A US study in this weeks issue of THE LANCET highlights how most newly acquired infections of the intestinal bacterium Helicobacter pylori probably occur in children younger than 10 years of age. The authors of the study suggest that treatment and prevention strategies should therefore be targeted at young children.

H pylori infection is associated with many gastro-intestinal disorders including gastritis, gastric ulcer, duodenal ulcer, gastric carcinoma, and primary gastric -cell lymphoma. H pylori is common worldwide, but the age at which it is acquired is unclear. Hoda Malaty and colleagues from Baylor College of Medicine, Houston, USA, studied 224 children (99 black, 125 white; 110 male, 114 female) from 197576 (ages 13 years) to 199596.

18 (8%) children at age 13 years had H pylori antibodies (13% black compared with 4% white children). By age 1823 years, the prevalence of the infection was 24.5% (43% black compared with 8% white participants). Of the 206 children not infected at the start of the study, 40 (19%) became infected by age 2123. The crude incidence rate per year was 1.4%, ranging from 2.1% at age 45 years and 1.5% at 79 years to 0.3% at 2123 years.

Black children were more than three times more likely to have H pylori infection, although the average age of acquisition at about 7.5 years was the same for both black and white children.

Hoda Malaty comments: This study confirms that even within the same community, different cohorts can have different risks of acquiring the infection. Race had an important effect on the acquisition, persistence, and clearance of the infection, whereas sex had no significant effect. H pylori infection was acquired at any time between infancy and young adulthood, but early childhood seems to be the important period when most of the infections are acquired. The period in life when the infection is acquired might also affect risk of development of forms of the infection with symptoms such
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Contact: Richard Lane
richard.lane@lancet.com
44-20-7424-4949
Lancet
14-Mar-2002

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