Pediatr Gastroenterol Hepatol Nutr.  2025 Jan;28(1):27-37. 10.5223/pghn.2025.28.1.27.

Association of Helicobacter pylori Infection with Pediatric Asthma in Palestine

Affiliations
  • 1Al-Quds University, Faculty of Medicine, Palestine
  • 2Department of Pathology and Genomic Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
  • 3Pediatric Department, Palestine Medical Complex, Ramallah, Palestine
  • 4Division of Pulmonary Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
  • 5Pediatric Department, Makassed Hospital, East Jerusalem, Palestine

Abstract

Purpose
Significant debate exists on the association between Helicobacter pylori infection and childhood asthma. We aimed to explore this association in a cohort of children in Palestine while estimating the prevalence of H. pylori in this population.
Methods
We conducted a prospective case-control study among children aged 6–15 years in Palestine, including 44 asthma cases diagnosed by pediatric pulmonologists and 99 age-matched healthy controls recruited through cluster sampling from schools. H. pylori status was determined using a stool antigen test. Asthma severity was assessed using the International Study of Asthma and Allergies in Childhood questionnaire. Data on recent antibiotic use, which could affect H. pylori status, were collected for both groups. Multiple logistic regression analyzed the association between H. pylori and asthma, adjusting for age and sex. The chi-square test assessed the impact of antibiotic use on H. pylori status.
Results
The prevalence of H. pylori infection in the study population was 45%. Children with asthma had a lower prevalence of H. pylori infection compared to healthy controls (32% vs. 51%, adjusted odds ratios, 0.46; 95% confidence interval, 0.22–0.99; p=0.04). Antibiotic use in the past month or year did not significantly impact H. pylori status. Among children with asthma, H. pylori infection rates did not vary by asthma severity (p=0.05).
Conclusion
H. pylori infection is associated with a reduced risk of asthma in children, suggesting a potential protective role. Further prospective cohort studies are warranted to clarify the mechanisms underlying this association.

Keyword

Helicobacter pylori; Asthma; Child
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