Inverse association between Helicobacter pylori and pediatric asthma in a high-prevalence population.
BACKGROUND
Helicobacter pylori-associated disease has led to aggressive diagnostic and eradication protocols that are partially responsible for the decrease in prevalence of H. pylori carriage. Recent evidence indicates that in low-prevalence populations, H. pylori may have protective effects on allergic diseases. The aim of this study was to explore the relationship between pediatric asthma and H. pylori infection in a population with high prevalence of H. pylori infection.


METHODS
A national referral laboratory was screened for all (13) C urea breath tests performed in children aged 5-18 years between 2007 and 2008, for patient demographics and physician-diagnosed asthma. Data concerning asthma-associated medication usage were extracted from electronic medical records and databases. Data were analyzed using a stepwise logistic regression model.


RESULTS
During the study period, 6959 patients underwent urea breath testing (average age 12.4±3.5years). Of these, 3175/6959 (45.6%) were positive for H. pylori, and 578/6959 (8.3%) had asthma. Rates of asthma in H. pylori-positive and H. pylori-negative children were 7.3 and 9.1%, respectively (odds ratio 0.82; 95% confidence interval (CI) 0.69-0.98; p=.032). We also confirmed that male gender, urban residence, and age are associated with childhood asthma.


CONCLUSIONS
We demonstrate an inverse association between H. pylori and pediatric asthma in a population with a high prevalence of H. pylori.
Institute of Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva, Israel. nzevit@gmail.com
Noam
N
Zevit
Ran D
RD
Balicer
Herman Avner
HA
Cohen
Dorit
D
Karsh
Yaron
Y
Niv
Raanan
R
Shamir
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology*; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D008297:Male; D015995:Prevalence