Date of Award

8-1-2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

First Advisor

David Sterling

Abstract

Transmission of Helicobacter pylori infection is thought to occur predominately during childhood in both developed and developing countries. Various bacterial, host and environmental factors influence H. pylori transmission and establishment of infection. The most likely routes of H. pylori transmission include gastro-oral, fecal-oral and oral-oral. Therefore, conditions such as close, personal contact with a child’s infected mother and siblings may favor H. pylori transmission. The immunological response mounted against H. pylori infection by a child, possibly modulated by age and passive immunity, may alter the establishment of infection.

The current research, utilizing data from The Pasitos Cohort Study, aimed to estimate the effect that H. pylori infected mothers, H. pylori infected siblings and breastfeeding may have in the acquisition and establishment of H. pylori infection in children. The Pasitos Cohort Study, a birth cohort established on the U.S.-Mexico border, recruited pregnant women from El Paso, Texas and Juarez, Mexico to identify risk factors for H. pylori infection during childhood. Assessment of active H. pylori infection for 615 children (472 index children and 143 younger siblings) was performed from April 1998 until December 2005 accounting for an average of 3.8 years of follow-up for the index child and an average of 2.5 years of follow-up for younger siblings of the index. The Pasitos Cohort Study provides advantages such as longitudinal assessment of H. pylori status for determination of directionality of H. pylori infection in familial transmission. In addition, differentiation between infection acquisition, short-term and long-term establishment of infection was attempted. The current study found that infected older siblings in the household were positively associated with both the acquisition and long-term infection establishment of H. pylori in younger siblings. Mothers and breastfeeding may also be positively associated with H. pylori outcomes but due to highly uncertain results obtained, further studies are need to assess their association with infection acquisition, short-term infection and long-term infection in children.

Comments

Cervantes, Diana T., Transmission and Establishment of Helicobacter pylori Infection in Childhood. Doctor of Public Health (Epidemiology), July 2013, 335 pp., 35 tables, 24 figures, bibliography, 159 titles.

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