Published online February 26, 2007
PEDIATRICS Vol. 119 No. 3 March 2007, pp. e754-e759 (doi:10.1542/peds.2006-2196)
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REVIEW ARTICLE

Childhood Helicobacter pylori Infection and Growth Impairment in Developing Countries: A Vicious Cycle?

Henry J. Windle, PhDa, Dermot Kelleher, MD, FRCPa and Jean E. Crabtree, DPhil, MRCPathb

a School of Medicine, Trinity College Dublin and Dublin Molecular Medicine Centre, Dublin, Ireland
b Leeds Institute of Molecular Medicine Unit, St James's University Hospital, Leeds, United Kingdom

We hypothesize that infection with the gastric pathogen Helicobacter pylori in children in developing countries is the initiator of a vicious cycle of events that result ultimately in malnutrition and growth impairment. Acute infection with H pylori is accompanied by hypochlorhydria, which facilitates the acquisition of other enteropathogens because of removal of the gastric acid barrier, which then results in diarrheal disease and iron-deficiency anemia. This is likely to occur most frequently in developing regions where the prevalence of H pylori infection is disproportionately high and multiple enteric coinfections are common. The consequent synergistic impact of diarrheal disease and micronutrient deficiency on growth and cognitive function in children has significant public health implications for socioeconomic development in these countries.

Key Words: H pylori • hypochlorhydria • diarrhea • enteric infections • iron-deficiency anemia • malnutrition

Abbreviations: IDA—iron-deficiency anemia • IL-1—interleukin 1

Accepted Oct 3, 2006.