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Citation/Abstract

Is Helicobacter pylori infection associated with diarrhea in a cohort of 3- to 8-year-old colombian children?


2011 2011

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Abstract (summary)


The Estudio Comunitario sobre la Salud del Niño cohort study followed 326 3- to 8-year-old Colombian children for 4 years to observe the natural history of Helicobacter pylori infection and identify risk factors for acquisition, recurrence and persistence. Acute H. pylori infection during childhood may predispose to other enteric infections and therefore increase the risk of diarrheal disease. This dissertation aimed to estimate the effect of H. pylori infection on the occurrence of diarrhea and parasitic co-infections. The analysis used Generalized Estimating Equations to obtain odds ratios to estimate relative risks for diarrhea and the Zhang-Yu algorithm to estimate relative risks for on parasitic infections. Andersen-Gill models were used to estimate rate ratios for the effect of H. pylori status on the recurrence of parasitic infections. H. pylori status was classified for the entire follow-up duration in 1 of 3 categories: persistently positive, intermittently positive, and persistently negative. Multivariable models included child's sex, age, symptoms, medication use, and socio-environmental factors. H. pylori infection was weakly and imprecisely associated with diarrheal disease, which occurred at an unexpectedly low frequency in this study. Persistently H. pylori -positive children had a somewhat higher incidence of reported diarrhea than intermittently positive or persistently negative children. Stratified analysis revealed that the presence of specific helminthes modified the effect of persistent H. pylori infection on diarrhea. The incidence of any parasitic infections was higher in children with persistent H. pylori infection relative to those with intermittent or persistently negative status, but this association did not hold when adjusted for the full set of selected covariates. The effects of H. pylori persistent status were similar for the occurrence or recurrence of Giardia duodenalis, Entamoeba histolytica, and Ascaris lumbricoides. These results show that H. pylori frequently co-exists with other parasites in Andean children and suggest that intermittently H. pylori -positive children might be at a lower risk of parasitic infections than persistently positive children. The relationship of H. pylori infection, helminthic infection and diarrheal disease should be further explored in studies that devote more intensive resources to accurate ascertainment of diarrhea.

Indexing (details)


Subject
Epidemiology
Classification
0766: Epidemiology
Identifier / keyword
Health and environmental sciences, Children, Colombia, Diarrhea, Helicobacter pylori
Title
Is Helicobacter pylori infection associated with diarrhea in a cohort of 3- to 8-year-old colombian children?
Author
Sierra, Monica S.
Number of pages
185
Publication year
2011
Degree date
2011
School code
0219
Source
DAI-B 73/06, Dec 2012
Place of publication
Ann Arbor
Country of publication
United States
ISBN
9781267193742
Advisor
Goodman, Karen J., Delclos, George P.
Committee member
Chan, Wenyaw, Risser, Jan, Waring, Stephen
University/institution
The University of Texas School of Public Health
Department
Epidemiology & Disease Control
University location
United States -- Texas
Degree
Ph.D.
Source type
Dissertations & Theses
Language
English
Document type
Dissertation/Thesis
Dissertation/thesis number
3495639
ProQuest document ID
923626714
Copyright
Copyright ProQuest, UMI Dissertations Publishing 2011
Document URL
http://search.proquest.com/docview/923626714