Where are we today with Helicobacter pylori infection among healthy children in Saudi Arabia?
Abdulrahman A Al-Hussaini1, Abdullah N Al Jurayyan2, Salman M Bashir3, Dayel Alshahrani4
1 The Division of Pediatric Gastroenterology, Children's Specialized Hospital, King Fahad Medical City; College of Medicine, Alfaisal University; Prince Abdullah bin Khalid Celiac Disease Research Chair, Department of Pediatrics, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
2 The Department of Pathology and Laboratory Medicine, Division of Immunology, King Fahad Medical City, Riyadh, Saudi Arabia
3 Department of Biostatistics, Research Services Administration, Research Center at King Fahad Medical City, Riyadh, Saudi Arabia
4 The Division of Pediatric Infectious disease, Children's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
Dr. Abdulrahman A Al-Hussaini
Associate Professor of Pediatrics, Consultant Pediatrician, Gastroenterologist and Hepatologist, College of Medicine, Alfaisal University, Children's Specialized Hospital, King Fahad Medical City, P. O. Box 59046, Riyadh- 11525
Source of Support: None, Conflict of Interest: None
Background/Aims: The available studies on Helicobacter pylori (H. pylori) prevalence among healthy asymptomatic population across Saudi Arabia suffers from significant limitations. We conducted this large population-based study to estimate the H. pylori seropositivity rate among apparently healthy children in Saudi Arabia, using anti-H. pylori immunoglobulin A (IgA) and IgG serology tests, and to study the influence of H. pylori infection on growth.
Materials and Methods: We conducted a cross-sectional study to screen apparently healthy school aged Saudi children (aged 6–15 years), attending primary and intermediate schools in Riyadh between 2014 and 2016, for H. pylori seropositivity by checking for the presence of anti-H. pylori IgG and IgA antibodies in serum specimens.
Results: Out of 3551 serum specimens, 1413 cases tested seropositive for H. pylori organism (40%): 430 (12.2%) were both IgG and IgA positive, 212 (6%) and 771 (21.7%) cases showed isolated positivity for IgG or IgA, respectively. Male gender, older age, lower levels of socioeconomic status (SES), and family members >10 were significantly associated with H. pylori seropositivity. The proportion of participants with short stature was significantly more in the H. pylori seropositive group than the seronegative group (OR1.249, confidence interval [1.020–1.531], P= 0.033). There was no significant association between H. pylori seropositivity and gastrointestinal symptoms.
Conclusion: The prevalence of H. pylori seropositivity among apparently healthy Saudi children (40%) is intermediate compared with that in developed and developing countries. The Saudi pediatric population shows a predominant IgA-type immunological response to H. pylori infection.