Role of Extended Family for Intrafamilial Transmission of Helicobacter pylori Infection in Bulgarian Children

Helicobacter pylori infection is one of the most common chronic bacterial infections worldwide. The infection is usually acquired during the first years of childhood and transmission from infected mother is considered an important epidemiological factor. The aim of this study was to assess the H. pylori positivity in Bulgarian symptomatic children in association with the presence or absence of family anamnesis of gastroduodenal diseases among their parents, siblings and grandparents. H. pylori infection was evaluated in 362 children in two groups: 181 children with family anamnesis of gastroduodenal diseases and 181 children without family anamnesis. All patients underwent esophagogastroduodenoscopy and gastric biopsy samples for microbiological examination for H. pylori were taken. H. pylori infection among children with family history of gastroduodenal diseases was significantly more frequent (69.1%) compared with the group of patients without a family anamnesis (21.0%, p <0.0001). In addition to the significance of the infected parents (69.4%) and siblings (52.0%), infected grandparents were also associated with high prevalence of the infection (77.8%, 21/27 cases) in the children. In conclusion, H. pylori infection among children with family history of gastroduodenal disease was 3.3-fold higher than that in the group without family anamnesis. The significance of the grandparents in the extended family households should be considered.