title: Intergenerational reduction in Helicobacter pylori prevalence is similar between different ethnic groups living in a Western city.
abstract: OBJECTIVE
  Helicobacter pylori colonisation rates in childhood have declined in Western populations, but it is unknown whether this trend is similar in children of non-Western ethnic backgrounds, born in a Western country. We aimed to identify H. pylori status in children, and determine mother-to-child transmission and risk factors for colonisation.
  
  
  METHODS
  Antibodies against H. pylori and cytotoxin-associated gene A (CagA) were measured in children participating in a population-based prospective cohort study in Rotterdam, the Netherlands. Information on demographics and characteristics was collected using questionnaires.
  
  
  RESULTS
  We analysed the serum of 4467 children (mean age 6.2 years±0.4 SD) and compared the results with the H. pylori status of their mothers (available for 3185 children). Overall, 438 (10%) children were H. pylori-positive, of whom 142 (32%) were CagA-positive. Independent risk factors for colonisation were: maternal H. pylori positivity (OR 2.12; 95% CI 1.62 to 2.77), non-Dutch ethnicity (OR 2.05; 95% CI 1.54 to 2.73), female gender (OR 1.47; 95% CI 1.20 to 1.80) and lower maternal education level (OR 1.38; 95% CI 1.06 to 1.79). Comparing mothers and children, we found an intergenerational decrease of 76% and 77% for Hp(+)CagA(-) and Hp(+)CagA(+)-strains, respectively, consistent across all nine ethnic groups studied. Male gender, higher maternal educational level and no older siblings, were independently associated with absence of H. pylori.
  
  
  CONCLUSIONS
  Although the highest H. pylori and CagA prevalence was found in children of non-Dutch ethnicities, the decreased colonisation rates were uniform across all ethnic groups, implying the importance of environmental factors in H. pylori transmission in modern cities, independent of ethnicity.
authors.affiliation: Departments of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Wouter J
authors.initials: WJ
authors.lastname: den Hollander
authors.affiliation: Departments of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: I Lisanne
authors.initials: IL
authors.lastname: Holster
authors.affiliation: Departments of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Bianca
authors.initials: B
authors.lastname: van Gilst
authors.affiliation: Departments of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Anneke J
authors.initials: AJ
authors.lastname: van Vuuren
authors.affiliation: The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands Department of Pediatrics, Erasmus University Medical Centre, Rotterdam, The Netherlands Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.affiliation: Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Departments of Medicine and Microbiology, New York University Langone Medical Centre, New York, USA.
authors.forename: Guillermo I
authors.initials: GI
authors.lastname: Perez-Perez
authors.affiliation: Departments of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.affiliation: Department of Pediatrics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Henriëtte A
authors.initials: HA
authors.lastname: Moll
authors.affiliation: Departments of Medicine and Microbiology, New York University Langone Medical Centre, New York, USA.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Blaser
mesh_terms: D002648:Child; D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000208:ethnology*; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D014505:Urban Population
keywords: EPIDEMIOLOGY; HELICOBACTER PYLORI - EPIDEMIOLOGY; HELICOBACTER PYLORI - IN CHILDREN