Risk Factors Associated with Helicobacter pylori Infection among Children in a Defined Geographic Area

Factors influencing the pattern of Helicobacter pylori infection among children living in adjacent urban and
rural areas of northern Sardinia, Italy, were compared. The seroprevalence of H. pylori infection was 22%
(625 of 2810 children) in the study population and was significantly higher among children in rural areas
(37%) than in urban areas (13%) (odds ratio [OR], 3.8; 95% confidence interval [CI], 3.2–4.7; P ! .005). This
difference was consistent within each age group. In rural areas, children who had dogs were at greatest risk
for H. pylori infection (OR, 1.8; 95% CI, 1.3–2.6; P ! .05). No association was seen between H. pylori seropositivity
and a history of breast-feeding. Urban children attending day care centers had a higher prevalence
of infection (17%) than did those who never attended (12%) (OR, 1.5; 95% CI, 1.1–2.0; P ! .05). The epidemiology
of H. pylori infection is complex; even within the same geographic area, different factors influence
acquisition of H. pylori infection.