Newly arrived refugee children with Helicobacter pylori are thinner than their non-infected counterparts
Jill Benson A C , Razlyn Abdul Rahim B and Rishi Agrawal B
+ Author Affiliations
- Author Affiliations
A Discipline of General Practice, University of Adelaide, 178 North Terrace, Adelaide SA 5000, Australia.
B Migrant Health Service, 21 Market Street, Adelaide, SA 5000, Australia.
C Corresponding author. Email: jill.benson@adelaide.edu.au
Australian Journal of Primary Health 23(1) 92-96 https://doi.org/10.1071/PY15187
Submitted: 8 December 2015 Accepted: 5 April 2016 Published: 5 August 2016
Abstract
The hypothesis of this study was that those refugee children with Helicobacter pylori are thinner than their non-infected counterparts. This cross-sectional study investigated the height and weight of newly arrived refugee children up to age 19 years, who were screened for H. pylori using a stool antigen test at the Migrant Health Service in Adelaide between August 2010 and October 2013. Of 460 children, 21% were infected with H. pylori. After adjusting for vitamin B12 and iron levels, ethnicity, age and sex, the odds of being thin in the 10- to 19-year-old age group was 4.28-fold higher (95% CI 1.48–12.4) if they were H. pylori positive compared with those who were H. pylori negative. The difference between the two groups is statistically significant (P = 0.01). Screening and treatment for H. pylori in the general population in developed countries is not recommended unless there are symptoms such as dyspepsia or risk of peptic ulcer, duodenal ulcer or gastric cancer. Given the findings of this study, a recommendation could be made that newly arrived refugee children who are thin should be tested for H. pylori. Thinness in children may influence their cognitive ability, school performance, physical endurance and hence their ability to successfully settle into their new country.
References
Arboleda RN, Schneider BG, Bravo LE, Romero-Gallo J, Peek RM, Mera RM, Yepez MC, Campo C, Correa P (2013) Use of the noninvasive entero-test in the detection of Helicobacter pylori in children in an endemic area in Colombia. Journal of Pediatric Gastroenterology and Nutrition 57, 192–196.| Use of the noninvasive entero-test in the detection of Helicobacter pylori in children in an endemic area in Colombia.Crossref | GoogleScholarGoogle Scholar | 23880626PubMed |
Bravo LE, Mera R, Reina JC, Pradilla A, Alzate A, Fontham E, Correa P (2003) Impact of Helicobacter pylori infection on growth of children: a prospective cohort study. Journal of Pediatric Gastroenterology and Nutrition 37, 614–619.
| Impact of Helicobacter pylori infection on growth of children: a prospective cohort study.Crossref | GoogleScholarGoogle Scholar | 14581807PubMed |
Chaves NJ, Gibney KB, Leder K, O’Brien DP, Marshall C, Biggs BA (2009) Screening practices for infectious diseases among Burmese refugees in Australia. Emerging Infectious Diseases 15, 1769–1772.
| Screening practices for infectious diseases among Burmese refugees in Australia.Crossref | GoogleScholarGoogle Scholar | 19891864PubMed |
Cherian S, Forbes D, Sanfilippo F, Cook A, Burgner D (2008) The epidemiology of Helicobacter pylori infection in African refugee children resettled in Australia. The Medical Journal of Australia 189, 438–441.
Cole TJ, Flegal KM, Nicholls D, Jackson AA (2007) Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 335, 194
| Body mass index cut offs to define thinness in children and adolescents: international survey.Crossref | GoogleScholarGoogle Scholar | 17591624PubMed |
De Vries AC, Van Driel HF, Richardus JH, Ouwendijk M, Van Vuuren AJ, De Man RA, Kuipers EJ (2008) Migrant communities constitute a possible target population for primary prevention of Helicobacter pylori-related complications in low incidence countries. Scandinavian Journal of Gastroenterology 43, 403–409.
| Migrant communities constitute a possible target population for primary prevention of Helicobacter pylori-related complications in low incidence countries.Crossref | GoogleScholarGoogle Scholar | 18365904PubMed |
Department of Immigration and Border Protection (2014) Australia’s Offshore Humanitarian Programme 2013–2014. (Commonwealth of Australia: Canberra) Available at https://www.border.gov.au/ReportsandPublications/Documents/statistics/australia-offshore-humanitarian-program- 2013-14.pdf [Verified June 2016]
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International Journal of Cancer 136, E359–E386.
| Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXitVyktbzI&md5=26e956d136519b937199eace5dd297f8CAS | 25220842PubMed |
Franceschi F, Annalisa T, Teresa DR, Giovanna D, Ianiro G, Franco S, Viviana G, Valentina T, Riccardo LL, Antonio G (2014) Role of Helicobacter pylori infection on nutrition and metabolism. World Journal of Gastroenterology 20, 12809–12817.
| Role of Helicobacter pylori infection on nutrition and metabolism.Crossref | GoogleScholarGoogle Scholar | 25278679PubMed |
Gibney KB, Mihrshahi S, Torresi J, Marshall C, Leder K, Biggs BA (2009) The profile of health problems in African immigrants attending an infectious disease unit in Melbourne, Australia. The American Journal of Tropical Medicine and Hygiene 80, 805–811.
