Spectrum of paediatric Helicobacter pylori infection in a tertiary care hospital

Abstract

Background: Helicobacter pylori infection affects more than half of the global population. The infection is typically acquired during childhood but can be asymptomatic, with long-term clinical consequences including gastritis, peptic ulcer disease, and stomach cancer. Objective: To evaluate the clinicodemographic and laboratory profile of paediatric Helicobacter pylori infection. Materials and Methods: This hospital-based cross-sectional study included 218 children with H. pylori infections from Bangladesh Shishu Hospital and Institute (BSH&I)’s, Department of Paediatric Gastroenterology, Hepatology, and Nutrition from March 2024 to February 2025. According to the ESPGHAN/NASPGHAN guidelines for children, all study participants between 3 to 18 years of age who had at least one of the following nonspecific abdominal symptoms— abdominal pain, nausea, vomiting, or bloating for more than four weeks were enrolled, had endoscopy, and had the Rapid Urease Test. Two gastric biopsies from the stomach’s body and two from the antrum were taken for histological analysis. The traditional Giemsa procedurestained stomach tissue for H. pylori. Results: Most participants were over 6 (77.9%) years old and male (55.9%). Regarding maternal education, 50.9% had primary education. Many households had more than five individuals (67.9%) and were rural (62.8%). Caregivers helped 87.1% to use toilets. They mostly used partially boiled (45.8%), tube well (32.1%), and tap water (11.9%). Handwashing was low at 63.8%. Most children (61.1%) had a healthy body mass index (BMI); however, 35.4% were underweight. Abdominal pain (83%), vomiting (72%), epigastric tenderness (67.9%), and heartburn (66.9%) were the most common clinical findings. Nearly half (48.1%) had mild anaemia, and microcytic hypochromic (72.0%) was the most common type. The rapid urease test (RUT) was positive in 94.04% of patients. Endoscopy showed erythema in 85.7% of cases, erosion to the tissue in 55.0%, and nodular lesions in 38.0% of cases. Histopathology revealed chronic gastritis in 88.9% of cases and an active H. pylori infection in 48.1% when using Giemsa staining. Conclusion: A Helicobacter pylori infection is common in older children and usually associated with gastrointestinal discomfort, anaemia, and poor hygiene. The rapid urease test and histopathology help in early diagnosis.

DS (Child) H J 2025; 41(1): 15-19