الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
H. pylori is one of the world’s most common bacterial infections. It is associated with chronic gastritis, PUD, and gastric carcinoma.It has been recognized as a Class I carcinogen by the International Agency for Research on Cancer. It is also associated with extra-gastrointestinal diseases such as anemia, allergic rhinitis and growth retardation.Infection is acquired in early childhood but mainly remain asymptomatic with possible long-term clinical sequelae. The mode of transmission of H. pylori is still unclear, however there are evidence pointing to the transmission of H. pylori from person-to-person and the most likely route of transmission is fecal-oral or oral-oral route.
Socioeconomic status of the family and personal hygienic habits of the mother might affect carriage of H. pylori in children, where contact within families, especially with their infected mothers.Communities with overcrowding, poor sanitation, low socioeconomic status and large numbers of siblings may also contribute to the early acquisition of the disease during childhood.
There are several diagnostic methods available for detection H. pylori infection. They are divided into invasive and non-invasive methods.
The present study aimed to:
1- To detect the carriage of H. pylori antigen in stool of asymptomatic infants and toddlers.
2- To detect of H. pylori antigen in stool of their mother using ELISA technique.
The study was conducted overa period of four-months from January to April 2017. It included 86 infants and toddlers whose ages ranged between 6 to 24 months and their mothers attending the Family health unit of kilo 21.
Stool samples were collected from each mother and diaper of her child by using tongue depressor in clean, airtight containers. Each sample was labelled and transported to the laboratory within 1-2 hours in an ice box. All the samples were stored at -80ºC at the laboratory of the Microbiology department of HIPH till H. pylori stool antigen ELISA test was performed.The results of the present study revealed that:1. The mean age of the 20 H. pyloricarriers children was 15.95 ± 4.99 month, their mean weight was 9.48 ± 1.24kg and their mean height was 69.45 ± 6.64 cm. These data proved to be non-significant as regarding carriage.
2. Out of the total 41 children aged 6-12 months, only 14.63 % were carriers of the H. pylori antigen and the carriage rate increased to 42.10 % and 23.10% among the age group >12 – 18 months and >18 – 24 months respectively. The results were not statistically significant.
3. Most of the studied cases belonged to either low or medium class (58.14% and 34.88% respectively). All 6 children with high socioeconomic class proved to be negative for carriage of H. pylori. Regarding mothers in the same class only 83.33% proved to be positive for carriage of H.pylori. The association between socioeconomic class and H.pylori carriage state of mothers and children were not carriers statistically significant.4.Out of the 86 studied pairs, 19 (29.23%) pairs were carriers of H. pylori antigen while 20 (95.24%) were not. On the other hand, 46 (70.77%) mothers were carriers while their children were notcarriers. Only one child showed carriage of H. pylori while his mother was not a carrier.5.Carriage of H. pylori in children was found to be significantly associated with carriage state of their mothers where children whose mothers were carriers had 8.26 times the rate of carriage of H. pylori compared to children whose mothers were not. Moreover, this rate increased to 9.29 and 10.86 after partly and fully adjustment respectively.6.Out of the 59 mothers who had good hygiene, only 9 (15.25%) of their children were carriers of H. pylori. On the other hand, out of the 27 mothers who had bad hygiene, 11 (40.74%) of their children were carriers. Although, the rate of H. pylori carriage in children whose mothers had bad hygiene was found to be statistically significant with an OR of 3.82, however, the results were not significant after full adjustment with an OR of 1.71.7. Only washing hands after changing diaper and using a personal spoon (no sharing of a spoon) affected carriage where their OR after part adjustment were 9.54 and6.22 respectively and their OR after full adjustment were 11.99 and 6.80 respectively.
8. Among comorbid conditions, neither allergic rhinitis, asthma, diarrhea, nor abdominal pain were statistically significant with the carriage state of children.
9. Anemia was the only associated condition that affected carriage of children where
H. pylori carriers’ children those who were anemic had 8.18 times rate of carriage than those who were not. OR of anemia increased to 8.21 (95% CI, 2.26 to 29.66) and 8.404 (95% CI, 1.85 to 37.98) after part and full adjustment respectively.
It can be concluded from the present study that:
1. There was no association between the socioeconomic status and carriage of H. pylori by either mothers or children.
2. Children of mother’scarriers of H. pyloriantigen were 8.26times more likely to be carriers.
3. Bad hygienic habits of the mother are risk factor for carriage of H. pylori, where the present study showed that mothers sharing spoon with their child is significant factor for H. pylori carriage.4.Anemia was the only comorbid condition that was significant association with
H. pylori carriage in studied children.
from the results of the present study, the following recommendations are suggested:
1. The organization of health education campaigns that educate the public about hand hygiene practicesand H. pyloriincluding its health effect and risk factors.2.Further research examining the carriage rate of H. pylori on large scale including population of different socioeconomic status.