© 1998 Oxford University Press
research-article |
Helicobacter pylori infection and mode of transmission in a population at high risk of stomach cancer
aWelfang Blood Center Welfang, Shandong, China 261041
bNational Cancer Institute Bethesda, MD 20892, USA
cBeijing institute for Cancer Research and School of Oncology. Beijing Medical University Beijing, China 100034
dInternational Epidemiology institute, Ltd. Rockville, MD 20850, USA
eBeijing Union Medical College Hospital Beijing, China 100730
fLinqu Public Health Bureau Linqu, Shandong 262600
gWestat, Inc. Rockville, MD 20850. USA
hReprints requests: Wei-cheng You, National Cancer Institute, EPN Room 431. Bethesda, MD 20892, USA.
BACKGROUND: Helicobacter pylori (H. pylori) is a recognized cause of chronic gastritis and peptic ulcer disease, and is strongly suspected to play a role in the aetiology of stomach cancer but little is known about the mode of transmission.
AIM: To determine the prevalence of H. pylori infection in children and investigate potential modes of transmission in rural China.
SUBJECTS AND SETTING: We examined 98 children aged 3–12 years and 289 adults aged 35–64 years in a village in Linqu County, China, which has one of the highest rates of stomach cancer in the world.
METHOD: H. pylori infection was determined by 13C-urea breath test in children and by an enzyme-linked immunosorbent assay in adults.
RESULTS: Among 98 tested children, 68 (69%) were H. pylori positive, but the prevalence rates varied as a function of age, rising from about 50% at ages 3–4 to 85% at ages 9–10 before falling to 67% at ages 11–12. Boys had a higher infection rate than girls (77.8% versus 59.1%, P < 0.05). Among 289 adults, 195 (68%) were H. pylori positive, with a somewhat higher rate of positivity in younger compared to older age groups. The prevalence of H. pylori infection clustered within families. In families with at least one infected parent, 85% of children were H. pylori positive, while in families with both parents uninfected, only 22% of children were H. pylori positive (odds ratio [OR] = 30.4. 95% CI: 4.0–232).
CONCLUSIONS: These findings demonstrate the acquisition of H. pylori infection during early childhood in a population at high risk of stomach cancer, in a marmer consistent with a person-to-person mode of transmission between parents and children.
Keywords Helicobacter pylori, children, transmission, stomach cancer
Accepted 28 November 1997
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