Establish Epidemiologic Data of H. Pylori Infection in Children and Adolescents-Using C13-UBT
Condition: H. Pylori Infection
MeSH terms: Infections; Communicable Diseases; Helicobacter Infections
Study type: Observational

Summary: 
      The aims of this prospective study are: (1) to prospectively investigate the "true"
      prevalence rate, the acquisition and spontaneous clearance of H. pylori infection year by
      year in the population whose ages between seven and fifteen. (2) to explore the risk factors
      of transmission of H. pylori infection in Taiwan. (This information may be use as the guide
      for conduction of the national policy of public health and disease prevention.)
    

Detailed description: 
      Helicobacter pylori (H. pylori), a spiral microaerophilic Gram-negative bacterium isolated in
      1983, is now known as the most common gastrointestinal bacterial infection worldwide. It is
      the principal cause of chronic gastritis and is strongly associated with peptic ulcer disease
      as well as gastric cancer, including gastric lymphoma (MALT type). In developed countries,
      infection occurs in more than 50% of adults, whereas developing countries have infection
      rates reaching 90%. Among those with H. pylori infection, eradication therapy alters the
      natural history of recurrences with attendant morbidity and death, which previously required
      lifelong maintenance therapy. Perhaps the greatest concern with regard to infection with H.
      pylori is the increased risk for the development of gastric cancers in adulthood. This is
      particularly relevant because infection dating from childhood appears to enhance the risk of
      carcinogenesis. Because H. pylori infection is contracted primarily during the childhood
      years, additional epidemiological studies among pediatric populations are imperative.
      Therefore the validation of an inexpensive, easy-to perform, sensitive, specific, and
      noninvasive diagnostic test for H. pylori infection in children and adolescents is of
      paramount importance to enhance our presently limited understanding of H. pylori-related
      diseases. The optimal noninvasive tests for epidemiological research of H. pylori infection
      in children are still not well identified. Serologic immunoassays based on H. pylori antigens
      require validation in the pediatric population under evaluation. As the result of our
      previous study, the serological test was not sensitive enough as an epidemiology screening
      tool for H. pylori infection in children.The aims of this prospective study are: (1) to
      prospectively investigate the "true" prevalence rate, the acquisition and spontaneous
      clearance of H. pylori infection year by year in the population whose ages between seven and
      fifteen. (2) to explore the risk factors of transmission of H. pylori infection in Taiwan.
      (This information may be use as the guide for conduction of the national policy of public
      health and disease prevention.) The study population will include students of one primary
      school and one junior high school in Lo-Tong area. There will be 150-160 cases in each age
      group and will be continuously followed-up for 3 years. Blood sample will be collected from
      each student for the serological test. 13C-urea breath test will be performed in each
      student, too. The parents of students will answer a questionnaire concerning the basic
      epidemiological data and possible factors related to the transmission of H. pylori. The
      students having new acquisition of H. pylori infection in the 2nd or 3rd years' follow-up
      period will be collected for further investigation. These student and their family will be
      invited to receive panendoscopy for the evaluation of possible pathology of stomach and the
      isolation H. pylori strain. These H. pylori isolates will be identified by molecular
      genotyping for the detection of possible source of transmission in the family. All of these
      results will be analyzed by a SAS system.
    

Observational model: Defined Population
Time perspective: Prospective
Keywords: H. pylori, 13C-urea breath test, serology, epidemiology