Low Prevalence ofHelicobacter PyloriInfection in Canadian Children: A Cross-Sectional Analysis

Abstract

BACKGROUND: The incidence and prevalence rates of childhoodHelicobacter pyloriinfection vary greatly by nation, with infection rates of 8.9% to 72.8% reported in developed and developing countries, respectively. To date, few studies have assessed the prevalence ofH pyloriin Canadian children, with studies limited to Aboriginal communities and single tertiary care centres from Ontario and Quebec.OBJECTIVES: To determine the prevalence ofH pyloriin consecutive children referred to three Canadian tertiary care academic centres for upper gastrointestinal (GI) endoscopy due to upper GI symptoms, and to determine the sensitivity and specificity of the carbon-13-labelled urea breath test, the rapid urease test and theH pyloristool monoclonal antigen test.RESULTS: Two hundred four patients were recruited. The prevalence ofH pyloriwas 7.1%. Of theH pylori-positive patients, 41.7% were male, with a mean age of 10.3 years. Ethnic minorities accounted for 42% of theH pylori-positive patients. Consistent with previous observations, the sensitivity and specificity of the carbon-13-labelled urea breath test were 1.0 and 0.98, respectively. The sensitivity and specificity of the rapid urease test were 1.0 and 0.99, respectively. Stool samples were collected from 34 patients from one centre, with a sensitivity and specificity of 1.0 and 0.68, respectively. No defining symptoms ofH pyloriinfection were evident and no peptic ulcer disease was demonstrated.CONCLUSION:H pyloriinfection rates in Canadian children with upper GI symptoms are low, and are lower than those reported for other developed countries. Further studies are required in Canada to determine the prevalence in the general population and specifically in the populations at risk.