Transmission of Helicobacter pylori among siblings
Transmission of Helicobacter pylori among siblings
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DOI：
10.1016/s0140-6736(99)05273-3
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发表时间：
2000-01-29
期刊：
影响因子：
168.9
通讯作者：
Correa, P
中科院分区：
文献类型：
--
作者：
Goodman, KJ;Correa, P
背景幽门螺杆菌感染引起慢性消化系统疾病，对公共卫生有重大影响，但由于对传播途径的了解有限，预防措施的设计受到阻碍。我们研究了家庭构成对哥伦比亚农村2-9岁儿童幽门螺杆菌患病率的影响。方法采用uc -尿素呼气试验对684例儿童进行幽门螺杆菌筛查，记录每个儿童的出生顺序、出生间隔、2-9岁兄弟姐妹数、2-9岁兄弟姐妹H-幽门螺杆菌阳性数。在控制卫生相关暴露、社会经济指标和家庭中儿童人数的情况下，通过逻辑回归估计优势比。发现感染的几率随着家庭中2-9岁兄弟姐妹的数量而增加（1、2、3和4 - 5个兄弟姐妹的比值分别为1.4、2.3、2.6和4.3）。与头胎相比，第二胎和第三胎至第九胎的优势比分别为1.8 （95% CI 1.0-3.3）和2.2（1.0-4.3）。与比下一位年长家庭成员晚10年或更长时间出生的儿童相比，4年内出生的儿童感染的可能性高出4.1倍（CI 2.0-8.6）；与下一个年轻家庭成员的年龄差距显示出较弱的影响。2-9岁的h -pylori阳性兄弟姐妹的数量具有特别强的效应梯度（1、2、3和4个阳性兄弟姐妹分别为1.5、3.2、5.6和7.1）。在安第斯地区10岁以下的农村儿童中，幽门螺杆菌感染似乎最容易在年龄相近的兄弟姐妹中传播，并且最常由哥哥姐姐传染给弟弟妹妹。
Background Helicobacter pylori infection causes chronic digestive diseases with a major public-health impact, yet the design of prevention measures is hampered by limited knowledge of transmission pathways. We studied the effect of family composition on H pylori prevalence among rural Colombian children aged 2-9 years.Methods 684 children were screened for H pylori with the UC-urea breath test, For each child, birth order, birth spacing, number of 2-9-year-old siblings, and number of H-pylori-positive 2-9-year-old siblings was recorded. Odds ratios were estimated by logistic regression, controlling for hygiene-related exposures, socioeconomic indicators, and the number of children in the household.Findings The odds of infection increased with the number of 2-9-year-old siblings in the household (odds ratios 1.4, 2.3, 2.6, and 4.3 for one, two, three, and four to five siblings, respectively). Compared with first-born children, odds ratios for children born second and third to ninth were 1.8 (95% CI 1.0-3.3) and 2.2(1.0-4.3), respectively. Compared with children born 10 or more years after the next older household member, those born within 4 years were 4.1 times (CI 2.0-8.6) more likely to be infected; the age gap to the next younger household member displayed a weaker effect. The number of H-pylori-positive 2-9-year-old siblings had particularly strong effect gradient (1.5, 3.2, 5.6, and 7.1, for one, two, three, and four positive siblings, respectively).Interpretation Among rural Andean children younger than 10 years, H pylori infection seems to be transmitted most readily among siblings who are close in age, and most frequently from older siblings to younger ones.