0000000001071191
AUTHOR
Ilva Daugule
Prevalence of Helicobacter pylori infection among preschool children in Latvia: no significant decrease in prevalence during a ten year period.
Aims: Published data show a trend of decreasing prevalence of Helicobacter pylori in Eastern European countries due to socioeconomic changes. The aim of this study was to determine the prevalence of H. pylori infection among children in Latvia and to compare these results with previous studies in the same population. The risk factors associated with infection were also analysed. Methods: Preschool children in kindergartens and primary health care centres were investigated using a stool antigen test. Their parents were asked to fill out a questionnaire about possible risk factors. Statistical analysis included Pearson’s χ2 test and linear regression analysis. Results: The prevalence of H. p…
Previous antibacterial treatment due to concomitant infections in preschool children is associated with a lower Helicobacter pylori positivity
Use of antimicrobial agents has been proposed as 1 of the factors that contribute to the loss of Helicobacter pylori (H. pylori) infection. The aim of the study was to investigate the influence of a previous treatment with antibiotics on the prevalence of H. pylori infection in preschool children. Parents of 146 asymptomatic children (aged 0.5-5 y; no antibiotic treatment during the previous 4 weeks) completed a questionnaire about previous treatment with antibiotics and socioeconomic status. Infection with H. pylori was assessed by the monoclonal stool antigen test. H. pylori positivity was 18% (27/146). It was significantly lower in children who had been treated with antibiotics previousl…
Comparison of breast milk composition among lactating women in Latvia
Abstract Although benefits of breast-feeding have been known for a long time and breast milk is considered as ideal nutrition for infants, the composition of breast milk is still being studied, since breast milk differs among mothers and populations, as well as during different times of lactation. Further, no study has been performed among lactating women in Latvia during recent years. The objective of the study was to determine the breast milk composition and influencing factors among lactating women in Latvia in different lactation periods, as well as to compare the results with data from other countries. Fifty breast milk samples were obtained from 44 mothers (on the 5th-7th and 11th-28t…
Multicentric randomised study ofHelicobacter pylorieradication and pepsinogen testing for prevention of gastric cancer mortality: the GISTAR study
IntroductionPopulation-based eradication ofHelicobacter pylorihas been suggested to be cost-effective and is recommended by international guidelines. However, the potential adverse effects of widespread antibiotic use that this would entail have not been sufficiently studied. An alternative way to decrease gastric cancer mortality is by non-invasive search for precancerous lesions, in particular gastric atrophy; pepsinogen tests are the best currently available alternative. The primary objective of GISTAR is to determine whetherH pylorieradication combined with pepsinogen testing reduces mortality from gastric cancer among 40–64-year-old individuals. The secondary objectives include evaluat…
Non-Invasive Diagnosis of Gastroesophageal Reflux Disease Using Gastrin- and Pepsinogen-Based Tests
Abstract Gastrin-17 (G-17), pepsinogen-1 (Pg1) and pepsinogen-2 (Pg2) reflect the functional state of gastric mucosa and are used for non-invasive diagnosis and screening of atrophic gastritis. The aim of the study was to clarify if erosive reflux disease (ERD) or non-ERD (NERD) can be distinguished from other dyspeptic conditions in patients, in a non-invasive manner using specific biomarkers. Levels of G-17, Pg1, and Pg2 were measured in 141 ERD patients (median age 48 years, males — 68), 122 NERD patients (median age 45 years, males — 32) and 410 control patients (median age 50 years, males — 97). Levels of biomarkers in ERD and NERD groups were compared to controls. Median levels of G-1…
Pepsinogen testing for evaluation of the success of Helicobacter pylori eradication at 4 weeks after completion of therapy.
