Background Helicobacter pylori (HP) infection has become one of the most common infections in adults and children. In children, the principal symptoms are the epigastralgia, with a repercussion on growth and epigastric sensibility on palpation. The presence of HP multiplies the risk of developing gastric cancer. The diagnosis of HP infection is made by high digestive endoscopy (which targets gastritis and/or peptic ulcer), allowing biopsies to be taken at the antropharmic level. Other non-invasive screening tests such as serology are used for epidemiological studies and not for the diagnosis of acute infection.
Purpose The objective of this work is to evaluate the cost of sequential treatment in children with epigastralgic symptoms and having a positive serology at HP, and to compare it with the cost of the usual procedure, which consists of digestive endoscopy plus anatomopathological examination.
Material and methods A search for anti-HP antibodies was carried out in all children who visited the paediatric hospital and had digestive symptoms of HP in addition to endoscopic and anatomopathological examination. A questionnaire was completed by conducting a direct interview with the parents of the patients in order to get an idea of the socio-economic level of these children and explore the family antecedents. We then calculated the cost of a sequential treatment and the cost of the endoscopic and pathological examination. Statistical analysis were performed with SPSS 13.0.
Results One hundred and six children were included in this study. Anti-HP antibodies were found in 72% of symptomatic children. The comparason between serological and anatomopathological examination was significant (88% of children with positive anatomopathological examination results have anti-HP antibodies, p<0. 001). The cost of sequential treatment was estimated at around €25 compared with €125 for the endoscopic and anatomopathological examination per child.
Conclusion The peptic ulcer caused by the presence of HP has become a real public health concern due to the heavy economic and health consequences. The introduction of systematic sequential treatment in symptomatic children with a positive serology can be a cost-effective solution, especially in low- and middle-income countries where human and material resources are not always available.
References and/or Acknowledgements Acknowledgements to microbiology team
No conflict of interest
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