helicobacter

International Journal of Infectious Diseases 14 (2010) e788–e791

Contents lists available at ScienceDirect

International Journal of Infectious Diseases
journal homepage: www.elsevier.com/locate/ijid

The effect of Helicobacter pylori infection on growth velocity in young children
from poor urban communities in Ecuador
´
Andrey I. Egorov a,b,*, Fernando Sempertegui b,c,d, BerthaEstrella b,c,d, Josefina Egas c,e,
Elena N. Naumova b,f, Jeffrey K. Griffiths b,f
a

US Environmental Protection Agency, National Center for Environmental Assessment, 26 W. Martin Luther King Drive, MS A110, Cincinnati, OH 45268, USA
Tufts School of Medicine, Department of Public Health and Family Medicine, Boston, Massachusetts, USA
´n
Corporacio Ecuatoriana de Biotecnologı´a, Quito, Ecuador
dFacultad de Medicina, Universidad Central del Ecuador, Quito, Ecuador
e
´lisis, Pontificia Universidad Cato
´lica del Ecuador, Quito, Ecuador
Escuela de Bioana
f
Tufts University Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA
b
c

A R T I C L E I N F O

S U M M A R Y

Article history:
Received 11 December 2009
Accepted 8 March 2010

Objective: Tocharacterize the potential effects of Helicobacter infections on growth velocity in low
socioeconomic status young children in a developing country.
Methods: Children were recruited in poor suburbs of Quito, Ecuador. Normally nourished, mildly and
substantially malnourished children (defined using weight-for-age Z-scores at recruitment) formed
equal strata. Six height and weight measurements werecollected during one year. Enrollment and exit
serum samples were analyzed for anti-Helicobacter IgG and exit non-diarrheal feces tested for
Helicobacter antigen.
Results: Among 124 participants (enrollment age 19 Æ 9 months), 76 (61%) excreted fecal antigen at exit
(were infected). Of these, 44 were seropositive at least once (chronic infections) and 32 tested seronegative
both times (new oracute phase infections). The adjusted linear growth velocity during follow-up in children
with new infections was reduced by 9.7 (3.8, 15.6) mm/year compared to uninfected controls and 6.4 (0.0,
12.9) mm/year compared to children with chronic infections. The effects of Helicobacter infections on
ponderal growth were not significant.
Conclusion: These results suggest that linear growth velocity isreduced in young children during the
initial phase of Helicobacter infection.
Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Corresponding Editor: William Cameron,
Ottawa, Canada
Keywords:
Helicobacter pylori
Growth velocity
Children
Fecal antigen
IgG antibody
Ecuador

1. Introduction
Helicobacter pylori is an important pathogen that cancause
gastritis, gastric and duodenal ulcers, and gastric cancer.1 This
bacterium is uniquely adapted to chronically infect the human
stomach. It elicits a predominantly Th1-type immune response,
which may be responsible for gastritis symptoms.2,3 Infections
typically spread through person-to-person contacts,2 but waterborne transmission may also occur.4 In developing countries, most
peopleacquire infection in early childhood.2,5 The acquisition of
infection is often followed by transient acute gastritis symptoms
and depressed gastric acid secretion.2,6,7 Helicobacter has been
shown to impair absorption of nutrients and vitamins,8,9 and
retard growth in children in developing countries.6,10–13
Helicobacter-infected individuals excrete Helicobacter antigen.
Fecal antigen tests haveexcellent sensitivity and specificity as
* Corresponding author. Tel.: +1 513 407 5491.
E-mail address: andrey.egorov@tufts.edu (A.I. Egorov).

compared to more invasive diagnostic tests in children.14–18
Helicobacter infection also induces strong antibody responses.19
Animal experiments have demonstrated that the development of
an antibody response reduces gastritis symptoms.20 In...