| Objective:To clarify the status of Helicobacter pylori(Hp)infection in children in Lhasa area,explore the related risk factors of Hp infection in children in Lhasa area,and lay the foundation for the comprehensive prevention and control of Hp infection in children in Tibet Plateauarea.Methods:A retrospective analysis was performed on children from Lhasa who were admitted to the People’s Hospital of Tibet Autonomous Region from January 1,2015 to December 31,2020.Urea breath test(13C-UBT)was routinely performed,and clinical data were statistically analyzed.Children were divided into early childhood(≤3 years old),pre-school age(～ 6 years old),school age(～ 10 years old)and adolescence(～ 14 years old).Some children received gastroscopy.A questionnaire was designed according to the characteristics of the plateau area.Children under 14 years old from Lhasa area were randomly selected from January 1,2020 to August 8,2022 in Tibet Autonomous Region People’s Hospital to investigate the risk factors of Helicobacter pylori in children,and urea breath test(13C-UBT)was conducted.Firstly,Tibetan investigators were trained to conduct a questionnaire survey by online telephone survey.The questionnaire includes children’s general information,personal living habits,mental factors,family conditions,etc.(see Annex I for details).The results of questionnaire survey were statistically analyzed and P < 0.05 was considered to have statistical significance.Results:(1)A total of 2666(61.2%)of 4353 children were Hp positive.The positive rate of Hp in male was 62.8%,higher than that in female(59.8%)(P <0.05).The positive rates of Hp in early childhood,early school age,school age and adolescence were 56.9%,58.9%,61.4% and 64.6%,respectively,and the positive rates showed an increasing trend with the increase of age(P < 0.05).A total of 163 children underwent gastroscopy,of which 101 cases(62%)were Hp positive.The positive rate of Hp in common diseases detected under microscope was compound ulcer(100%),duodenal bulbar ulcer(82.6%),gastric ulcer(66.7%),chronic superficial gastritis(55.6%),duodenal bulbar inflammation(53.8%).(2)There were336 questionnaires in total,19 invalid questionnaires were excluded.208 cases(65.6%)were Hp positive in 317 valid questionnaires.The positive rate of Hp was69.2% in males and 62.1% in females,and there was no significant difference between genders(x2 =1.78,P=0.182).The positive rates of Hp in early childhood,pre-school age,school age and adolescence were 33.3%,64.5%,67.8% and 69.0%,respectively,with statistical difference between different age groups(x2 =9.173,P=0.027),and also showed an increasing trend with the increase of age.Single factor analysis showed that: Hp infection and age of children(x2 =9.173,P=0.027),nationality(x2 =8.995,P=0.003),learning stage(x2 =8.379,P=0.039),tabletop disinfection(x2 =6.509,P=0.039),consumption of spicy food(x2 =4.406,P=0.036),whether eating regularly(x2 =5.491,P=0.019),staple food(x2 =10.292,P=0.016),whether eating raw meat(x2 =5.388,P=0.02),frequency of eating garlic(x2 =11.490,P=0.003),parental occupation(x2 =7.888,P=0.048),guardian Hp infection history(x2 =11.187,P=0.004),and the difference was statistically significant(p<0.05).The significant results of univariate analysis were incorporated into the binary multivariate logistic regression analysis,and the results showed no statistical significance among all factors.Conclusions:The Hp infection rate of children in Lhasa was higher than the national average.With the increase of age,the infection rate of Hp in children showed an increasing trend.Hp infection in children may be closely related to the occurrence of upper gastrointestinal diseases.The risk factors of Hp infection in children in Lhasa region have certain regional characteristics,so effective prevention and control measures should be formulated according to local conditions,so as to lay an important foundation for effectively reducing Hp infection in this region. |
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