Clemens J, Albert M J, Rao M, Huda S, Qadri F, Van Loon F P, Pradhan B, Naficy A, Banik A
Epidemiology Branch, National Institute of Child Health and Human Development, Bethesda, MD 20892, USA.
Pediatr Infect Dis J. 1996 Dec;15(12):1113-8. doi: 10.1097/00006454-199612000-00012.
By the age of 10 years most children in developing countries have been infected by Helicobacter pylori Identification of clues to modes of transmission of this organism to children, as well as evaluation of the sequelae of childhood infections, constitute important research priorities for developing countries.
To evaluate demographic, socioeconomic and hygienic factors associated with acquisition of infection by H. pylori early in childhood among Bangladeshi children ages 2 to 5 years and to assess whether infection by H. pylori was associated with poor nutritional status in these children and in an older group ages 6 to 9 years.
A random population-based survey of 257 rural Bangladeshi children ages 2 to 5 years and 312 children ages 6 to 9 years. Seropositivity for H. pylori, as manifested by the presence of serum IgG anti-H. pylori antibodies, was correlated with nutritional status of the sampled children and with sociodemographic features and access to clean water and latrine facilities among families of the children.
Among children ages 2 to 5 years, the 123 (48%) who were infected by H. pylori were similar to the 134 noninfected children with respect to socioeconomic level, family access to tube well water and family ownership of a latrine. However, families of infected children had more persons per sleeping room in the home (3.8 vs. 3.2, P < 0.05) and were more likely to be Hindu (20% vs. 10%, P < 0.05). Infected children did not differ significantly from noninfected children in Z scores for weight-for-age (-2.66 vs. -2.78), weight-for-height (-1.17 vs. -1.28) or height-for-age (-3.58 vs. -3.56). Analysis of survey children ages 6 to 9 years also revealed similar nutritional indexes among infected vs. noninfected children.
Household crowding and behaviors that differ between Hindus and Muslims, but not lack of access to clean water and latrines, may enhance the transmission of H. pylori to rural Bangladeshi children. Although confirming the high frequency of infections in young Bangladeshi children, our findings do not support the notion that H. pylori is responsible for the high prevalence of malnutrition in this setting.
到10岁时，发展中国家的大多数儿童已感染幽门螺杆菌。确定该生物体向儿童传播的模式线索，以及评估儿童期感染的后遗症，是发展中国家重要的研究重点。
评估与孟加拉国2至5岁儿童早期感染幽门螺杆菌相关的人口统计学、社会经济和卫生因素，并评估这些儿童以及6至9岁年龄较大儿童中幽门螺杆菌感染是否与营养状况不佳有关。
对257名2至5岁的孟加拉国农村儿童和312名6至9岁的儿童进行基于人群的随机调查。幽门螺杆菌血清阳性，表现为血清抗幽门螺杆菌IgG抗体的存在，与抽样儿童的营养状况以及儿童家庭的社会人口学特征和获得清洁水和厕所设施的情况相关。
在2至5岁的儿童中，123名（48%）感染幽门螺杆菌的儿童在社会经济水平、家庭获得管井水的情况和家庭拥有厕所方面与134名未感染儿童相似。然而，感染儿童的家庭每个卧室的人数更多（3.8比3.2，P<0.05），并且更有可能是印度教徒（20%比10%，P<0.05）。感染儿童与未感染儿童在年龄别体重Z评分（-2.66比-2.78）、身高别体重Z评分（-1.17比-1.28）或年龄别身高Z评分（-3.58比-3.56）方面没有显著差异。对6至9岁调查儿童的分析也显示，感染儿童与未感染儿童的营养指标相似。
家庭拥挤以及印度教徒和穆斯林之间不同的行为，而非缺乏获得清洁水和厕所的机会，可能会增加幽门螺杆菌向孟加拉国农村儿童的传播。尽管证实了孟加拉国幼儿感染幽门螺杆菌的频率很高，但我们的研究结果不支持幽门螺杆菌是导致该地区营养不良高发的原因这一观点。