Background and objective: Pepsinogen levels in plasma are increased by inflammation in the gastric mucosa, including inflammation resulting from Helicobacter pylori infection. A decrease in pepsinogen II level has been suggested as a reliable marker to confirm the successful eradication of infection. The aim of our study was to evaluate the potential role of pepsinogens I and II, gastrin-17 and H. pylori antibodies in confirming successful eradication. Material and methods: Altogether 42 patients (25 women, 17 men), mean age 45 years (range 23–74), were enrolled. Pepsinogens I and II, gastrin-17 and H. pylori IgG antibodies were measured in plasma samples using an ELISA test (Biohit, Oyj., …
Association of obesity with proteasomal gene polymorphisms in children.
The aim of this study was to ascertain possible associations between childhood obesity, its anthropometric and clinical parameters, and three loci of proteasomal genes rs2277460 (PSMA6c.-110C>A), rs1048990 (PSMA6c.-8C>G), and rs2348071 (PSMA3c. 543+138G>A) implicated in obesity-related diseases. Obese subjects included 94 otherwise healthy children in Latvia. Loci were genotyped and then analyzed using polymerase chain reactions, with results compared to those of 191 nonobese controls.PSMA3SNP frequency differences between obese children and controls, while not reaching significance, suggested a trend. These differences, however, proved highly significant (P<0.002) in the subset…
Accuracy of two plasma antibody tests and faecal antigen test for non-invasive detection of H. pylori in middle-aged Caucasian general population sample.
The aim of the study was to assess the accuracy of two plasma Helicobacter pylori (H. pylori) antibody test-systems and a stool antigen test (SAT) system in a general population sample in Latvia.Blood and faecal samples were analysed in healthy individuals (40-64 years), referred for upper gastrointestinal endoscopy according to pilot study protocol within a population-based study investigating gastric cancer prevention strategies (GISTAR pilot study). Antibodies to H. pylori were assessed in plasma by latex-agglutination test and enzyme-linked immunosorbent assay (ELISA). H. pylori antigen in faecal samples was detected by a monoclonal enzyme immunoassay-based SAT. Histological assessment …
Helicobacter pylori and allergy: Update of research.
Recently a lot of literature has been published about the possible preventive action of Helicobacter pylori (H. pylori) against allergy. The present review summarizes research data about the association between H. pylori and allergic diseases, as well as discusses possible hypotheses about the preventive action of H. pylori against atopy. There is evidence from observational studies to support a weak inverse association between prevalence of H. pylori infection and allergy. However, confounders like some unidentified socioeconomic factors, antibiotic use and others could bias the association. Although data from cohort studies point to a possible association of H. pylori with some of the all…
Low Prevalence of Celiac Disease among Patients with Functional Gastrointestinal Disorders in Latvia.
Background and Aims: Studies suggest that the prevalence of celiac disease (CD) is increased in individuals with functional gastrointestinal disorders (FGIDs), in particular, irritable bowel syndrome (IBS); however, the evidence is conflicting. We aimed to analyze the prevalence of CD in patients with FGIDs in Latvia.
