Paediatric Helicobacter Pylori Infection in Taiwan: Current Status and Perspectives

Abstract

Helicobacter pylori infection is the most prevalent chronic bacterial infection in the world. The prevalence of H. pylori infection ranges from approximately 10–90% and is influenced by age, country, socioeconomic status, nutritional status, urbanisation, hygiene, and diagnostic tools available. In general, chronic H. pylori infection can lead to chronic antral gastritis, peptic ulcer disease, primary gastric lymphoma, and gastric adenocarcinoma. As public hygiene and sanitation have improved, the rates of H. pylori infection and related diseases have been declining annually in developed and rapidly developing countries, although the infection is still common in some geographic areas. In Taiwan, an Asian country with a high incidence rate of gastric malignancy, there is a similar trend of declining H. pylori prevalence rates. Prevalence rate differed vastly between rural and urban areas; however, rates have fallen greatly in recent decades. Optimal treatment of H. pylori infection in children has not yet been determined and will require further collaborative studies. However, eradication failures are concerning since global rates of antibiotic resistance are increasing and therapy for H. pylori infection is increasingly prescribed. In Taiwan, the overall antimicrobial resistant rates to clarithromycin, metronidazole, and levofloxacin were 23.4%, 20.3%, and 11.8%, respectively. With the propagation of public health education, advancement of diagnostic tools, and patient-specific tailoring of therapeutic strategies, the prevalence and eradication failure rate of H. pylori infection in children should improve in the near future, both in developed and developing countries.