Nabwera H M, Nguyen-Van-Tam J S, Logan R F, Logan R P
Division of Public Health Medicine and Epidemiology, University of Nottingham Medical School, Queen's Medical Centre, UK.
Eur J Gastroenterol Hepatol. 2000 May;12(5):483-7. doi: 10.1097/00042737-200012050-00002.
To determine the prevalence of Helicobacter pylori (Hp) infection in Kenyan schoolchildren aged 3-15 years and the risk factors for infection.
A cross-sectional survey and study of risk factors.
Primary-school children in Trans Nzoia district, Kenya.
Hp status was determined using the 13C-urea breath test. Risk factors were assessed using a structured interview schedule.
Of 205 children interviewed, valid breath test results were obtained for 192 (93.7%), of whom 155 (80.7% (95% CI 75.2-86.3)) were infected. Univariate analysis showed weak associations between Hp infection and rural areas (location of home, Relative Risk (RR)= 1.2 (1.0-1.4); location of school, RR = 1.2 (1.0-1.3)) and lower socio-economic status (RR = 1.2 (1.0-1.4)). Access to only a pit-latrine in the home (RR = 1.2 (1.0-1.4)) and plate-sharing with other family members in the home also increased the likelihood of Hp infection (RR = 1.3 (1.1 -1.6)). However, after logistic regression modelling only plate-sharing in the home remained as an independent risk factor (odds ratio (OR) = 2.8 (1.3-6.3)).
The prevalence of Hp infection in Kenyan schoolchildren aged 3-15 years is already high, suggesting that most acquisition occurs before age 3 years. Children who normally shared a plate with other family members during meals in the home had a higher prevalence of infection, suggesting that oro-oral transmission may be important in this population. Future studies in developing countries should focus on younger children (before age 3 years), and consider the possibility of adult-child, oro-oral transmission in order to establish likely modes of transmission.
确定肯尼亚3至15岁学童幽门螺杆菌（Hp）感染率及其感染风险因素。
一项横断面调查及风险因素研究。
肯尼亚特兰斯佐亚区的小学生。
采用13C-尿素呼气试验确定Hp感染状况。通过结构化访谈问卷评估风险因素。
在接受访谈的205名儿童中，192名（93.7%）获得了有效的呼气试验结果，其中155名（80.7%（95%可信区间75.2 - 86.3））被感染。单因素分析显示，Hp感染与农村地区（家庭所在地，相对风险（RR）= 1.2（1.0 - 1.4）；学校所在地，RR = 1.2（1.0 - 1.3））以及较低的社会经济地位（RR = 1.2（1.0 - 1.4））之间存在弱关联。家中仅有旱厕（RR = 1.2（1.0 - 1.4））以及在家中与其他家庭成员共用盘子也会增加Hp感染的可能性（RR = 1.3（1.1 - 1.6））。然而，经过逻辑回归建模后，仅在家中与他人共用盘子这一因素仍作为独立的风险因素（比值比（OR）= 2.8（1.3 - 6.3））。
肯尼亚3至15岁学童的Hp感染率已然很高，这表明大多数感染发生在3岁之前。在家中用餐时通常与其他家庭成员共用盘子的儿童感染率更高，这表明口口传播在该人群中可能很重要。未来在发展中国家开展的研究应聚焦于年龄更小的儿童（3岁之前），并考虑成人与儿童之间口口传播的可能性，以便确定可能的传播方式。