 Methods: This retrospective study included patients with FGIDs, referred for a gastroenterologist consultation in a secondary gastroenterology practice unit. Patients were divided into three groups – patients only with IBS (IBS group), patients only with functional dyspepsia (FD) (FD group), patients with mixed symptoms IBS and FD (Mixed group). Patient levels of tissue …
Gastric plasma biomarkers and Operative Link for Gastritis Assessment gastritis stage
Introduction The Operative Link for Gastritis Assessment (OLGA) staging system has been proposed as a histopathological reporting system of gastric atrophy. Noninvasive methods for indirect evaluation of gastric mucosal atrophy by biomarkers are also being introduced. Objectives To analyze gastric mucosal atrophy by biomarkers, pepsinogen I (PgI), pepsinogen II (PgII), PgI/PgII ratio, fasting gastrin-17 (G-17), stimulated gastrin-17 (sG-17), in relation to OLGA gastritis stage. Patients and methods Gastric biopsies were taken from 269 prospective patients referred for upper endoscopy because of dyspeptic problems and evaluated by two expert pathologists (D.J. and P.S.). Atrophy was assessed…
Helicobacter pyloriinfection among children with gastrointestinal symptoms: a high prevalence of infection among patients with reflux oesophagitis
Aim: To investigate the link between H.pylori infection and dyspepsia in children, and association with reflux oesophagitis. Patients and Methods: H.pylori status was detected by rapid urease test and/or culture in 130 consecutive symptomatic children coming for upper gastrointestinal endoscopy: 40 – aged 8–12 years (55% boys); 90 – aged 13–18 years (21% boys). Endoscopic findings were analyzed. H.pylori prevalence in the age group 8–12 years was compared to the prevalence among 55 asymptomatic children, aged 7–12 years (13C–urea breath test). Statistical analysis: χ2 test, Fisher's test, and logistic regression analysis. Results: The prevalence of H.pylori infection among patients with gas…
Prevalence and Potential Risk Factors of Helicobacter pylori Infection among Asymptomatic Individuals in Kazakhstan
Background: Helicobacter pylori (H. pylori) infection is associated with several risk factors such as demographic, socioeconomic status and personal habits, which vary in different populations. This is the most up-to-date data on H. pylori prevalence and potential risk factors for H. pylori infection among asymptomatic middle-aged individuals in Kazakhstan. Methods: Apparently healthy individuals aged 40 to 64, who took part in the health control in the outpatient clinic, were invited to participate in the study; answered a questionnaire, donated a blood sample. The antibodies to H. pylori were analysed by latex agglutination method. The baseline characteristics of study subjects with or wi…
711 Pancreatic Exocrine Function in Allergic Children
Background and aims: The concentration of human pancreatic elastase1 in faeces reflects exocrine pancreatic function. Patients with allergy may have damaged intestinal mucosa or inflammation within the duodenal mucosa that could be associated with pancreatic dysfunction and disturbed digestion of allergens (that are mainly of protein origin). The aim of the study was to compare pancreatic function in allergic patients and children without allergy. Methods: The total patient sample consisted of 109 children, aged 1-10 yrs (mean age 5.2): 49 children were having allergy while 60 were healthy children or children with minor health problems. Faecal samples were gathered and the activity of huma…
258 Helicobacter Pylori Infection in Allergic Children
Background and aims: Studies have suggested that Helicobacter pylori (H.pylori) infection could be considered as a protective factor against development of allergic illnesses. The goal of our study was to compare the prevalence of H. pylori infection in allergic patients and children without allergy. Methods: The total patient sample consisted of 147 children aged 1-10 yrs (mean age 5.2): 58 children had allergy diagnosis and 89 were healthy children or children with minor health problems. Parents were asked to bring a faecal samples of the child and to fill out a questionnaire (demographic data, socio-economical factors). Presence of active H. pylori infection was detected by stool antigen…
Dominating taxonomic composition of the early life gut microbiota and influencing factors in infants up to seven months of age in Latvia
Abstract It has been hypothesised that the establishment of stable adult microbiota is programmed in infancy, and therefore early life gut colonisation may lead to a lifelong microbiota pattern with significant effects on health. The aim of the study was to analyse the composition of gut microbiota and influencing factors in infants up to seven months of age in Latvia. A cross-sectional study was performed at primary healthcare centres. The parents of healthy infants filled out a questionnaire and brought the child’s faecal sample. 16 rRNS gene sequencing was performed to identify the bacterial taxonomic units. The composition of gut microbiota was compared between children with different r…
Helicobacter pylori infection in children.
