School of Pediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.
Helicobacter. 2010 Apr;15(2):88-97. doi: 10.1111/j.1523-5378.2009.00740.x.
Refugee children have complex medical needs and often have multiple infections. The relationship between infection, gastrointestinal symptoms, and systemic inflammation is poorly understood. We investigated these parameters in refugee children with a high prevalence of Helicobacter pylori, helminth, and malaria infection.
African refugee children were recruited at resettlement health screening. Data were collected on demography, gastrointestinal symptoms, co-morbid infection, and serum for peripheral cytokine levels. Helicobacter pylori infection was diagnosed by a fecal-based immunoassay.
Data from 163 children were analyzed, of which 84.0% were positive for H. pylori. Infected children were significantly older (9.2 years +/- 3.7 vs 7.1 years +/- 3.9, p = .01). Half the cohort (84/163, 51.5%) described gastrointestinal symptoms but these were not strongly associated with co-morbid infections. Helicobacter pylori-infected children had significantly lower circulating log-interleukin-8 (IL-8) (odds ratio 0.61, 95% confidence interval (CI) 0.40, 0.94, p = .025). Helminth infections were common (75/163, 46%) and associated with elevated log-IL-5 (beta: 0.42, 95% CI 0.077, 0.76). Children with malaria (15/163, 9.2%) had elevated log-tumor necrosis factor-alpha (TNFalpha) and log-IL-10 (beta: 0.67, 95% CI 0.34, 1.0 and beta: 1.3, 95% CI 0.67, 1.9, respectively). IL-10 : IL-12 ratios were increased in H. pylori-infected children with malaria or helminth infections. Symptoms were generally not associated with levels of circulating peripheral cytokines irrespective of co-morbid infection diagnosis.
There is a high prevalence of asymptomatic H. pylori infection in recently resettled African refugee children. Gastrointestinal symptoms were not predictive of H. pylori nor of helminth infections. Serum cytokines, particularly IL-5, IL-10, and TNFalpha, were significantly elevated in children with malaria and helminth infections but not in those with H. pylori infection.
难民儿童有复杂的医疗需求，通常有多种感染。感染、胃肠道症状和全身炎症之间的关系尚未得到充分了解。我们调查了这些参数在难民儿童中具有高流行的幽门螺杆菌，寄生虫和疟疾感染。
在重新安置健康筛查时招募了非洲难民儿童。收集了人口统计学，胃肠道症状，合并感染和外周细胞因子水平的血清数据。幽门螺杆菌感染通过粪便免疫测定法诊断。
分析了 163 名儿童的数据，其中 84.0％为 H. pylori 阳性。感染儿童的年龄明显较大（9.2 岁 +/- 3.7 与 7.1 岁 +/- 3.9，p =.01）。队列的一半（84/163，51.5％）描述了胃肠道症状，但这些症状与合并感染没有强烈关联。 H. pylori 感染儿童的循环白细胞介素-8（IL-8）水平明显降低（比值比 0.61，95％置信区间（CI）0.40，0.94，p =.025）。寄生虫感染很常见（75/163，46％），并与升高的 log-IL-5 相关（β：0.42，95％CI 0.077，0.76）。疟疾患儿（15/163，9.2％）的肿瘤坏死因子-α（TNFalpha）和白细胞介素-10（IL-10）水平升高（β：0.67，95％CI 0.34，1.0 和β：1.3，95％CI 0.67，1.9）。 H. pylori 感染的疟疾或寄生虫感染儿童的 IL-10：IL-12 比值增加。无论合并感染诊断如何，症状通常与循环外周细胞因子水平无关。
最近重新安置的非洲难民儿童中存在无症状幽门螺杆菌感染的高流行率。胃肠道症状不能预测 H. pylori 或寄生虫感染。患有疟疾和寄生虫感染的儿童的血清细胞因子，特别是 IL-5，IL-10 和 TNFalpha，明显升高，但 H. pylori 感染的儿童则没有。
