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. 2021 Jan 29;67(1):fmaa079.
doi: 10.1093/tropej/fmaa079.

Asymptomatic Duodenitis and Helicobacter pylori associated Dyspepsia in 2-Year-Old Chronic Malnourished Bangladeshi Slum-Dwelling Children: A Cross-Sectional Study

Md Shabab Hossain  1 , Subhasish Das  1 , S M Khodeza Nahar Begum  2 , M Masudur Rahman  3 , Ramendra Nath Mazumder  1 , Md Amran Gazi  1 , Shah Mohammad Fahim  1 , Mustafa Mahfuz  1 , Rashidul Haque  1 , William A Petri  4 , Shafiqul Alam Sarker  1 , Tahmeed Ahmed  1
Affiliations

Asymptomatic Duodenitis and Helicobacter pylori associated Dyspepsia in 2-Year-Old Chronic Malnourished Bangladeshi Slum-Dwelling Children: A Cross-Sectional Study

Md Shabab Hossain et al. J Trop Pediatr. .

Abstract

Aim: There is insufficient knowledge on the * duodenal histology and Helicobacter pylori infection in malnourished Bangladeshi children. Therefore, we attempted to explore the prevalence of H. pylori infection and duodenal histopathology in 2-year-old chronic malnourished Bangladeshi slum-dwelling children and investigate their association with dyspeptic symptoms.

Methods: This cross-sectional study was conducted using the data of the Bangladesh Environmental Enteric Dysfunction study in an urban slum of Dhaka, Bangladesh. With a view to address the association of environmental enteric dysfunction (EED) with stunting, upper gastrointestinal endoscopy was performed on 54 chronic malnourished children {31 stunted [length-for-age Z-scores (LAZ) <-2] and 23 at risk of stunting (LAZ <-1 to -2)} aged between 12-24 months and the mucosal biopsies were subjected to histopathological examination after obtaining proper clinical history. Stool antigen for H. pylori (HpSA) was assessed to determine H. pylori status.

Results: In all, 83.3% (45/54) of the children had histopathological evidence of duodenitis. Chronic mild duodenitis was found to be the most prevalent form of duodenitis (53.7%) in the children. Only 8.9% (4/45) of the children with duodenitis had dyspepsia (p < 0.05). The 14.8% (8/54) of the children were found positive for H. pylori infection. Logistic regression analysis revealed children positive for HpSA had significant association with dyspepsia (OR 9.34; 95% CI 1.54-56.80).

Conclusions: The number of chronic malnourished children suffering from duodenitis was found to be very high. Majority of these children was asymptomatic. Children positive for HpSA had significant association with dyspeptic symptoms.

Keywords: Helicobacter pylori; Bangladesh; child; duodenitis; dyspepsia; malnutrition.

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Figures

Fig. 1.
Fig. 1.
Distribution of severity of histopathology findings.
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