The seroprevalence of Helicobacter pylori in a referral population of children in the United States.
OBJECTIVE
The purpose of this study was to determine the prevalence of serum antibodies directed against Helicobacter pylori (H. pylori) in children referred to children's hospitals or medical centers throughout the United States.


METHODS
This multisite cross-sectional prospective study involved 992 children from 12 states using a validated anti-H. pylori IgG enzyme immunoassay. The children were recruited into two groups: those without any GI complaints (non-GI referral, n = 619) and those who were referred for endoscopy because of abdominal pain (GI referral, n = 373).


RESULTS
GI referral children had a higher rate of seropositivity (22.5%) than non-GI referral children (14.1%) from the same geographic regions. In both groups, older children were more likely to be seropositive for H. pylori, as were nonwhite children and those with lower socioeconomic status. H. pylori seropositivity rates were higher in GI referral children with four or more household members (relative risk [RR] = 1.47; CI 1.01-2.14). Multivariate analysis controlling for age, ethnicity, and household income, showed that presence of GI symptoms were associated with a nearly 2-fold risk for H. pylori seropositivity (odds ratio = 1.77, CI 1.27-2.47). Epigastric pain (RR = 2.21; CI = 1.33-3.66) and having three or more episodes of abdominal pain in the last 3 months (RR = 0.59, CI = 0.35-0.99) were the only specific symptoms significantly associated with H. pylori seropositivity.


CONCLUSIONS
The H. pylori seropositivity rate of GI referral children with symptoms of abdominal pain was significantly higher. H. pylori infection in early childhood was found to be associated primarily with the child's household size and socioeconomic status.
Chong
Sonny K F
SK
Riley Hospital for Children, Indianapolis, Indiana, USA.
Lou
Qinyuan
Q
Zollinger
Terrell W
TW
Rabinowitz
Simon
S
Jibaly
Rima
R
Tolia
Vasundhara
V
Elitsur
Yoram
Y
Gold
Benjamin D
BD
Rosenberg
Allan
A
Johnson
Abiodun
A
Elkayam
Orit
O
Rosenthal
Philip
P
Gilger
Mark
M
Li
B U K
BU
Peacock
Jeffrey S
JS
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005756:Gastritis / Q000453:epidemiology / Q000821:virology; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D012017:Referral and Consultation; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012698:Serologic Tests; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology