Helicobacter Pylori in Children is Strongly Associated with Poverty

Abstract

Background and Aims: To examine the association between prevalence of H. pylori colonisation and social deprivation in a sample of children investigated in hospital. Methods: A retrospective review of the hospital records of all children (n = 626) who underwent 13C-urea breath testing for suspected H. pylori infection at the Royal Hospital for Sick Children, Glasgow, Scotland between August 1995 to December 2002 was performed. Prevalence of H. pylori colonisation was measured by the 13C-urea breath test and socioeconomic status was measured by the Carstairs and Morris index of deprivation. Results: The overall prevalence of H. pylori was 26%. There was a highly significant positive association between H. pylori colonisation and poor socioeconomic status (p < 0.0001). The prevalence of colonisation was significantly higher in children from the most deprived areas (DepCat 6 and 7; 34%) compared to children from intermediate (DepCat 3 to 5; 22%) and the most affluent areas (DepCat 1 and 2; 16%) (p < 0.0001). Conclusions: Socioeconomic deprivation in childhood is associated with a high prevalence of H. pylori colonisation. While the incidence of H. pylori may be declining, it remains common in poor families. If the prevalence of H. pylori (26%) in this selected group reflects that of the population at large, then over gooo (5%) of Glasgow's children are at risk of this preventable disease. In a city where the majority of adults are colonised with H. pylori, colonisation in early life adds to the burden of health risks to which deprived children are exposed.