Long-term recurrence rate after treatment of Helicobacter pylori infection in children and adolescents in Estonia

BACKGROUND: Helicobacter pylori infection is common in Estonia: 87% of adults and 56% of children aged 9-15 years have been found to be H. pylori seropositive. The aim of this study was to evaluate the long-term recurrence rate after treatment in children and adolescents in a setting of high H. pylori prevalence. METHODS: All children (n = 27) who underwent gastroscopy at the Children's Clinic of Tartu University Clinics during 1993--95 and in whom H. pylori infection was verified by histological examination and rapid urease test and who had completed a treatment course against H. pylori infection were invited for a post-treatment follow-up endoscopy 4-6 weeks after completion of therapy (1st follow-up visit) and to the follow-up control by [13C]-urea breath test in 1997 (2nd follow-up visit) and 2002 (3rd follow-up visit). RESULTS: Recurrence of H. pylori infection occurred in I patient out of 16 at the 2nd follow-up visit (mean 17.8+/-7.1 months after treatment), and in 5 patients out of 15 at the 3rd follow-up visit (mean 6.6+/-0.9 years after treatment). The recurrence rate calculated for the period between the 1st and the 2nd follow-up visits was 4.2% per patient-year, and between the 2nd and the 3rd follow-up visits the rate was 7.6% (95% CI 2.5%-17.6%) per patient-year. The recurrence rate calculated for the whole follow-up period was 6.7% (95% CI 2.5%-14.5%) per patient-year. CONCLUSION: The post-treatment recurrence rate of H. pylori infection in children and adolescents is higher in Estonia than in low prevalence settings.