Brief Reports
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World J Gastroenterol. May 14, 2005; 11(18): 2759-2763
Published online May 14, 2005. doi: 10.3748/wjg.v11.i18.2759
Association of Helicobacter pylori infection and giardiasis: Results from a study of surrogate markers for fecal exposure among children
Edson Duarte Moreira Jr, Victor Bastos Nassri, Rafaela Sousa Santos, Junísia Ferraz Matos, Wilson Andrade de Carvalho, Célia Stolve Silvani, Círia Santana e Sant’Ana
Edson Duarte Moreira Jr, Victor Bastos Nassri, Rafaela Sousa Santos, Célia Stolve Silvani, Círia Santana e Sant’Ana, Núcleo de Apoio à Pesquisa, Fundação Irmã Dulce, Salvador, Bahia, Brazil
Edson Duarte Moreira Jr, Victor Bastos Nassri, Rafaela Sousa Santos, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil
Edson Duarte Moreira Jr, Victor Bastos Nassri, Rafaela Sousa Santos, Junísia Ferraz Matos, Wilson Andrade de Carvalho, Diretoria Científica e Laboratório do Hospital São Rafael, Salvador, Bahia, Brazil
Author contributions: All authors contributed equally to the work.
Correspondence to: Edson Duarte Moreira Jr, MD, PhD, Chief, Department of Epidemiology and Biostatistics, Oswaldo Cruz Foundation, Brazilian Ministry of Health Address: Rua Waldemar Falcão 121 Salvador, Bahia, Brazil, CEP 40.295-001. edson@cpqgm.fiocruz.br
Telephone: +55-71-356-8781-243 Fax: +55-71-356-2155
Received: October 9, 2004
Revised: October 10, 2004
Accepted: December 20, 2004
Published online: May 14, 2005
Abstract

AIM: To investigate whether Helicobacter pylori (H pylori) infection is associated with hepatitis A virus (HAV) infection, presence of enteroparasites, and other surrogates of fecal exposure.

METHODS: We conducted a cross-sectional study in 121 children consecutively admitted at a pediatric hospital in Salvador, Brazil. H pylori and HAV infection were identified by the presence of serum antibodies. Stool specimens were examined for the presence of ova and parasites. A structured questionnaire inquiring about sanitary conditions and life style was applied to each subject.

RESULTS: Fifty-one of the 121 children (42.1%) were found to be seropositive for H pylori, and 45 (37.2%) for HAV. The seroprevalence of H pylori and HAV both increased significantly with age. Cross-tabulation of data showed that 26 (21.5%) were seropositive and 51 (42.1%) were negative for both H pylori and HAV antibodies (χ2 = 7.18, OR = 2.8, CI 1.30-5.97). The age adjusted OR for an HAV-infected child being H pylori positive was 2.3 (CI 1.02-5.03). The agreement between H pylori and HAV seropositivity was fair (κ = 0.24). After controlling for possible confounding, the variables remaining independently associated with seropositivity to H pylori were age, presence of Giardia lamblia in feces (OR = 3.2, 95%CI, 1.1-9.5) and poor garbage disposal quality (OR = 2.4, 95%CI, 1.1-5.1).

CONCLUSION: Our data suggest that H pylori infection is associated with surrogate markers of fecal exposure. Thus, we conclude that the fecal-oral route is relevant in the transmission of HP among children in an urban setting of a developing country. The association observed between G. lamblia and H pylori infection may have several explanations. Further studies to investigate this relationship are warranted.

Keywords: H pylori; Hepatitis A virus; Epidemiology; Transmission; Enteroparasites; Brazil