Goodman KJ, Correa P, Mera R, Yepez MC, Ceron C, Campo C, Guerrero N, Sierra MS, Bravo LE (2011) Effect of Helicobacter pylori infection on growth velocity of school-age Andean children. Epidemiology 22, 118–126.
| Effect of Helicobacter pylori infection on growth velocity of school-age Andean children.Crossref | GoogleScholarGoogle Scholar | 21068668PubMed |
Johnston V, Smith L, Roydhouse H (2012) The health of newly arrived refugees to the Top End of Australia: results of a clinical audit at the Darwin Refugee Health Service. Australian Journal of Primary Health 18, 242–247.
| The health of newly arrived refugees to the Top End of Australia: results of a clinical audit at the Darwin Refugee Health Service.Crossref | GoogleScholarGoogle Scholar | 23069368PubMed |
Kocaoglu C, Ozel A, Cayci M, Solak ES (2016) Effect of long-term Helicobacter pylori infection on growth of children: a cohort study. World Journal of Pediatrics 12, 196–201.
| Effect of long-term Helicobacter pylori infection on growth of children: a cohort study.Crossref | GoogleScholarGoogle Scholar | 25846067PubMed |
Koletzko S, Jones NL, Goodman KJ, Gold B, Rowland M, Cadranel S, Chong S, Colletti RB, Casswall T, Elitsur Y, Guarner J, Kalach N, Madrazo A, Megraud F, Oderda G (2011) Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children. Journal of Pediatric Gastroenterology and Nutrition 53, 230–243.
Malaty HM (2000) Helicobacter pylori infection and eradication in paediatric patients. Paediatric Drugs 2, 357–365.
| Helicobacter pylori infection and eradication in paediatric patients.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvmsl2gtg%3D%3D&md5=d258675d86756ef60cc6dc52952c50b9CAS | 11022797PubMed |
Malfertheiner P, Megraud F, O’Morain CA, Atherton J, Axon AT, Bazzoli F, Gensini GF, Gisbert JP, Graham DY, Rokkas T, El-Omar EM, Kuipers EJ (2012) Management of Helicobacter pylori infection – the Maastricht IV/ Florence Consensus Report. Gut 61, 646–664.
| Management of Helicobacter pylori infection – the Maastricht IV/ Florence Consensus Report.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xps1Kiu7o%3D&md5=3983025adb56fbd5fe8bb27cf1772be7CAS | 22491499PubMed |
Marshall BJ, Warren JR (1984) Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 323, 1311–1315.
| Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration.Crossref | GoogleScholarGoogle Scholar |
Mera RM, Correa P, Fontham EE, Reina JC, Pradilla A, Alzate A, Bravo LE (2006) Effects of a new Helicobacter pylori infection on height and weight in Colombian children. Annals of Epidemiology 16, 347–351.
| Effects of a new Helicobacter pylori infection on height and weight in Colombian children.Crossref | GoogleScholarGoogle Scholar | 16246582PubMed |
Murray RJ, Davis JS, Burgner DP, Australasian Society for Infectious Diseases Refugee Health Guidelines Writing Group Hansen-Knarhoi M, Krause V, Biggs BA, Lemoh C, Benson J, Cherian S, Buttery J, Paxton G (2009) The Australasian Society for Infectious Diseases guidelines for the diagnosis, management and prevention of infections in recently arrived refugees: an abridged outline. The Medical Journal of Australia 190, 421–425.
Mutch RC, Cherian S, Nemba K, Geddes JS, Rutherford DM, Chaney GM, Burgner DP (2012) Tertiary paediatric refugee health clinic in Western Australia: analysis of the first 1026 children. Journal of Paediatrics and Child Health 48, 582–587.
| Tertiary paediatric refugee health clinic in Western Australia: analysis of the first 1026 children.Crossref | GoogleScholarGoogle Scholar | 22429646PubMed |
Myint T, Shiota S, Vilaichone RK, Ni N, Aye TT, Matsuda M, Tran TT, Uchida T, Mahachai V, Yamaoka Y (2015) Prevalence of Helicobacter pylori infection and atrophic gastritis in patients with dyspeptic symptoms in Myanmar. World Journal of Gastroenterology 21, 629–636.
| Prevalence of Helicobacter pylori infection and atrophic gastritis in patients with dyspeptic symptoms in Myanmar.Crossref | GoogleScholarGoogle Scholar | 25605987PubMed |
Phillips CB, Smith MM, Kay M, Casey S (2011) The Refugee Health Network of Australia: towards national collaboration on health care for refugees. The Medical Journal of Australia 195, 185–186.
