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Controlled, household-randomized, open-label trial of the effect of treatment of Helicobacter pylori infection on iron deficiency among children in rural Alaska: results at 40 months.
J Infect Dis. 2009 Mar 01; 199(5):652-60.JI

Abstract

BACKGROUND

Helicobacter pylori infection treatment was found not to reduce the prevalence of iron deficiency or anemia among Alaska Native children at 14 months after treatment initiation. We hypothesized that 14 months was to early to resolve H. pylori-induced gastric damage. Consequently, we conducted a 40-month follow-up.

METHODS

We enrolled 219 children 7-11 years old who had H. pylori infection (as diagnosed by (13)C-labeled urea breath test) and iron deficiency (serum ferritin level, <22.47 pmol/L) in a controlled, household-randomized trial of the effect of treatment of H. pylori on iron deficiency and anemia (hemoglobin level, <115 g/L). At 40 months, 176 children were evaluated.

RESULTS

Forty-four (52%) of 85 children in the intervention group and 53 (58%) of 91 in the control group had iron deficiency (adjusted relative risk [ARR], 0.92 [95% confidence interval {CI}, 0.68-1.26]), versus 4 (5%) and 17(19%), respectively, with both iron deficiency and anemia (ARR, 0.25 [95% CI, 0.09-0.73]). Reinfection occurred among 33 (52%) of 64 children who had cleared their infection. H. pylori-negative children had lower prevalences of iron deficiency (ARR, 0.62 [95% CI, 0.38-1.01]) and iron deficiency and anemia (ARR, 0.22 [95% CI, 0.03-1.50]), compared with H. pylori -positive children.

CONCLUSIONS

The resolution of H. pylori infection for >14 months modestly reduced the prevalence of iron deficiency and substantially reduced the prevalence of iron deficiency and anemia. H. pylori likely plays a casual role in hematological outcomes for some children.

Authors+Show Affiliations

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; and Alaska Division of Public Health, Anchorage, Alaska.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19125674

Citation

Fagan, Ryan P., et al. "Controlled, Household-randomized, Open-label Trial of the Effect of Treatment of Helicobacter Pylori Infection On Iron Deficiency Among Children in Rural Alaska: Results at 40 Months." The Journal of Infectious Diseases, vol. 199, no. 5, 2009, pp. 652-60.
Fagan RP, Dunaway CE, Bruden DL, et al. Controlled, household-randomized, open-label trial of the effect of treatment of Helicobacter pylori infection on iron deficiency among children in rural Alaska: results at 40 months. J Infect Dis. 2009;199(5):652-60.
Fagan, R. P., Dunaway, C. E., Bruden, D. L., Parkinson, A. J., & Gessner, B. D. (2009). Controlled, household-randomized, open-label trial of the effect of treatment of Helicobacter pylori infection on iron deficiency among children in rural Alaska: results at 40 months. The Journal of Infectious Diseases, 199(5), 652-60. https://doi.org/10.1086/596659
Fagan RP, et al. Controlled, Household-randomized, Open-label Trial of the Effect of Treatment of Helicobacter Pylori Infection On Iron Deficiency Among Children in Rural Alaska: Results at 40 Months. J Infect Dis. 2009 Mar 1;199(5):652-60. PubMed PMID: 19125674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Controlled, household-randomized, open-label trial of the effect of treatment of Helicobacter pylori infection on iron deficiency among children in rural Alaska: results at 40 months. AU - Fagan,Ryan P, AU - Dunaway,C Eitel, AU - Bruden,Dana L, AU - Parkinson,Alan J, AU - Gessner,Bradford D, PY - 2009/1/8/entrez PY - 2009/1/8/pubmed PY - 2009/4/16/medline SP - 652 EP - 60 JF - The Journal of infectious diseases JO - J Infect Dis VL - 199 IS - 5 N2 - BACKGROUND: Helicobacter pylori infection treatment was found not to reduce the prevalence of iron deficiency or anemia among Alaska Native children at 14 months after treatment initiation. We hypothesized that 14 months was to early to resolve H. pylori-induced gastric damage. Consequently, we conducted a 40-month follow-up. METHODS: We enrolled 219 children 7-11 years old who had H. pylori infection (as diagnosed by (13)C-labeled urea breath test) and iron deficiency (serum ferritin level, <22.47 pmol/L) in a controlled, household-randomized trial of the effect of treatment of H. pylori on iron deficiency and anemia (hemoglobin level, <115 g/L). At 40 months, 176 children were evaluated. RESULTS: Forty-four (52%) of 85 children in the intervention group and 53 (58%) of 91 in the control group had iron deficiency (adjusted relative risk [ARR], 0.92 [95% confidence interval {CI}, 0.68-1.26]), versus 4 (5%) and 17(19%), respectively, with both iron deficiency and anemia (ARR, 0.25 [95% CI, 0.09-0.73]). Reinfection occurred among 33 (52%) of 64 children who had cleared their infection. H. pylori-negative children had lower prevalences of iron deficiency (ARR, 0.62 [95% CI, 0.38-1.01]) and iron deficiency and anemia (ARR, 0.22 [95% CI, 0.03-1.50]), compared with H. pylori -positive children. CONCLUSIONS: The resolution of H. pylori infection for >14 months modestly reduced the prevalence of iron deficiency and substantially reduced the prevalence of iron deficiency and anemia. H. pylori likely plays a casual role in hematological outcomes for some children. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/19125674/Controlled_household_randomized_open_label_trial_of_the_effect_of_treatment_of_Helicobacter_pylori_infection_on_iron_deficiency_among_children_in_rural_Alaska:_results_at_40_months_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/596659 DB - PRIME DP - Unbound Medicine ER -