title: Effect of early and current Helicobacter pylori infection on the risk of anaemia in 6.5-year-old Ethiopian children.
abstract: BACKGROUND
  Epidemiological and clinical studies in high income countries have suggested that Helicobacter pylori (H. pylori) may cause anaemia, but evidence is lacking from low income countries.We examined associations between H. pylori infection in early childhood and anaemia at the age of 6.5 years in an Ethiopian birth cohort.
  
  
  METHODS
  In 2011/12, 856 children (85.1 % of the 1006 original singletons in a population-based birth cohort) were followed up at age six and half. An interviewer-led questionnaire administered to mothers provided information on demographic and lifestyle variables. Haemoglobin level and red cell indices were examined using an automated haematological analyzer (Cell Dyn 1800, Abbott, USA), and stool samples analyzed for H. pylori antigen. The independent effects of H. pylori infection (measured at age 3.5 and 6.5 years) on anaemia, haemoglobin level, and red cell indices (measured at age 6.5 years) were determined using multiple logistic and linear regression.
  
  
  RESULTS
  The prevalence of anemia was 34.8 % (257/739), and the mean (SD) haemoglobin concentration was 11.8 (1.1) gm/dl. Current H. pylori infection at age 6.5 years was positively, though not significantly related to prevalence of anaemia (adjusted OR, 95 % CI, 1.15; 0.69, 1.93, p = 0.59). Any H. pylori infection up to age 6.5 years was significantly associated with an increased risk of anaemia at age 6.5 (adjusted OR, 95 % CI, 1.68; 1.22, 2.32, p = 0.01). A significant reduction in haemoglobin concentration and red cell indices was also observed among children who had any H. pylori infection up to age 6.5 (Hb adjusted β = -0.19, 95 % CI, -0.35 to -0.03, p = 0.01; MCV adjusted β = -2.22, 95 % CI, -3.43 to -1.01, p = 0.01; MCH adjusted β = -0.63, 95 % CI, -1.15 to - 0.12, p = 0.01; and MCHC adjusted β = -0.67, 95 % CI, -1.21 to -0.14, p = 0.01), respectively.
  
  
  CONCLUSIONS
  This study provides further evidence from a low income country that any H. pylori infection up to age 6.5 is associated with higher prevalence of anaemia, and reduction of haemoglobin level and red cell indices at age 6.5.
authors.affiliation: School of Public Health, College of Health Sciences, Addis Ababa University, PO Box 80596, Addis Ababa, Ethiopia. bineymt@gmail.com.|School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. bineymt@gmail.com.
authors.forename: Bineyam
authors.initials: B
authors.lastname: Taye
authors.affiliation: School of Public Health, College of Health Sciences, Addis Ababa University, PO Box 80596, Addis Ababa, Ethiopia. fikreens@yahoo.com.
authors.forename: Fikre
authors.initials: F
authors.lastname: Enquselassie
authors.affiliation: School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. tsegayeaster@yahoo.com.
authors.forename: Aster
authors.initials: A
authors.lastname: Tsegaye
authors.affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Nottingham, UK. alemayehu.amberbir@lshtm.ac.uk.
authors.forename: Alemayehu
authors.initials: A
authors.lastname: Amberbir
authors.affiliation: Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia. gtmedhine@yahoo.com.
authors.forename: Girmay
authors.initials: G
authors.lastname: Medhin
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK. Andrew.Fogarty@nottingham.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Fogarty
authors.affiliation: Nottingham Digestive Diseases Biomedical Research Unit, School of Medicine, University of Nottingham, Nottingham, UK. karen.robinson@nottingham.ac.uk.
authors.forename: Karen
authors.initials: K
authors.lastname: Robinson
authors.affiliation: Brighton & Sussex Medical School, Nottingham, UK. g.davey@bsms.ac.uk.
authors.forename: Gail
authors.initials: G
authors.lastname: Davey
mesh_terms: D000328:Adult; D000740:Anemia / Q000150:complications / Q000453:epidemiology*; D002648:Child; D002662:Child Health Services; D015331:Cohort Studies; D004909:Erythrocyte Indices; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D009035:Mothers; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires