Helicobacter pylori Prevalence and Impact: A Histology-Based Report About Children from an Endemic Country

Background: Helicobacter pylori is spreading worldwide with a high prevalence rate in the developing countries. Our primary goal was to measure the histology-based prevalence of Helicobacter pylori infection in children and to quantify its impact on the gastric inflammation and anemia. Our secondary goal was to study possible predictors for the presence of Helicobacter pylori in this cohort. Methods: A retrospective chart review was performed for children who underwent Esophago-gastro-duodenoscopy at Jordan university hospital in Jordan from 2008 to 2016. Data collected included epidemiological data, indication for endoscopy, endoscopic findings, and laboratory data. The gastric biopsies were re-examined by a pathologist to check for the presence of Helicobacter pylori, the presence of gastritis, and to grade gastritis according to the updated Sydney criteria. Results: A total of 98 children (53 girls-54%) underwent Esophago-gastro-duodenoscopy. The average age was 11.7 years +/- 4.7 years. Of them, 53 patients (29 boys-55%) had Helicobacter pylori identified in the gastric biopsy. The histology-based prevalence rate of Helicobacter pylori was 54%. The most common indication for endoscopy was abdominal pain (53%) followed by vomiting (18%). Nodular gastric mucosa was present in 43% of the Helicobacter pylori-positive group, and in only 11% of the Helicobacter pylori-negative group (P-value <0.0.5). Moderate to severe chronic gastritis was seen in 59% of the biopsies of Helicobacter pylori-positive group, compared to 31% in the Helicobacter pylori-negative group (p value <0.05). Presence of anemia was not different between the two groups (p value > 0.05). Presence of endoscopic nodularity, active gastritis by histology, and moderate to severe gastritis by histology were positive predicators for the presence of Helicobacter pylori. (p value <0.05). Conclusion: Helicobacter pylori infection in this study cohort of Jordanian children is common, with a histology-based prevalence rate of 54%. Nodularity of the stomach is the most common positive endoscopic feature, and its presence predicts the presence of Helicobacter pylori. Moderate to severe active gastritis is associated with Helicobacter pylori. The presence of Helicobacter pylori does not affect anemia status in this cohort of Jordanian children.