Prevalence of and risk factors for Helicobacter pylori infection in children under 64 months in Thimphu, Bhutan, and introducing the new in-house immunochromatography test kit: a cross-sectional study.

IF 4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gut Pathogens Pub Date : 2025-06-04 DOI:10.1186/s13099-025-00715-2

Passang Lhamo Sherpa, Takashi Matsumoto, Kinley Tshering, Birendra Pradhan, Junko Akada, Yoshio Yamaoka

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引用次数: 0

Abstract

Background: Helicobacter pylori (H. pylori) is a lifelong infection, often acquired in childhood and persisting throughout life, that can lead to serious gastric diseases, including gastric cancer in adults. While asymptomatic in most children, it may cause extraintestinal manifestations affecting growth, necessitating distinct pediatric management strategies-particularly in countries with a high risk of gastric cancer. Accurate diagnosis is critical in high-risk populations. The stool antigen test is a reliable, non-invasive method for young children. Despite Bhutan's high H. pylori burden, diagnostic tools remain scarce. This study aimed to determine the prevalence and risk factors of H. pylori infection in Bhutanese children and validate a new in-house immunochromatography test (the A-ICT) kits.

Methods: A cross-sectional study was conducted in 2023 among children under 64 months of age at three immunization clinics in Thimphu. H. pylori antigen in stool was detected using an ICT kit. After obtaining informed consent, parents completed questionnaires. Data were analyzed using STATA version 14.2 and R version 4.4.1.

Results: A total of 226 children (mean age 33.28 months) participated in the study. The A-ICT kit showed high concordance with the commercial kit (Kappa 0.84 [95% CI: 0.78-0.89]) and excellent sensitivity (0.96) and specificity (0.95). The prevalence of H. pylori was 19.54% (95% CI:14.95-24.83). Risk factors included increasing age, having two or more siblings, and fathers who were farmers/wagers, and who worked in government/private sector. Children who were fed with or who ate using a spoon had a significantly lower risk of H. pylori infection than those who were fed or ate with fingers (p < 0.05).

Conclusions: The A-ICT kit demonstrated remarkable sensitivity and specificity. Improvements in hygiene and sanitation related to child feeding practices are essential. Awareness programs should target large families and individuals employed in the formal sector, including both household and workplace settings. The validation of the A-ICT is a significant step toward a gastric cancer prevention program that facilitates early diagnosis and H. pylori eradication. The test kit is highly recommended for H. pylori screening and the confirmation of eradication post-treatment given its accuracy, rapidity, and simplicity in execution.

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不丹廷布64个月以下儿童幽门螺杆菌感染的流行率和危险因素，以及引进新的内部免疫层析检测试剂盒：一项横断面研究。

背景：幽门螺杆菌（h.p ylori）是一种终身感染，通常在儿童时期获得并持续一生，可导致严重的胃疾病，包括成人胃癌。虽然在大多数儿童中无症状，但它可能引起影响生长的肠外表现，需要独特的儿科管理策略-特别是在胃癌高风险的国家。准确的诊断对高危人群至关重要。粪便抗原测试是一种可靠的，无创的方法，为幼儿。尽管不丹的幽门螺杆菌负担很高，但诊断工具仍然很少。本研究旨在确定不丹儿童幽门螺杆菌感染的患病率和危险因素，并验证一种新的内部免疫层色谱测试（a - ict）试剂盒。方法：于2023年在廷布的三个免疫诊所对64个月以下的儿童进行了横断面研究。采用ICT试剂盒检测粪便中幽门螺杆菌抗原。在获得知情同意后，家长填写问卷。数据分析采用STATA 14.2版本和R 4.4.1版本。结果：共有226名儿童参与研究，平均年龄33.28个月。A-ICT试剂盒与商用试剂盒的一致性高（Kappa 0.84 [95% CI: 0.78-0.89]），灵敏度（0.96）和特异性（0.95）优异。幽门螺杆菌患病率为19.54% （95% CI:14.95 ~ 24.83）。风险因素包括年龄增长，有两个或两个以上的兄弟姐妹，父亲是农民/赌徒，在政府/私营部门工作。用勺子喂食或用勺子进食的儿童感染幽门螺杆菌的风险明显低于用手指喂食或用手指进食的儿童(p结论：a - ict试剂盒具有显著的敏感性和特异性。改善与儿童喂养方法有关的个人卫生和环境卫生至关重要。提高认识方案应针对大家庭和在正规部门就业的个人，包括家庭和工作场所。a - ict的验证是胃癌预防项目的重要一步，有助于早期诊断和根除幽门螺杆菌。由于该检测试剂盒的准确性、快速性和简易性，强烈推荐用于幽门螺杆菌筛查和治疗后根除的确认。

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来源期刊

Gut Pathogens GASTROENTEROLOGY & HEPATOLOGY-MICROBIOLOGY

CiteScore

7.70

自引率

2.40%

发文量

期刊介绍： Gut Pathogens is a fast publishing, inclusive and prominent international journal which recognizes the need for a publishing platform uniquely tailored to reflect the full breadth of research in the biology and medicine of pathogens, commensals and functional microbiota of the gut. The journal publishes basic, clinical and cutting-edge research on all aspects of the above mentioned organisms including probiotic bacteria and yeasts and their products. The scope also covers the related ecology, molecular genetics, physiology and epidemiology of these microbes. The journal actively invites timely reports on the novel aspects of genomics, metagenomics, microbiota profiling and systems biology. Gut Pathogens will also consider, at the discretion of the editors, descriptive studies identifying a new genome sequence of a gut microbe or a series of related microbes (such as those obtained from new hosts, niches, settings, outbreaks and epidemics) and those obtained from single or multiple hosts at one or different time points (chronological evolution).