected children using cohort and case-crossover analyses.


RESULTS
Sera were obtained from 345 children from January 1, 1995, through September 1, 1997. H pylori incidence was 12% per year (36 H pylori infections in 109 866 seronegative days). In adjusted cohort analyses, seroconverters had more diarrhea days (rate ratio: 2.0; 95% confidence interval: 1.6-2.4), episodes, and sick days in the year after infection than did uninfected children; and more diarrhea days and sick days than did persistently infected children. This effect was strongest in the first 2 months. Case-crossover analyses supported these findings.


CONCLUSIONS
Preventing H pylori infection may help reduce pediatric diarrheal disease.
Passaro
D J
DJ
Division of Infectious Diseases and Geographic Medicine, Stanford University Medical Center, Stanford, California, USA. doug@uic.edu
Taylor
D N
DN
Meza
R
R
Cabrera
L
L
Gilman
R H
RH
Parsonnet
J
J
D000208:Acute Disease; D000465:Algorithms; D000704:Analysis of Variance; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018592:Cross-Over Studies; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D015994:Incidence; D007223:Infant; D010568:Peru / Q000453:epidemiology; D011204:Poverty Areas; D012307:Risk Factors
D000907:Antibodies, Bacterial