Decrease in prevalence of Helicobacter pylori infection during a 10-year period in Brazilian children.
BACKGROUND
Decreasing prevalence of H pylori infection has been reported in some countries.


OBJECTIVE
To evaluate the prevalence of Helicobacter pylori infection in a 10-year period in children submitted to upper digestive endoscopy.


METHODS
It was a retrospective observational study. The records of 1,165 endoscopies performed during a 10-year period in a public hospital of the City of São Paulo, SP, Brazil, in patients up to 18-year-old. Only the first endoscopy was considered. Helicobacter pylori infection was defined by the rapid urease test, performed with one fragment of antral mucosa. Chi-square for trend has been estimated to compare Helicobacter pylori prevalence across the period.


RESULTS
The main indication for endoscopy was epigastric pain (47.4%). There were 392 patients with H pylori infection (33.6%), 12.8% being infants, 19.4% toddlers, 28.8% schoolchildren and 46.3% adolescents. Prevalence was 60.47% in the first year of the study and 30.43% in the last. Among the less than 6-year-old patients there was a decrease in infection prevalence from 25% for the 1993--6 period to 14.3% in the 2000--02 period, while among the over 12-year-old patients the decrease was from 55.5% in the first period to 39.6% in the latter. The decrease in H pylori infection prevalence was more intense within patients with epigastric pain, in which prevalence has decreased from 48.2% (92/191) in 1993--6, to 41.9% (65/155) in 1997--9 and 27.7% (57/206) in 2000--02.


CONCLUSIONS
The study suggests a significant decrease in the prevalence of H pylori infection regarding the studied patients. The trend was mainly observed in the younger age group and in patients with epigastric pain.
Kawakami
Elisabete
E
Machado
Rodrigo Strehl
RS
Ogata
Silvio Kazuo
SK
Langner
Marini
M
D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D007223:Infant; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult