Mahalanabis D, Rahman M M, Sarker S A, Bardhan P K, Hildebrand P, Beglinger C, Gyr K
Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Int J Epidemiol. 1996 Aug;25(4):894-8. doi: 10.1093/ije/25.4.894.
The gastric acid barrier, an important host defence against small bowel infection, may be compromised by infection with Helicobacter pylori. In developing countries, H. pylori infection occurs early in life and prevalence of hypochlorhydria is high particularly in the malnourished, which may predispose a child to repeated gastrointestinal infection and diarrhoea. Diarrhoea being a leading cause of childhood mortality and morbidity in developing countries, we investigated the prevalence of H. pylori infection in children in a poor Bangladeshi community and explored its association with socioeconomic and nutritional status.
The study was conducted in a poor periurban community among 469 children aged 1-99 months. Parents were interviewed using a questionnaire. To detect active infection with H. pylori a 13C-urea breath test was performed and weight was recorded on a beam balance with a sensitivity of 20 g.
In all, 61% of 36 infants aged 1-3 months were positive for H. pylori; this rate dropped steadily with increasing age and was 33% in 10-15 month old children and then rose to 84% in 6-9 year olds. Overall H. pylori infection had no association with nutritional state of the child, or family income but the infection rate was 2.5 times higher in children of mothers with no schooling.
The H. pylori infection rate is very high in early infancy in a poor periurban community of Bangladesh. The reason for a drop in the infection rate in late infancy is unclear but could be due to initial clearance of the infection by the body's defence mechanisms but with possible alteration of the gastric mucosa which sustains infection. Maternal education may be protective and may operate through some unidentified proximate behavioural determinants. The rate of H. pylori infection in infants and young children may predispose them to repeated gastrointestinal infection and diarrhoea.
胃酸屏障是宿主抵御小肠感染的重要防线，而幽门螺杆菌感染可能会损害这一屏障。在发展中国家，幽门螺杆菌感染在儿童早期就会发生，胃酸过少的患病率很高，尤其是在营养不良的儿童中，这可能使儿童易患反复的胃肠道感染和腹泻。腹泻是发展中国家儿童死亡和发病的主要原因，我们调查了孟加拉国一个贫困社区儿童幽门螺杆菌感染的患病率，并探讨了其与社会经济和营养状况的关系。
该研究在一个贫困的城郊社区对469名年龄在1至99个月的儿童进行。通过问卷调查对家长进行访谈。为检测幽门螺杆菌的现症感染，进行了13C尿素呼气试验，并使用灵敏度为20克的杆秤记录体重。
总体而言，36名1至3个月大的婴儿中，61%幽门螺杆菌检测呈阳性；随着年龄增长，这一比例稳步下降，10至15个月大的儿童中为33%，然后在6至9岁儿童中升至84%。总体而言，幽门螺杆菌感染与儿童的营养状况或家庭收入无关，但母亲未受过教育的儿童感染率高出2.5倍。
在孟加拉国一个贫困的城郊社区，婴儿早期幽门螺杆菌感染率非常高。婴儿后期感染率下降的原因尚不清楚，但可能是由于机体防御机制最初清除了感染，但胃黏膜可能发生了改变，从而持续感染。母亲的教育可能具有保护作用，可能通过一些未明确的直接行为决定因素发挥作用。婴幼儿幽门螺杆菌感染率可能使他们易患反复的胃肠道感染和腹泻。
