Seroepidemiology of Helicobacter pylori infection among preschool childrenin Taiwan

Helicobacter pylori is associated with chronic antral gastritis that is rel ated to duodenal ulcer, gastric ulcer, and probably gastric adenocarcinoma. Infection with H. pylori during childhood is considered an important risk factor for gastric carcinoma in adult life. To examine the epidemiologic ch aracteristics of H. pylori infection among preschool children in central Ta iwan, a community-based survey was carried out in 54 kindergartens in 10 ur ban townships, 10 metropolitan precincts, and 2 aboriginal townships random ly selected through stratified sampling. Serum specimens of 2,551 healthy p reschool children (3-6 years old) randomly sampled from study kindergartens were screened for antibodies to H. pylori by latex agglutination and ELISA methods. Multivariate-adjusted odds ratios (ORs) with their 95% confidence intervals (CIs) were estimated by multiple logistic regression analysis. A total of 207 subjects were antibody-positive, giving a prevalence of 8.1% The overall seropositive rates were 4.5% in 3-year-old group, 4.4% in 4-yea r-old group, 9.4% in 5-year-old group, and 11.7% in 6-year-old group. The o lder the age, the higher the seroprevalence (OR = 3.2, 95% CI = 1.5-6.8 for 3-year-old children versus the 6-year-old children). Seroprevalence was no t different between boys and girls. The aboriginal townships had a seroprev alence greater than the urban townships and metropolitan precincts (OR = 2. 6, 95% CI = 1.9-3.7). The larger the number of siblings, the higher the ser oprevalence (OR = 2.4, 95% CI = 1.0-5.8 for those with no sibling versus th ose with greater than or equal to 3 siblings). In the multiple logistic reg ression analysis, the seroprevalence of H. pylori remained significantly in creased with age, aboriginal township, and large sibship size after multiva riate adjustment. A poor water supply system, sewage disposal, and other en vironmental hygiene in the aboriginal townships might have played some role in infection with H. pylori. The early childhood transmission among siblin gs might also be an important determinant of H. pylori seropositivity in Ta iwan.