A controlled, household-randomized, open-label trial of the effect that treatment of Helicobacter pylori infection has on iron deficiency in children in rural Alaska.
BACKGROUND
Helicobacter pylori infection and iron deficiency are prevalent in disadvantaged populations worldwide. Previous small or uncontrolled studies have reported that successful treatment of H. pylori infection may resolve iron deficiency or anemia.


METHODS
We screened 68% of children 7-11 years old living in 10 western Alaska villages. The 219 children with iron deficiency (serum ferritin level, <22.5 pmol/L [<10 microg/L]) and H. pylori infection (diagnosed on the basis of (13)C-labeled urea breath tests) were enrolled in a household-randomized, unblinded trial. All children received iron supplementation for 6 weeks; children in the intervention group also received a 2-week course of treatment for H. pylori infection plus another 2-week course of treatment if the infection had not resolved at 2 months after treatment initiation.


RESULTS
At 2 months after treatment initiation, 32% of children in the intervention group and 39% of children in the control group had iron deficiency. At 14 months after treatment initiation, 65% of children in the intervention group and 72% of children in the control group had iron deficiency (adjusted relative risk [ARR], 0.90 [95% confidence interval [CI], 0.74-1.1]); in addition, 22% of children in the intervention group and 14% of children in the control group had anemia (ARR, 1.6 [95% CI, 0.86-2.9]). Results were similar when children were compared by H. pylori infection status.


CONCLUSIONS
In a high-prevalence population, treatment and resolution of H. pylori infection did not improve isolated iron deficiency or mild anemia up to 14 months after treatment initiation.
Gessner
Bradford D
BD
Section of Epidemiology, Alaska Division of Public Health, National Center for Infectious Diseases, US Centers for Disease Control and Prevention, Anchorage, 99524, USA. Brad_Gessner@health.state.ak.us
Baggett
Henry C
HC
Muth
Pam T
PT
Dunaway
Eitel
E
Gold
Benjamin D
BD
Feng
Ziding
Z
Parkinson
Alan J
AJ
D000413:Alaska; D018798:Anemia, Iron-Deficiency / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D004359:Drug Therapy, Combination; D005191:Family Characteristics; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D007501:Iron / Q000378:metabolism; D019189:Iron Metabolism Disorders; D008297:Male; D012424:Rural Population; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D007501:Iron