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© 1996 Oxford University Press

research-article

Helicobacter pylori Infection in the Young in Bangladesh: Prevalence, Socioeconomic and Nutritional Aspects

DILIP MAHALANABIS*,**, MOHAMMED M RAHMAN*, SHAFIQUL A SARKER*, PRADIP K BARDHAN*, PIUS HILDEBRAND{dagger}, CHRIS BEGLINGER{dagger} and KLAUS GYR*

*Clinical Sciences Division, International Centre for Diarrhoeal Disease Research Bangladesh, GPO Box 128, Dhaka 1000, Bangladesh.
**Society for Applied Studies Calcutta, India.
{dagger}Department of Medicine and Research, University Hospital Basel, Switzerland.

BACKGROUND: The gastric acid barrier, an important host defence against small bowel infection, may be compromised by infection with Helicobacter pylori. In developing countries, H.pylori infection occurs early in life and prevelance of hypochlorhydria is high particularly in the malnourished, which may predispose a child to repeated gastrointestinal Infection and diarrhoea. Diarrhpea being a leading cause a childhood mortality and morbidity in developing countries, we investigated the prevelance of H. pylori infection in children in poor Bangladeshi community and explored its association with socioeconomic and nutritional status.

METHODS: The study was conducted in a poor periurban community among 469 children aged –99months. Parents were interviewed ising a questionnaire. To detect active infection with H. pyloria13 C-urea broath test was performed and weight was recorded on a beam balance with a sensitivity of 20g.

RESULTS: In all, 61% of 36 infants aged 1–3 months were positive for H. pylori, this rate dropped steadily with increasing age and was 33% in 10–15 month old children and then rose to 84% in 6–9 year olds. Overall H. pylori infection had no association with nutritional state of the child or family income but the infection rate was 2.5 times higher in children of mothers with no schooling.

CONCLUSIONS: The H. pylori infection rate is very high in early infancy in a poor periurban community of Bangladesh. The reason for a drop in the infection rate infancy is unclear but could be due to initial clearance of the infection by the body's defence mechanisms but with possible alteration of the gastric mucosa which sustains infection. Maternal education may be protective and may operate through some underlined proximate behavioural determinants. The rate of H. pylori infection and young children may predispose them to reapeated gastrointestinal infection and diahorreas.

Keywords Helicobacter pylori, infants, nutrition, socioeconomic status, diarrhoea, developing countries

Revised 1 August 1995


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