Prevalence and determinants of Helicobacter pylori infection among children attending regional and tertiary hospitals in Dar es Salaam, Tanzania

Abstract

Background: Helicobacter pylori (H.pylori) infection represents a significant public health concern affecting half of the world’s population. The organism is more prevalent in low-middle-income countries due to poor socioeconomic status and inadequate sanitation and hygiene practices. There is a limited up to date, locally relevant data quantifying the prevalence and key determinants of H. pylori infection in children. Objective: The study aimed to determine the prevalence and determinants of H. pylori infection among children attending regional referral and tertiary hospitals in Dar es Salaam, Tanzania. Method: We conducted a cross-sectional study between March and May 2019 among children aged 2-14 years admitted at Muhimbili National Hospital and two regional referral hospitals (Temeke and Amana). We used a structured questionnaire to collect socio-demographic and clinical data. H. pylori was detected using H. pylori stool Antigen (HpSA) Rapid Test. Data analysis was performed using SPSS version 23. Descriptive analysis was summarized as frequency and proportions for categorical variables. We performed a Chi-square test for within-variables comparison. We used bivariate and multivariable logistic regression analysis to determine factors associated with H.pylori infection. A p-value of less than 0.05 was considered statistically significant. Results: A total of 281 children were enrolled in the study. The majority, 195 (69.4%), were under five, and 148 (52.5%) were male. The prevalence of H. pylori infection was 61/281(21.3%). Children who use untreated drinking water had twice as much H. pylori infection than those who use treated drinking water (aOR = 2.18, 95% CI = 1.18-4.06, p=0.012). The odds of acquiring H. pylori infection were five times higher among children whose parents had informal employment than children whose parents were formally employed (aOR = 4.9, 95% CI (1.12-21.61, p=0.03). Conclusion: The prevalence of H. pylori infection among children is relatively high and comparable with that in other low-middle-income countries. Drinking untreated water and parental involvement in informal employment were independently associated with H. pylori infection. Water treatment from water sources is crucial to prevent H. pylori transmission.