Investigation of Helicobacter pylori infection among symptomatic children in Hangzhou from 2007 to 2014: a retrospective study with 12,796 cases

BACKGROUND AND AIM The infection of Helicobacter pylori (H. pylori) is acquired in childhood and the prevalence vary greatly in different countries and regions. The study aimed to investigate the characteristics of H. pylori infection among children with gastrointestinal symptoms in Hangzhou, a representative city of eastern China. METHODS A systematic surveillance of H. pylori infection according to the 13C-urea breath test was conducted from January 2007 to December 2014 in the Children's hospital, Zhejiang University School of Medicine. The demographic information and main symptoms of every subject were recorded. RESULTS A total of 12,796 subjects were recruited and 18.6% children evaluated as H. pylori positive. The annual positive rates decreased from 2007 to 2014 (χ2 = 20.461, p < 0.01). The positive rates were 14.8%, 20.2% and 25.8% in 3-6, 7-11 and 12-17 years age group respectively, which increased with age (χ2 = 116.002, p < 0.01). And it was significantly higher in boys than girls (χ2 = 15.090, p < 0.01). Multivariate logistic regression identified possible risk factors for H. pylori infection. Age, gender, gastrointestinal symptoms and history of H. pylori infected family member were all significantly associated with H. pylori infection (all p < 0.05). CONCLUSIONS H. pylori infection rates in children with gastrointestinal symptoms were lower than most of those reported in mainland China. Further studies are required to determine the prevalence in the general population. Comprehensively understanding of the characteristics and the possible risk factors of H. pylori infection will be helpful to its management strategies in children in China.