SEROEPIDEMIOLOGY OF H ELICOBACTER PYLORI INFECTION IN CHILDREN ATTENDING CHILDREN’S EMERGENCY UNIT OF UNIVERSITY OF UYO TEACHING HOSPITAL UYO

Abstract

H elic o b a c t e r p ylo ri infection occurs worldwide but infection rates are considerably
different for different populations. High seroprevalence rates have been reported in the
childhood populations of developing countries. There is paucity of data concerning the
occurrence of
H . p ylo ri in the Nigerian paediatric population. A prospective
seroepidemiologic survey to determine the prevalence rate and possible associations of
environmental, socio-demographic and clinical features with H. pylori seropositivity was
conducted between 26th August 2008 and 23rd January 2009. The subjects were
children seen at the Children Emergency Unit of University of Uyo Teaching Hospital in
southern Nigeria. Two hundred and thirty subjects comprising 132(57.4%) males and
98(42.6%) females (male: female ratio= 1.3:1) with an age range of 0.5-15 years and
a mean age of 5.2 (SD±4.0) years were recruited. The median age was 4.0 years. One
hundred and forty three subjects were enrolled in schools.
H. pylori immunoglobulin G
(1gG) antibodies were determined from serum samples stored at -200C using a
commercial Enzyme-linked immunosorbent assay (ELISA) kit,
VicTorch . The overall
seroprevalence rate was 30.9% with a peak prevalence of 37.5% seen in the 5.0-9.9
years age group. The data show that
H. pylori seroprevalence in our children is high
and is associated with social class (p=0.038), increased household population
(p=0.009), source of drinking water (p=0.014), type of convenience used (p=0.019)
and the method of disposal of household waste (p=0.043). These findings suggest that
poverty, overcrowding and poor sanitary conditions may impact positively on the
acquisition of this infection. Clinical features including abdominal pains,[(P=0.001);
RR=2.56, (95% CI=1.42, 4.59)], bad breath [(p=0.000); RR=5.71,(95% CI=2.08,
9.74)], family history of dyspepsia [(p=0.002);RR=2.92, (CI=1.46,5.83) and use of
antacids [(p=0.004); RR=3.98, (95% CI=1.47, 9.78)] showed significant association
with seropositivity. The duration of abdominal pains (p=0.002) also showed a
significant association with the infection. Gastroduodenal ulcer disease was associated
with H. pylori seropositivity [(p=0.012); RR=7.25, (95% CI=1.43, 6.38)] . Age, gender,
weight, height, body mass index, number of siblings and the number of persons
sleeping on the same bed with the subject were not significant associated factors.
There is need for government to intensify efforts on poverty relief programmes and
provision of adequate improved housing with standard sanitary conditions to reduce the
prevalence of this infection in our children. The identification of the dynamics of this
infection should be researched further to contribute to the improvement of the health of
our nation.

SEROEPIDEMIOLOGY OF H ELICOBACTER PYLORI INFECTION IN CHILDREN ATTENDING CHILDREN’S EMERGENCY UNIT OF UNIVERSITY OF UYO TEACHING HOSPITAL UYO