Prevalence and factors associated with Helicobacter Pylori infection among children with sickle cell anemia attending Mulago hospital, in Uganda

Background: Children with sickle cell anemia (SCA) have a high predisposition to a range of infections and gastrointestinal disorders. Studies of children living in low income countries have shown high levels of infection with Helicobacter Pylori (H. pylori), however, there are no reports in Ugandan children with SCA.

Objectives: We aimed to describe the prevalence and factors associated with H. pylori infection among children with SCA at Mulago Hospital.

Methods: A cross-sectional study was conducted on 340 children with SCA aged 5-18 years. Assessments included recurrent abdominal pain(RAP), dyspeptic symptoms, relevant medical and social histories. Stool samples were collected and an antigen test carried out to determine H. pylori infection. H. pylori prevalence and its associated factors were determined.

Results: Helicobacter pylori infection was detected in 49%(168/340); (95%Confidence interval (CI): 44.1, 54.7) of the study subjects. Having epigastric pain was independently associated with H. pylori infection; (Adjusted odds ratio [aOR] = 1.89; 95%CI: 1.1, 3.6; p= 0.048). Pneumococcal vaccination; (aOR=0.425; 95%CI: 0.2, 0.9; p=0.019) and appetite loss; (aOR=0.588; 95%CI: 0.3, 0.9; p=0.046) were negatively associated with H. pylori infection. RAP was not associated with H. pylori infection.

Conclusions: H. pylori infection was common among children with SCA and independently associated with epigastric pain but not recurrent abdominal pain. Pneumococcal vaccination and appetite loss were protective against the infection. Screening for H. pylori should be carried out in SCA children with epigastric pain.