Abstract
Background: Helicobacter pylori infection affects over 50% of the world's population and is the primary cause of duodenal and gastric ulcers, as well as gastric cancer. Objectives: To investigate the risk factors for recurrence following successful eradication of H. pylori infection in children aged 4 - 16 years in the Baoding area. Methods: The study included 328 children diagnosed with H. pylori infection at our hospital from January 2021 to June 2022, who had successfully undergone eradication treatment. A questionnaire covering personal history, family history, health status, and family socioeconomic status was administered to the children, coupled with a 1-year follow-up. Recurrence within this period was monitored, along with an analysis of the risk factors for recurrence post-eradication. Results: Out of 328 children with H. pylori infection, 295 (89.9%) were successfully followed up. Among these, 55 (18.6%) tested positive on the 13C-urea breath test and were considered to have recurrent infection (recurrence group), while 240 (81.4%) tested negative and were considered to have no recurrence (non-recurrence group). Univariate chi-square analysis of the questionnaire results indicated that age (P < 0.05), number of eradication treatments (P < 0.05), mother's education level (P < 0.05), place of residence (P < 0.05), family income (P < 0.05), family history of H. pylori infection (P < 0.05), separate meals (P < 0.05), and lunch location (P < 0.05) significantly influenced H. pylori recurrence. Multivariate analysis, which included factors showing significant differences in univariate analysis, was performed using a logistic regression model. This analysis identified multiple treatments (> 2 eradication attempts), residing in rural areas, and low family income as combined risk factors for H. pylori recurrence in children. Conversely, being older than 10 years, eating separate meals, and higher maternal education level emerged as protective factors against recurrence. Conclusions: There is a relatively high rate of H. pylori recurrence among children aged 4 - 16 years in this region, which may be linked to age, number of eradication treatments, dietary and hygiene habits, educational levels of family members, and economic status.