Prevalence and risk factors of Helicobacter pylori infection among children in Kuichong Subdistrict of Shenzhen City, China

Background: Helicobacter pylori infection is a significant burden to the public health in China as it can lead to various gastric diseases including peptic ulcers and gastric cancer. Since most infections occurred during childhood, it is therefore necessary to understand the prevalence and risk determinants of this bacterial infection in children. Herewith, we conducted a cross-sectional study in the Kuichong Subdistrict of Shenzhen City to assess the prevalence and risk factors of H. pylori infection among children.

Methods: From September 2018 to October 2018, 1,355 children aged 6-12 years from four primary schools in the Kuichong Subdistrict of Shenzhen City were recruited. These children were screened for H. pylori infection using the 13C-urea breath test. In addition, parents were requested to fill out a standardized questionnaire. The chi-square test and multivariable logistic regression analysis were used to identify risk factors for H. pylori.

Results: Among 1,355 children recruited in this study, 226 (16.7%; 95% CI [14.7-18.7]) were positive of H. pylori infection. Multivariable logistic regression analysis identified six factors significantly associated with H. pylori infection children including parent(s) with tertiary education level (OR: 0.64; 95% CI [0.46-0.89]), testing bottle feed temperature using the mouth (OR: 1.79; 95% CI [1.19-2.68]), sharing of cutlery between the feeding person and young children during meals (OR: 1.84; 95% CI [1.22-2.78]), eating fruit after peeling (OR: 2.56; 95% CI [1.4-4.71]), frequent dining out (OR: 3.13; 95% CI [1.46-6.68]) and snacking (OR: 1.43; 95% CI [1.01-2.01]).

Conclusions: Overall, better educated parent(s) played a protective role against the acquisition of H. pylori infection in children. Testing bottle feed temperature using the mouth, cutlery sharing between the feeding person and young children, and snacking posed a lower but significant risk for H. pylori infection. Only eating peeled fruits and frequent dining out were associated with greater infection risks.