Abstract
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Abstract; 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 children with sickle cell anemia.Objectives We aimed to describe the prevalence and factors associated with Helicobacter pylori infection among children with sickle cell anemia at Mulago Hospital Sickle Cell Clinic, in Uganda.Methods A cross sectional design was employed to consecutively enroll 369 children with confirmed sickle cell anemia aged 5-18 years, attending the Mulago hospital sickle cell clinic. Assessments included; abdominal pain (current, recurrent, generalized or epigastric), dyspeptic symptoms, other relevant medical and social histories. Blood and stool samples were collected and an antigen test (test kit SD Bioline) was carried out on the latter to determine H.pylori infection. Ethical approval, consent and assent (for children above 8 years of age) were obtained. Data was entered using EPI DATA version 3.1 and analysed using STATA version 12.0. H. pylori prevalence was determined as a proportion of children with a positive stool test expressed as a percentage. Adjusted Odds ratios (aOR) were used to determine factors associated with H.pylori infection.Results H.pylori infection was detected in 47.7% (176/379), 95% CI (42.9-53.1) of the cases. Having epigastric pain was independently associated with H.pylori infection; aOR 2.22, 95%CI: (1.1 – 4.6), p-value= 0.03 . Pneumococcal vaccination aOR 0.41, 95% (CI 0.2-0.9; p=0.019 ) or H.pyroli combination therapy aOR 0.183, 95% (CI 0.1- 0.6; p=0.006 ) were protective against H.pylori. Recurrent abdominal pain did not predict H.pyroli infection. Conclusions H.pylori infection was common among children with sickle cell anemia and was independently associated with epigastric pain but not recurrent pain. Pneumococcal vaccination and combination H. pylori treatment were protective against the infection. Screening for H.Pylori should be carried out in sickle cell anaemia children with epigastric pain.