title: Epidemiology of Helicobacter pylori infection in asymptomatic children: a prospective population-based study from the Czech Republic. Application of a monoclonal-based antigen-in-stool enzyme immunoassay.
abstract: BACKGROUND
  Acquisition of Helicobacter pylori occurs mainly in childhood and is significantly influenced by geographical variations. The aim of this study is to evaluate the prevalence of H. pylori infection in a population-based sample of asymptomatic children in the Czech Republic. Furthermore, this study aims to identify potential risk factors associated with this infection.
  
  
  METHODS
  A prospective, cross-sectional, population-based study was undertaken in 1545 asymptomatic Czech children (aged 0-15 years; male 49.3%). Active H. pylori infection was diagnosed by monoclonal antibody-based antigen-in-stool enzyme immunoassay. Socio-demographic details of each subject were analyzed using a self-administered standardized questionnaire. Multiple regression analysis was performed.
  
  
  RESULTS
  Overall, 7.1% of asymptomatic children were diagnosed with H. pylori infection. Of the infected children, 5.8% lived in the general population. A positive association was found with increasing age, although not with gender. Independent risk factors associated with H. pylori infection in our pediatric population were: the number of children in a household (odds ratio [OR] 4.26; confidence interval [CI] 1.91-9.80); lack of formal education of fathers (OR 0.23; CI 0.18-0.64) and institutionalized children (OR 6.33; CI 2.25-26.50).
  
  
  CONCLUSIONS
  This study of a large cohort of children demonstrated that, independent of gender, H. pylori infection in the Czech Republic is among the lowest reported in Europe. Socioeconomically disadvantaged children, unfortunately, are still at risk of harboring this potentially preventable infection in this low-prevalence region.
authors.affiliation: Department of Paediatrics, Faculty Hospital, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic. sykorajo@fnplzen.cz
authors.forename: Josef
authors.initials: J
authors.lastname: Sýkora
authors.forename: Konrad
authors.initials: K
authors.lastname: Siala
authors.forename: Jana
authors.initials: J
authors.lastname: Varvarovská
authors.forename: Petr
authors.initials: P
authors.lastname: Pazdiora
authors.forename: Renáta
authors.initials: R
authors.lastname: Pomahacová
authors.forename: Michal
authors.initials: M
authors.lastname: Huml
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018153:Czech Republic / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies