Journal Information
Vol. 63. Issue 6.
Pages 489-494 (1 December 2005)
Share
Share
Download PDF
More article options
Vol. 63. Issue 6.
Pages 489-494 (1 December 2005)
Originales
Full text access
Infección por Helicobacter pylori en población infantil: prevalencia, factores asociados e influencia sobre el crecimiento
Helicobacter pylori infection in the child population in spain: prevalence, related factors and influence on growth
Visits
12969
S.V. Leandro Liberatoa,
Corresponding author
vleandrl@cfnavarra.es

Correspondencia: Dr. S.V. Leandro Liberato. Centro de Salud Gayarre.Gayarre, 17. 31500 Tudela. España.
, M. Hernández Galindoa, L. Torroba Álvarezb, F. Sánchez Miramóna, S.E. Leandro Cirizaa, A. Gómez Abadíaa, P. Chueca Rodríguezc
a Centro de Salud Gayarre. Tudela. España
b Servicio de Microbiología. Hospital Virgen del Camino. Pamplona. España
c Hospital Reina Sofía. Tudela. España
This item has received
Article information
Introducción

Está demostrado que hay relación de causalidad entre la infección por Helicobacter pylori y la aparición de patología digestiva en adultos y niños. La prevalencia mundial es variable y posiblemente está influida por el grado de desarrollo. Los objetivos de este estudio son conocer la prevalencia de infección por H. pylori en nuestra población infantil, analizar diversos factores asociados a esta infección y estudiar su posible influencia sobre el crecimiento.

Pacientes y métodos

Estudio descriptivo transversal realizado en una muestra representativa de la población de niños con edades entre 1 y 14 años. El tamaño muestral es de 284 niños (prevalencia = 15%; precisión = 4%; IC > 95%). La muestra fue elegida de manera aleatoria y estratificada por edades y sexo. Se recogen datos en un cuestionario precodificado. El diagnóstico de infección por H. pylori se realiza por detección de antígeno de H. pylori en heces mediante enzimoinmunoanálisis.

Resultados

La muestra estaba formada por 144 niños y 140 niñas con una media de edad de 6,89±4,25 años. La prevalencia de infección por H. pylori fue del 15,8%. Esta aumenta progresivamente con la edad: 1-3 años (8,4 %); 4-9 años (13,9 %), y 10-14 años (24 %) (p<0,05) y es más frecuente en varones (p<0,01).El análisis de las variables socioambientales demuestran elevada frecuencia de infección por H. pylori en niños de familias con bajo nivel socioeconómico (p<0,01), alto índice de hacinamiento (p<0,05) e inmigrantes (p<0,001).Se observa mayor frecuencia de H. pylori en niños que presentan dolor abdominal recurrente (DAR) (p<0,001) y cuyos padres presentan patología gastroduodenal (p<0,001).Con más frecuencia de la esperada aparece H. pylori en niños de 10 a 14 años con percentiles de peso y talla < P25 (p<0,05). En el contraste de medias no se observan diferencias significativas.

Conclusiones

La prevalencia de infección por H. pylori en nuestro estudio es algo menor de lo encontrado en otros estudios realizados en nuestro país, ya que se acerca al patrón de países industrializados.Está asociado a la edad, sexo y ambientes socioeconómicos poco favorecidos. Es más frecuente esta infección en niños con DAR y cuando los padres sufren patología gastroduodenal.Esta infección parece no influir negativamente en el crecimiento de los niños de nuestra población infantil.

Palabras clave:
Helicobacter pylori
Prevalencia
Antígeno H. pylori en heces
Crecimiento
Niños
Introduction

A causal relationship between Helicobacter pylori infection and the occurrence of digestive diseases in adults and children has been proven. Worldwide, the prevalence of H. pylori varies and it is possibly influenced by differences in the level of development. The goals of this study were a) to ascertain the prevalence of H. pylori infection in the child population in Spain, b) to study several factors related to this infection, and c) to establish its possible influence on growth.

Patients and methods

We performed a descriptive, cross-sectional survey of a representative sample of children aged 1 to 14 years old. The sample consisted of 284 children (prevalence = 15%; accuracy = 4%; CI > 95%), selected at random and stratified by age and sex. A pre-coded questionnaire was used for data collection. Diagnosis of H. pylori was established by detection of H. pylori antigen in stools with enzyme immunoassay.

Results

The sample consisted of 144 boys and 140 girls, with a mean age of 6.89±4.25 years. The prevalence of H. pylori infection was 15.8 % and progressively increased with age: 1- to 3-year-olds (8.4 %), 4- to 9-year-olds (13.9 %), 10- to 14-year-olds (24 %) (p<0.05). The prevalence was significantly higher in boys (p<0.01).Analysis of socio-environmental variables showed a higher H. pylori infection rate in children from families with a low socioeconomic level (p<0.01), a high rate of overcrowding (p<0.05), and in immigrants (p<0.001).The H. pylori infection rate was higher in children with recurrent abdominal pain (p<0.001) and in those whose parents had suffered from gastroduodenal disease (p<0.001). H. pylori infection was more frequent in children aged 10 to 14 years old with weight and height percentiles below the 25th percentile (p<0.05).Comparison of means revealed no significant differences.

Conclusions

The prevalence of H. pylori infection found in our study was slightly lower than that found in other studies carried out in Spain; our data were more similar to those of industrialized countries. H. pylori infection was linked to age, sex and deprived socioeconomic environments, and was more frequent in children with recurrent abdominal pain and in those whose parents suffered from gastroduodenal disease. H. pylori infection did not seem to negatively affect growth in our child population.

Key words:
Helicobacter pylori
Prevalence
H. pylori stool antigen.Growth
Children
Full text is only aviable in PDF
Bibliografía
[1.]
M.J. Martínez Gómez.
Gastritis y ulcus. Infección por Helicobacter pylori.
Pediatr Integral, 7 (2003), pp. 93-98
[2.]
The European Helicobacter pylori Study group.
Current European Concepts in the manegement of Helicobacter pylori infection. The Maastricht Consensus Report.
Gut, 41 (1997), pp. 8-13
[3.]
K.J. Goodman, P. Correa, H.J. Tengana Aux, J.P. DeLany, T. Collazos.
Nutritional factors and Helicobacter pylori infection in Colombian children.
J Pediatr Gastroenterol Nutr, 25 (1997), pp. 507-515
[4.]
J.E. Thomas, A. Dale, M. Harding, W.A. Coward, T.J. Cole, L.T. Weaver.
Helicobacter pylori colonization in early life.
Pediatr Res, 45 (1999), pp. 218-223
[5.]
M.K. Glynn, C.R. Friedman, B.D. Gold, B. Khanna, L. Hutwagner, N. Lihoshi, et al.
Seroincidence of Helicobacter pylori infection in a cohort of rural bolivian children: acquisition and analysis of possible rish factors.
Clin Infect Dis, 45 (2002), pp. 1059-1065
[6.]
M.N. Rodríguez, D.M. Queiroz, J.G. Bezerra Filho, L.K. Pontes, R.T. Rodríguez, L.L. Braga.
Prevalence of Helicobacter pylori infection in children from urban community in nort-east Brazil and risk factors for infection.
Eur J Gastroenterol Hepatol, 16 (2004), pp. 201-205
[7.]
P. Patel, M.A. Mendall, S. Khulusi, T.C. Northfield, D.P. Strachan.
Helicobacter pylori infection in childhood: Risk factors and effect on growth.
BMJ, 29 (1994), pp. 1119-1123
[8.]
F. Perri, M. Pastore, G. Leandro, C. Rocco, Y. Ghoo, M. Peeters, et al.
Helicobacter pylori infection and growth delay in older children.
Arch Dis Child, 77 (1997), pp. 46-49
[9.]
J. Raymond, M. Bergeret, K. Benhamou, K. Mensah, C. Dupont.
A 2-Year-study of Helicobacter pylori in children.
J Clin Microbiol, 32 (1994), pp. 461-463
[10.]
S.K. Chong, Q. Lou, T.W. Zollinger, S. Rabinowitz, R. Jibaly, V. Tolia, et al.
