Prevalence of H. pylori Infection and Chronic Atrophic Gastritis in the Dominican Children

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TITLE : Prevalence of H. pylori Infection and Chronic Atrophic Gastritis in the Dominican ChildrenPURPOSE : To show the prevalence of H. pylori infection and chronic atrophic gastritis (CAG) and the positivity of CagA antibody to H. pylori in the Dominican children, and to clarify the several factors that related to H. pylori infection and CAG by multivariate analysis.METHODS : One thousand and thirty one subjects who have given us the informed consent in writing were volunteers from children of the nursery school, a kindergarten, a primary school, and a junior high school in the Dominican Republic. Each individual underwent a health checkup and blood sampling for measurement of serum pepsinogen I and II, pepsinogen I/II ratio, serum gastrin, H. pylori antibodies, and CagA antibody to H. pylori, and responded to a questionnaire on upper digestive tract diseases.RESULTS : The prevalence of H. pylori infection (0.000-0.467) and CAG (0.000-0.158) varied by age and sex. The positivity of C … More agA antibody to H. pylori for boys and girls increased by advancing age in the Dominican children.To show the factors related to be H. pylori infection was done the stepwise regression analysis using forward likelihood procedure and choosing H. pylori infection as the dependent variable. The model included twenty-five independent variables (gastrointestinal disease-related subjective symptom, past history, and family history, environment, lifestyle, gender and age, and subjects examined data ; serum gastrin level. In this final step of the logistic regression model, of the subjects without H. pylori infection, 93.5% were correctly classified. Of the subjects with H. pylori infection, 27.7% were correctly classified. Overall, 75.6% of all subjects were correctly classified. The odds ratio of H. pylori infection in male subjects was 1.465 to female subjects. The odds ratio of H. pylori infection was 1.326 when age of the subject increase one year old. The odds ratio of H. pylori infection was 1.185 when numbers of children who live together increase one person. The odds ratio of H. pylori infection in subjects with diarrhea as subjective symptom was 1.567 to those without diarrhea. The odds ratio of H. pylori infection was 1.008 when serum gastrin level of the subject increases 1 pg/ml.To clarify the factors related to be chronic atrophic gastritis (CAG) was done the stepwise regression analysis using forward likelihood procedure and choosing chronic atrophic gastritis (CAG) as the dependent variable. The model included nine independent variables (gastrointestinal disease-related subjective symptom, past history, and family history, environment, lifestyle, gender, and age, subjects examined data; serum gastrin level, H. pylori infection, and antibody of CagA to H. pylori). In this final step of the logistic regression model, of the subjects without CAG, 99.0% were correctly classified. Of the subjects with CAG, 18.5% were correctly classified. Overall, 88.0% of all subjects were correctly classified. The odds ratio of CAG was 1.006 when serum gastrin level of the subject increased 1 pg/ml. The odds ratio of CAG in subjects with antibody of CagA to H. pylori infection was 2.090 to those without antibody of CagA. The odds ratio of CAG in subjects with H. pylori infection was 2.738 to those without H. pylori infection.The Cross tabulation by gender between H. pylori infection and antibody of CagA to H. pylori showed it that the positivity of CagA antibody has not seen significant differences between boys and girls. However, the positivity of CagA antibody was about 20 % by our CagA measurement kit in subjects1 who have had no H. pylori infection.CONCLUSIONS :Our results indicated that serum gastrin, CagA antibody to H. pylori, and H. pylori infection are a good marker of CAG even in children. To clarify the relationship between the positivity of CagA antibody to H. pylori and chronic atrophic gastritis need further study. Less