Prevalência de infecção por Helicobacter pylori em uma comunidade indígena em São Paulo e fatores associados: estudo transversal

ABSTRACT CONTEXT AND OBJECTIVE: The prevalence of Helicobacter pylori infection is unevenly distributed among different populations. The aim here was to evaluate the factors associated with Helicobacter pylori infection among children up to five years of age living in a high-risk community. DESIGN AND SETTING: Cross-sectional study in an indigenous community of Guarani Mbya ethnicity, Tekoa Ytu and Tekoa Pyau villages, Jaraguá district, city of São Paulo (SP), Brazil. METHODS: 74 children aged 0.4 to 4.9 years (mean 2.9 ± 1.3 years; median 3.1), and 145 family members (86 siblings, 43 mothers and 16 fathers) were evaluated for Helicobacter pylori infection using the validated 13C-urea breath test. Clinical and demographic data were collected. RESULTS: The prevalence was 8.3% among children aged 1-2 years and reached 64.3% among those aged 4-5 years (P = 0.018; overall 31.1%). The prevalence was 76.7% among siblings and 89.8% among parents. There was a negative association with previous use of antibiotics in multivariate analysis adjusted for age (odds ratio, OR: 0.07; 95% confidence interval, CI: 0.01 to 0.66; P = 0.02). The prevalence was higher among males (OR: 1.55), and was associated with maternal infection (OR: 1.81), infection of both parents (OR: 1.5), vomiting (OR: 1.28), intestinal parasitosis (OR: 2.25), previous hospitalization (OR: 0.69) and breastfeeding (OR: 1.87). CONCLUSIONS: The prevalence was high among subjects older than three years of age, thus suggesting that the incidence of infection was higher over the first three years of life. Previous use of antibiotics was inversely associated with current Helicobacter pylori infection. RESUMO CONTEXTO E OBJETIVO: A prevalência da infecção pelo Helicobacter pylori é desigualmente distribuída entre diferentes populações. O objetivo foi avaliar fatores associados à infecção pelo Helicobacter pylori em crianças de até cinco anos de idade morando numa comunidade de alto risco. TIPO DE ESTUDO E LOCAL: Estudo transversal na comunidade indígena da etnia Guarani Mbya das aldeias Tekoa Ytu e Tekoa Pyau do distrito de Jaraguá da cidade de São Paulo (SP), Brasil. MÉTODOS: 74 crianças de 0,4 a 4,9 anos (média 2,9 ± 1,3 anos; mediana 3,1), e 145 familiares (86 irmãos, 43 mães e 16 pais) foram avaliadas quanto à infecção pelo Helicobacter pylori com o teste respiratório com ureia 13C validado. Dados clínicos e demográficos foram coletados. RESULTADOS: Prevalência foi 8,3% entre 1-2 anos, atingindo 64,3% ent