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Helicobacter pylori infection is usually acquired in childhood but the factors predisposing to infection are not well understood. A study of children from minority groups in Houston, Texas (Hoda M Malaty and colleagues. Clinical Infectious Diseases2001;32:1387–92) has illustrated the importance of socioeconomic conditions. The study included 273 black and 83 Hispanic children aged 2–16 years attending day care centres (the school age children attended before and after school).H pylori infection was tested for using the13C-urea breath test. The overall prevalence ofH pylori infection was 24%, increasing from 14% at age 2–5 years to 49% at age 11–16 years. There were no significant differences in infection rates between boys and girls and between black and Hispanic children. Risk factors forH pylori infection included crowded day centres, crowding at home, and low level of maternal education. Breastfeeding was protective independently of the mother's education. In this group of children, overcrowding and the mother's low level of education were the main environmental factors predisposing to H pylori infection.
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