The seroprevalence of Helicobacter pylori in a referral population of children in the United States.
Am J Gastroenterol, 98 (2003), pp. 2162-2168
[11.]
D. Rothembacher, G. Bode, H. Brenner.
History of breastfeeding and Helicobacter pylori infection in school children: Results of a population-based study from Germany.
Int J Epidemiol, 31 (2002), pp. 632-637
[12.]
H.M. Malaty, N.D. Logan, D.Y. Grahan, J.E. Ramchatesingh.
Helicobacter pylori infection in preschool and school-aged minority children: Effect of socioeconomic indicators and breast-feeding practices.
Clin Infect Dis, 32 (2001), pp. 1387-1392
[13.]
J.C. Sanz, M. Fernández, M.J. Sagües, R. Ramírez, L. García-Comas, M. López-Brea.
Seroprevalencia dependiente de la edad frente a Helicobacter pylori en niños y adolescentes de la Comunidad de Madrid.
Enferm Infecc Microbiol Clin, 18 (2000), pp. 147-148
[14.]
J.M. Baena Díez, M. García Lareo, J. Martí Fernández, I. León Marín, D. Muñiz Llama, J. Teruel Gila, et al.
Prevalencia de la infección por Helicobacter pylori en atención primaria: estudio seroepidemiológico.
Aten Primaria, 29 (2002), pp. 553-557
[15.]
O. Pérez Rodríguez, A. Bodas Pinedo, M.T. Lacasa Pérez, A. Gutiérrez del Olmo, C. Maluenda Carrillo.
Lesiones gastroduodenales y Helicobacter pylori: nuestra experiencia.
Acta Pediatr Esp, 61 (2003), pp. 288-291
[16.]
Y.H. Choe, S.K. Kim, Y.C. Hong.
Helicobacter pylori infection with iron deficiency anaemia and subnormal growth at puberty.
Arch Dis Child, 82 (2000), pp. 136-140
[17.]
H. Demir, I.N. Saltik, N. Kocak, A. Yüce, H. Özen, F. Gürakan.
Subnormal growth in children with Helicobacter pylori infection.
Arch Dis Child, 84 (2001), pp. 89-90
[18.]
A. González-Cuevas, T. Juncosa, M. Jené, V. Varea, A. Gene, C. Muñoz, et al.
Infecciones por Helicobacter pylori: detección de antígeno en muestras fecales.
Enferm Infecc Microbiol Clin, 19 (2001), pp. 49-52
[19.]
J.P. Gisbert, M.M. Cabrera, J.M. Pajares.
Detección del antígeno de Helicobacter pylori en heces para el diagnóstico inicial de la infección y para la confirmación de su erradicación tras el tratamiento.
Med Clin (Barc), 118 (2002), pp. 401-404
[20.]
D.C. Metz.
Stool testing for Helicobacter pylori infection: Yet another noninvasive alternative.
Am J Gastroenterol, 95 (2000), pp. 546-548
[21.]
Two factor index of social position,
[22.]
M. Hernández, J. Catellet, J.L. Narvaiza, J.M. Rincón, E. Ruiz, E. Sánchez, et al.
Curvas y tablas de crecimiento. Instituto de Investigación sobre Crecimiento y Desarrollo.
Fundación Faustino Orbegozo, Editorial Garsi, (1988),
[23.]
L. Rodrigo Sáenz, S. Riestra Menéndez, E. Fernández Rodríguez, M.R. Fernández Velázquez, S. García Alonso, M.E. Lauret Braña.
Estudio epidemiológico de la prevalencia de la infección por Helicobacter pylori en población general en Asturias.
Rev Esp Enf Digest, 89 (1997), pp. 511-522
[24.]
G. Cilla, E. Pérez Trallero, M. García Bengoechea, J.M. Marimón, J.I. Arenas.
Helicobacter pylori infection: A seroprepidemiological study in Gipuskoa, Basque Country, Spain.
Eur J Epidemiol, 13 (1997), pp. 945-949
[25.]
T. Ritcher, T. Richter, S. List, D.M. Muller, J. Deutscher, H.H. Uhlig, P. Krumbiegel, et al.
Five-to-7-year-old children with Helicobacter pylori infection are smaller than Helicobacter-negative children: a cross-sectional population-based study of 3,315 children.
J Pediatr Gastroenterol Nutr, 33 (2001), pp. 472-475
[26.]
A. Granquist, A. Bredberg, T. Sveger, I. Axelsson.
