The epidemiology of Helicobacter pylori infection in African refugee children resettled in Australia

Objective: To determine the prevalence and associated epidemiological features of Helicobacter pylon infection in child refugees in Western Australia. Design and participants: Cross-sectional study of 193 eligible African refugee children (aged < 16 years) at their initial health assessment after resettlement in Australia between 1 February and 30 November 2006. Main outcome measures: (i) Prevalence of H. pylori infection determined by monoclonal faecal antigen enzyme immunoassay testing (MFAT); (ii) associations of H. pylori infection with epidemiological factors (age, sex, transit through refugee camps, comorbidities and treatment interventions). Results: MFAT was performed in 182 of the 193 children; 149 of these 182 (82%) had H. pylori infection. Age was an independent predictor of H. pylori infection (odds ratio [OR], 1.18; 95% Cl, 1.07-1.31). No sex differences were observed. Premigration antimalarial therapy (with sulfadoxine-pyrimethamine and artesunate) significantly reduced the prevalence of H. pylori infection (age-adjusted OR, 0.33; 95% Cl, 0.15-0.75). Conclusion: African refugee children have a high prevalence of H. pylori infection. Increasing age is a strong predictor of infection and antimalarial treatment may have a protective effect.