SOCIODEMOGRAPHIC, HYGIENIC AND NUTRITIONAL CORRELATES OF HELICOBACTER-PYLORI INFECTION OF YOUNG BANGLADESHI CHILDREN

Background. By the age of 10 years most children in developing countri es have been infected by Helicobacter pylori Identification of clues t o modes of transmission of this organism to children, as well as evalu ation of the sequelae of childhood infections, constitute important re search priorities for developing countries. Objectives. To evaluate de mographic, socioeconomic and hygienic factors associated with acquisit ion of infection by H. pylori early in childhood among Bangladeshi chi ldren ages 2 to 5 years and to assess whether infection by H. pylori w as associated with poor nutritional status in these children and in an older group ages 6 to 9 years. Methods. A random population-based sur vey of 257 rural Bangladeshi children ages 2 to 5 years and 312 childr en ages 6 to 9 years, Seropositivity for H. pylori, as manifested by t he presence of serum IgG anti-H. pylori antibodies, was correlated wit h nutritional status of the sampled children and with sociodemographic features and access to clean water and latrine facilities among famil ies of the children. Results. Among children ages 2 to 5 years, the 12 3 (48%) who were infected by A pylori were similar to the 134 noninfec ted children with respect to socioeconomic level, family access to tub e well water and family ownership of a latrine, However, families of i nfected children had more persons per sleeping room in the home (3.8 v s. 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 nutritiona l indexes among infected vs, noninfected children. Conclusions. Househ old crowding and behaviors that differ between Hindus and Muslims, but not lack of access to clean water and latrines, may enhance the trans mission of H. pylori to rural Bangladeshi children, Although confirmin g the high frequency of infections in young Bangladeshi children, our findings do not support the notion that H. pylori is responsible for t he high prevalence of malnutrition in this setting.