Rothenbacher D, Bode G, Berg G, Gommel R, Gonser T, Adler G, Brenner H
Department of Epidemiology, University of Ulm, Germany.
Int J Epidemiol. 1998 Feb;27(1):135-41. doi: 10.1093/ije/27.1.135.
Helicobacter pylori is among the most common infections in humans and has been recognized as major cause of various gastroduodenal diseases. There is limited knowledge, however, on the prevalence and determinants of this infection in children. We addressed these issues in a population-based cross-sectional study in Southern Germany.
Study subjects were all preschool children in Ulm, a city in the South of Germany, who were screened for school fitness by physicians of the public health service in 1996. Infection status was determined by 13C-urea breath test. In addition, the parents of the children were asked to fill out a standardized questionnaire.
In total, 945 out of the 1201 eligible preschool children participated in the study (response rate = 79%). The children were aged 5-8 years. The majority were of German nationality (72.6%). Overall, 127 children (13.4%) were infected with H. pylori. Nationality, place of residence in the first year of life and duration of living in Germany were strongly associated with H. pylori infection status. The prevalence varied from 4.8% (95% confidence interval [CI]: 3.3-6.8%) in children with German nationality who were born in Germany or had lived in Germany since their first year of life to 66.7% (95% CI: 29.9-92.5%) in the children with Turkish nationality who came to Germany after the first year of life.
Our results showed a large variation in prevalence of H. pylori infection in children living in the same geographical area according to nationality. They indicate an association between living conditions in early childhood and H. pylori infection and indicate that H. pylori associated morbidity may evolve very differently in population subgroups living in the same area.
幽门螺杆菌是人类最常见的感染之一，已被确认为各种胃十二指肠疾病的主要病因。然而，关于儿童中这种感染的患病率及其决定因素的了解有限。我们在德国南部进行了一项基于人群的横断面研究，以解决这些问题。
研究对象为德国南部城市乌尔姆的所有学龄前儿童，他们在1996年由公共卫生服务部门的医生进行入学健康筛查。通过¹³C-尿素呼气试验确定感染状况。此外，还要求儿童的父母填写一份标准化问卷。
在1201名符合条件的学龄前儿童中，共有945名参与了研究（应答率=79%）。这些儿童年龄在5至8岁之间。大多数为德国国籍（72.6%）。总体而言，127名儿童（13.4%）感染了幽门螺杆菌。国籍、出生后第一年的居住地点以及在德国的居住时间与幽门螺杆菌感染状况密切相关。患病率从出生在德国或自出生第一年起就居住在德国的德国国籍儿童中的4.8%（95%置信区间[CI]：3.3 - 6.8%）到出生后第一年后来到德国的土耳其国籍儿童中的66.7%（95%CI：29.9 - 92.5%）不等。
我们的结果显示，在同一地理区域内，根据国籍不同，儿童幽门螺杆菌感染的患病率存在很大差异。这表明儿童早期的生活条件与幽门螺杆菌感染之间存在关联，并表明在同一地区生活的不同人群亚组中，幽门螺杆菌相关疾病的发生可能有很大差异。
