Epidemiological, Clinical, and Evolutionary Profile of Helicobacter pylori Infection in the Pediatric Population of the Eastern Region of Morocco: A Series of 118 Cases

Abstract

INTRODUCTION: Helicobacter pylori (H. pylori) is a bacterium that affects a significant portion of the global population and can lead to gastroduodenal ulcers and gastric cancers in adulthood. In pediatric practice, H. pylori infection is a common concern, although most affected children remain asymptomatic. This study aims to describe the epidemiological, clinical, endoscopic, and histological profile of H. pylori gastritis in the pediatric population of the Eastern region of Morocco. MATERIALS AND METHODS:  Patients aged between one and 16 years who underwent upper gastrointestinal endoscopy between January 2022 and June 2024 were included in this study. Gastric biopsies were taken, and the presence of H. pylori infection was confirmed by Giemsa staining. Demographic data and clinical and endoscopic characteristics were collected, along with histopathological results according to theSydneysystem. RESULTS: Among the 230 children studied, 118 (51%) were infected with H. pylori, with the prevalence of infection increasing with age, notably in children aged between 10 to 16 years (46.61%). A female predominance was observed, representing 59% of the cases. The majority of children (68%) came from disadvantaged socioeconomic backgrounds. Abdominal pain was the primary symptom, reported in 60.5% of infected children. All patients exhibited macroscopic gastritis, with petechial and erosive features found in 59% and 62% of cases, respectively. Histologically, H. pylori gastritis was active in 87.2% of cases in the antrum, with a follicular pattern observed in 43.2%. Gastric atrophy was present in 25.42% of the children. The H. pylori eradication rate in our study was 94.92%, with therapeutic failure observed in 5.08% of patients, mainly due to insufficient treatment adherence. CONCLUSION: Helicobacter pylori infection can cause several gastrointestinal issues, and early detection and treatment are important to prevent complications and promote successful eradication.