First Detected Helicobacter pylori Infection in Infancy Modifies the Association Between Diarrheal Disease and Childhood Growth in Peru. Issue 4 (20th April 2014)

• Record Type: Journal Article
• Authors: Jaganath, Devan; Saito, Mayuko; Gilman, Robert H.; Queiroz, Dulciene M.M.; Rocha, Gifone A.; Cama, Vitaliano; Cabrera, Lilia; Kelleher, Dermot; Windle, Henry J.; Crabtree, Jean E.; Checkley, William
• Is Part Of: Helicobacter. Volume 19:Issue 4(2014:Aug.)
• Page Start: 272
• Page End: 279
• Publication Date: 2014-04-20
• Subjects: Helicobacter -- Periodicals; Helicobacter infections -- Periodicals; Stomach -- Diseases -- Periodicals; 616.3301405
• DOI: 10.1111/hel.12130
• Languages: English
• ISSNs: 1083-4389

Abstract

<abstract abstract-type="main" id="hel12130-abs-0001"> <title>Abstract</title> <sec id="hel12130-sec-0001" sec-type="section"> <title>Background</title> <p>In endemic settings, <italic>Helicobacter pylori</italic> infection can occur shortly after birth and may be associated with a reduction in childhood growth.</p> </sec> <sec id="hel12130-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>This study investigated what factors promote earlier age of first <italic>H. pylori</italic> infection and evaluated the role of <italic>H. pylori</italic> infection in infancy (6–11 months) versus early childhood (12–23 months) on height. We included 183 children near birth from a peri‐urban shanty town outside of Lima, Peru. Field‐workers collected data on socioeconomic status (SES), daily diarrheal and breast‐feeding history, antibiotic use, anthropometrics, and <italic>H. pylori</italic> status via carbon 13‐labeled urea breath test up to 24 months after birth. We used a proportional hazards model to assess risk factors for earlier age at first detected infection and linear mixed‐effects models to evaluate the association of first detected <italic>H. pylori</italic> infection during infancy on attained height.</p> </sec> <sec id="hel12130-sec-0003" sec-type="section"> <title>Results</title> <p>One hundred and forty (77%) were infected before 12 months of age. Lower SES was associated with earlier age at first detected <italic>H. pylori</italic> infection (low vs middle‐to‐high SES Hazard ratio (HR) 1.59, 95% CI 1.16, 2.19; <italic>p </italic>= .004), and greater exclusive breast‐feeding was associated with reduced likelihood (HR 0.63, 95% CI 0.40, 0.98, <italic>p </italic>= .04). <italic>H. pylori</italic> infection in infancy was not independently associated with growth deficits (<italic>p </italic>= .58). However, children who had their first detected <italic>H. pylori</italic> infection in infancy (6–11 months) versus early childhood (12–23 months) and who had an average number of diarrhea episodes per year (3.4) were significantly shorter at 24 months (−0.37 cm, 95% CI, −0.60, −0.15 cm; <italic>p </italic>= .001).</p> </sec> <sec id="hel12130-sec-0004" sec-type="section"> <title>Discussion</title> <p>Lower SES was associated with a higher risk of first detected <italic>H. pylori</italic> infection during infancy, which in turn augmented the adverse association of diarrheal disease on linear growth.</p> </sec> </abstract>