title: Prevalence and risk factors of Helicobacter pylori infection in Saudi children: a three-year prospective controlled study.
abstract: BACKGROUND
  Helicobacter pylori (H. pylori) infection is the most common chronic infections. The risk factors for H. pylori infection in both developing and developed countries are closely related to poor living conditions in childhood. This study aimed to establish the prevalence of H. pylori infection and its associated risk factors among children in the western and central regions of Saudi Arabia.
  
  
  METHODS
  A prospective cross-sectional study was performed among symptomatic children in National Guard hospitals who underwent esophagogastroduodenoscopy from 2010 to 2013. The gold standard diagnosis of H. pylori infection was histologic presence of the bacteria in the gastric biopsy. The variables analyzed as possible risk factors included demographic and living characteristics, socioeconomic status, potential mode of transmission, and clinical indications of H. pylori infection.
  
  
  RESULTS
  A total of 303 children were included in the study. The overall prevalence of H. pylori infection was 49.8%. Among the studied variables, the following were positively associated with the presence of H. pylori in multivariable analyses: age above 10 years(OR = 11.84, 95% CI = 3.90-35.94, p < .0001), an income of <5000 SR (OR = 2.06, 95% CI = 1.07-3.95), more than eight persons in the household (OR = 3.46, 95% CI = 1.67-7.20), bed sharing (OR = 2.26, 95% CI = 1.32-3.86), and two affected parents (OR = 11.19, 95% CI = 1.29-97.27). Abdominal pain and anorexia were significant predictors of H. pylori infection (p = .005 and .009, respectively).
  
  
  CONCLUSIONS
  Helicobacter pylori infection had a high prevalence among Saudi children in the cities of Jeddah and Riyadh. It was a relatively common cause of abdominal pain and anorexia. In this cohort of children, H. pylori infection was associated with variables indicative of a crowded environment and poor living conditions, further supporting the conclusion that improving socioeconomic conditions and designing a preventive health strategy in Saudi Arabia will likely protect children against this infection.
authors.affiliation: Pediatric Gastroenterology Department, King Saud Bin Abdulaziz University for Health Sciences, National Guard Hospital, Jeddah, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Hasosah
authors.forename: Mohammed
authors.initials: M
authors.lastname: Satti
authors.forename: Amir
authors.initials: A
authors.lastname: Shehzad
authors.forename: Ashraf
authors.initials: A
authors.lastname: Alsahafi
authors.forename: Ghassan
authors.initials: G
authors.lastname: Sukkar
authors.forename: Abdullah
authors.initials: A
authors.lastname: Alzaben
authors.forename: Areej
authors.initials: A
authors.lastname: Sunaid
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ahmed
authors.forename: Sami
authors.initials: S
authors.lastname: AlThubiti
authors.forename: Areej
authors.initials: A
authors.lastname: Mufti
authors.forename: Kevan
authors.initials: K
authors.lastname: Jacobson
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002947:Cities; D003430:Cross-Sectional Studies; D003710:Demography; D016145:Endoscopy, Digestive System; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012959:Socioeconomic Factors
keywords: Helicobacter pylori; children; prevalence; risk factors