A longitudinal cohort study on the prevalence of Helicobacter pylori antibodies in Swedish children and adolescents.
Acta Paediatr, 91 (2002), pp. 636-640
[27.]
H.M. Malaty, T. Haverman, D.Y. Graham, J.K. Fraley.
Helicobacter pylori infections in asyntomatic children: Impact of epidemiologic factors on accuracy of diagnostic tests.
J Pediatr Gastroenterol Nut, 35 (2000), pp. 59-63
[28.]
D. Ertem, H. Harmanci, E. Pehlivanoglu.
Helicobacter pylori infection in Turkish preschool and school children: Role of socioeconomic factors and breast feeding.
Turk J Pediatr, 45 (2003), pp. 114-122
[29.]
D. Rothenbacher, G. Bode, H. Brenner.
Dynamic of Helicobacter pylori infection in early childhood in a high-risk group living in Germany: Loss of infection higher than acquisition.
Aliment Pharmacol Ther, 16 (2002), pp. 1663-1668
[30.]
C.D. Xu, S.N. Chen, S.H. Jiang, J.Y. Xu.
Seroepidemiology of Helicobacter pylori infection among asyntomatic Chinese children.
World J Gastroenterol, 6 (2000), pp. 759-761
[31.]
N.R. Yoshida, E.M. Webber, R.B. Fraser, M.T. Ste-Marie, J.M. Giacomantonio.
Helicobacter pylori is not associated with nonspecific abdominal pain in children.
J Pediatr Surg, 31 (1996), pp. 747-749
[32.]
F. Gottrand.
The role of Helicobacter pylori in abdominal pain in children.
Arch Pediatr, 7 (2000), pp. 197-200
[33.]
B. Drumm, S. Koletzko, G. Oderda.
Helicobacter pylori infection in children: A consensus statement. Medical position paper: A report of the European Paediatric Task Force on Helicobacter pylori on a Consensus Conference, Budapest, Hungary, September 1998.
J Pediatr Gastroenterol Nutr, 30 (2000), pp. 207-213
[34.]
R.P. Allaker, K.A. Young, J.M. Hardie, P. Domizio, N.J. Meadows.
Prevalence of Helicobacter pylori at oral and gastrointestinal sites in children: Evidence for possible oral-to-oral transmission.
J Med Microbiol, 51 (2002), pp. 312-317
[35.]
D. Rothembacher, M. Winkler, T. Gonser, G. Adler, H. Brenner.
Role of infected parents in transmission of Helicobacter pylori their children.
Pediatr Infect Dis J, 21 (2002), pp. 674-679
[36.]
S.K. Sinha, B. Martin, B.D. Gold, Q. Song, M. Sargent, C.N. Bernstein.
The incidence of Helicobacter pylori acquisition in children Canadian First Nations community and the potential for parent-to-child transmission.
Helicobacter, 9 (2004), pp. 59-68
[37.]
L.E. Bravo, R. Mera, J.C. Reina, A. Pradilla, A. Alzate, E. Fontham, et al.
Impact of Helicobacter pylori infection on growth of children: a prospective cohort study.
J Pediatr Gastroenterol Nutr, 37 (2003), pp. 614-619
[38.]
S.H. Murch, V.A. Lamkin, M.O. Savage, J.A. Walker-Smith, T.T. MacDonald.
Serum concentrations of tumour necrosis factor alpha in childhood chronic inflammatory bowel disease.
Gut, 32 (1991), pp. 913-917
[39.]
J.E. Crabtree, P. Peichl, J.I. Wyatt, U. Stachl, I.J. Lindley.
Gastric interleukin-8 and IgA IL-8 autoantibodies in Helicobacter pylori infection.
Scand J Immunol, 37 (1993), pp. 65-70
[40.]
N.J. Rothwell.
The endocrine significance of cytokines.
J Endocrinol, 128 (1991), pp. 171-173
[41.]
Y.H. Choe, S.K. Kim, Y.C. Hong.
The relationship between Helicobacter pylori infection and iron deficiency: seroprevalence study in 937 pubescent children.
Arch Dis Child, 88 (2003), pp. 178
Copyright © 2005. Asociación Española de Pediatría
Download PDF
Idiomas
Anales de Pediatría (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?