What are the risk factors for person-to-person transmission of pediatric Helicobacter pylori (Hp) infection?

Updated: Nov 16, 2018
  • Author: Mutaz I Sultan, MBChB, MD; Chief Editor: Carmen Cuffari, MD  more...
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Causes of H pylori infection include the following:

  • Person-to-person transmission of H pylori infection is noted.

    • Infection clusters are noted, particularly in families with infected children. The possible routes are fecal-oral, oral-oral and gastro-oral. Mother-to-child transmission was strongly suggested in a study of DNA analysis of the H pylori strains. [26] The data showed identical H pylori strains between mothers and their toddler-aged children. Moreover, the mother’s symptoms of nausea and vomiting and the use of pacifier were significantly associated with the risk of H pylori infection in children.

    • In a very interesting longitudinal study from the US-Mexican border, Cervantes et al showed that a younger sibling was 4 times more likely to become infected with H pylori if the mother was infected with H pylori compared with an uninfected mother. Younger siblings were 8 times more likely to become infected if their older index sibling had persistent H pylori infection. [27]

    • The possibility of H pylori transmission among children in daycare centers or kindergarten, where interpersonal contacts are common, was also proposed. A meta-analysis of 16 studies did not confirm this hypothesis. The summary OR was 1.12 (95% confidence interval, 0.82–1.52). However, the authors highlighted the limitations of the published studies, including different types of childcare, different age groups, and lack of differences in the exposure duration, with exposure giving a high heterogeneity to the meta-analysis results. [28]

    • Crowding and poor personal hygiene may also play a role.

    • An increased prevalence of H pylori infection is noted in developing countries. This may reflect the combined effects of poor living conditions, poor hygiene, and crowding.

    • In the United States, socioeconomic level is strongly and inversely related to the prevalence of H pylori infection, a finding that may also reflect the same factors as those noted in developing countries.

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