Queiroz DM, Rocha AM, Crabtree JE (2013) Unintended consequences of Helicobacter pylori infection in children in developing countries: iron deficiency, diarrhea, and growth retardation. Gut Microbes 4, 494–504.
| Unintended consequences of Helicobacter pylori infection in children in developing countries: iron deficiency, diarrhea, and growth retardation.Crossref | GoogleScholarGoogle Scholar | 23988829PubMed |
Sandjaja , Poh BK, Rojroonwasinkul N, Le Nyugen BK, Budiman B, Ng LO, Soonthorndhada K, Xuyen HT, Deurenberg P, Parikh P, SEANUTS Study Group (2013) Relationship between anthropometric indicators and cognitive performance in Southeast Asian school-aged children. British Journal of Nutrition 110, S57–S64.
| Relationship between anthropometric indicators and cognitive performance in Southeast Asian school-aged children.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhsVWrs73K&md5=ef455b2a21a1b0d77e59f49cd8e76179CAS | 24016767PubMed |
Schulz TR, McBryde ES, Leder K, Biggs BA (2014) Using stool antigen to screen for Helicobacter pylori in immigrants and refugees from high prevalence countries is relatively cost effective in reducing the burden of gastric cancer and peptic ulceration. PLoS One 9, e108610
| Using stool antigen to screen for Helicobacter pylori in immigrants and refugees from high prevalence countries is relatively cost effective in reducing the burden of gastric cancer and peptic ulceration.Crossref | GoogleScholarGoogle Scholar | 25268809PubMed |
Shiota S, Mahachai V, Vilaichone RK, Ratanachu-ek T, Tshering L, Uchida T, Matsunari O, Yamaoka Y (2013) Seroprevalence of Helicobacter pylori infection and gastric mucosal atrophy in Bhutan, a country with a high prevalence of gastric cancer. Journal of Medical Microbiology 62, 1571–1578.
| Seroprevalence of Helicobacter pylori infection and gastric mucosal atrophy in Bhutan, a country with a high prevalence of gastric cancer.Crossref | GoogleScholarGoogle Scholar | 23831768PubMed |
Suzuki H, Moayyedi P (2013) Helicobacter pylori infection in functional dyspepsia. Nature Reviews. Gastroenterology & Hepatology 10, 168–174.
| Helicobacter pylori infection in functional dyspepsia.Crossref | GoogleScholarGoogle Scholar |
Thomas JE, Dale A, Bunn JE, Harding M, Coward WA, Cole TJ, Weaver LT (2004) Early Helicobacter pylori colonisation: the association with growth faltering in The Gambia. Archives of Disease in Childhood 89, 1149–1154.
| Early Helicobacter pylori colonisation: the association with growth faltering in The Gambia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2crotlShtQ%3D%3D&md5=b226d917809dd35c852b4f1f4887d412CAS | 15557054PubMed |
Tolia V (1999) Helicobacter pylori infection in pediatric patients. Current Gastroenterology Reports 1, 308–313.
| Helicobacter pylori infection in pediatric patients.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M%2FitVOlsA%3D%3D&md5=8e1b78c11f5ff0e17b0846f9bb2ecf76CAS | 10980965PubMed |
Torres J, Perez-Perez G, Goodman KJ, Atherton JC, Gold BD, Harris PR, Madrazo de-la Garza A, Guarner J, Munoz O (2000) A comprehensive review of the natural history of Helicobacter pylori infection in children. Archives of Medical Research 31, 431–469.
| A comprehensive review of the natural history of Helicobacter pylori infection in children.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M3osFGltQ%3D%3D&md5=c967447272dd420e7dc588d8b783f34dCAS | 11179581PubMed |
Wang P, Adair R (1999) Helicobacter pylori in immigrants from East Africa. Journal of General Internal Medicine 14, 567–568.
| Helicobacter pylori in immigrants from East Africa.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1MvitFyksQ%3D%3D&md5=ee448d8543fecc9b22255da96f63f4adCAS | 10491248PubMed |
Wang Y, Chen HJ (2012) Use of percentiles and Z-scores in anthropometry. In ‘Handbook of Anthropometry: Physical Measures of Human Form in Heath and Disease’. (Ed. VR Preedy) pp. 29–48. (Springer-Verlag: New York)
