title: Exposure to Helicobacter pylori-positive siblings and persistence of Helicobacter pylori infection in early childhood.
abstract: OBJECTIVE
  Cross-sectional studies suggest that Helicobacter pylori may be transmitted between siblings. The present study aimed to estimate the effect of an H pylori-infected sibling on the establishment of a persistent H pylori infection.
  
  
  METHODS
  The authors used data collected from a Texas-Mexico border population from 1998 to 2005 (the "Pasitos Cohort Study"). Starting at age 6 months, H pylori and factors thought to be associated with H pylori were ascertained every 6 months for participants and their younger siblings. Hazard ratios were estimated from proportional hazards regression models with household-dependent modeling.
  
  
  RESULTS
  Persistent H pylori infection in older siblings always preceded persistent infection in younger siblings. After controlling for mother's H pylori status, breast-feeding, antibiotic use, and socioeconomic factors, a strong effect was estimated for persistent H pylori infection in an older sibling on persistent infection in a younger sibling (hazard ratio 7.6, 95% confidence interval 1.6-37], especially when the difference in the age of the siblings was less than or equal to 3 years (hazard ratio 16, 95% confidence interval 2.5-112).
  
  
  CONCLUSIONS
  These results suggest that when siblings are close in age, the older sibling may be an important source of H pylori transmission for younger siblings.
authors.affiliation: University of North Texas Health Science Center, Fort Worth, Canada. Cervantes@unt.edu
authors.forename: Diana T
authors.initials: DT
authors.lastname: Cervantes
authors.forename: Lori A
authors.initials: LA
authors.lastname: Fischbach
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Goodman
authors.forename: Carl V
authors.initials: CV
authors.lastname: Phillips
authors.forename: Shande
authors.initials: S
authors.lastname: Chen
authors.forename: Cheryl S
authors.initials: CS
authors.lastname: Broussard
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D015331:Cohort Studies; D016481:Helicobacter Infections / Q000382:microbiology / Q000635:transmission*; D016480:Helicobacter pylori; D006801:Humans; D007223:Infant; D008800:Mexico; D016016:Proportional Hazards Models; D012307:Risk Factors; D035781:Siblings; D013781:Texas