The review summarizes the articles published on Helicobacter pylori in children between April 2007 and March 2008. Evidence is emerging in different populations including developing countries that the prevalence of H. pylori is declining in all age groups. The reasons for this are unclear but it is unlikely that treatment of infection or improvement in socioeconomic conditions fully explains the decline. For the first time, differences in the inflammatory response between adults and children have been well characterized in a group of adults and children from Chile with similar levels of H. pylori infection. This study suggests that the reduced inflammatory response to H. pylori at a cellula…
Pathogenic Escherichia coli Among Asymptomatic Children and Associated Factors
Abstract Although Escherichia coli is a part of the commensal flora of the gastrointestinal tract, pathogenic types of E. coli can cause diarrhea, especially in children. Pathogenic types are found also in healthy individuals, but prevalence of pathogenic E. coli among asymptomatic children varies and has not been studied in Latvia. The aim of the study was to determine prevalence of pathogenic E. coli among asymptomatic children and identify factors associated with presence of bacterium. Children (aged 0.5–8 years) without acute gastrointestinal symptoms were included in a cross-sectional study. Parents were asked to answer a questionnaire (demographic data, parental education, type of del…
Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study
Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings.Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updat…
Helicobacter pylori and some aspects of gut microbiota in children
Helicobacter pylori infection in children differs from infection in adults in many aspects. The rate of infection, epidemiology, clinical presentations and complications, the applicability of diagnostic tests, antibiotic resistance, treatment options, and success rates differ significantly. Due to all these differences, management guidelines for children and adults differ also substantially. In 2017, the Updated ESPGHAN and NASPGHAN Guidelines on the management of H. pylori infection in children were published, emphasizing the differences in clinical presentation and indications for treatment, stating that the primary goal of clinical investigation in children is to identify the cause of up…
Infection with cagA -Positive and cagA -Negative Types of Helicobacter pylori Among Children and Adolescents with Gastrointestinal Symptoms in Latvia
In order to determine the prevalence of concomitant cagA-positive and cagA-negative Helicobacter pylori genotypes in individual subjects, a group of 56 symptomatic patients (aged 8-18 years) was studied. Among 31 patients culture-positive for Helicobacter pylori, only cagA-positive colonies were isolated from 18 patients, both cagA-positive and cagA-negative genotypes were isolated from 4 patients, and in 9 patients all of the individual colonies isolated were cagA-negative, but in seven of them a pool of colonies was positive for cagA. Thus, the presence of both cagA-positive and cagA-negative genotypes in the same individual was identified in 11 of the 31 culture-positive patients tested,…
Helicobacter pylori Infection and Risk Factors in Relation to Allergy in Children
Purpose To analyze presence of Helicobacter pylori infection and environmental risk factors among children with and without allergy. Methods Parents of children at primary health care centres/kindergartens and allergologist consultation were asked to answer a questionnaire and to bring a faecal sample. H. pylori infection was detected by monoclonal stool antigen test. Prevalence of H. pylori infection and risk factors were compared between individuals with and without allergy using χ2 test, ANOVA test and parameters and logistic regression. Results Among 220 children (mean age, 4.7 years; ±standard deviation 2.3 years) H. pylori positivity was non-significantly lower among patients with all…
Accuracy of two plasma antibody tests and faecal antigen test for non-invasive detection of H. pylori in middle-aged Caucasian general population sample
Objective: The aim of the study was to assess the accuracy of two plasma Helicobacter pylori (H. pylori) antibody test-systems and a stool antigen test (SAT) system in a general population sample in Latvia. Materials and methods: Blood and faecal samples were analysed in healthy individuals (40–64 years), referred for upper gastrointestinal endoscopy according to pilot study protocol within a population-based study investigating gastric cancer prevention strategies (GISTAR pilot study). Antibodies to H. pylori were assessed in plasma by latex-agglutination test and enzyme-linked immunosorbent assay (ELISA). H. pylori antigen in faecal samples was detected by a monoclonal enzyme immunoassay-…
Prevalence of Helicobacter pylori infection and atrophic gastritis in Latvia.
Helicobacter pylori infection and atrophic gastritis are related to an increased risk for gastric cancer. There is a decrease in global H. pylori prevalence. We analyzed the prevalence of H. pylori infection in Latvia by the plasma IgG test and the presence of atrophy by means of pepsinogen testing.This subanalysis was carried out on a randomly selected cross-sectional sample of a general population of adults to access cardiovascular risk factors. Plasma samples were screened for H. pylori IgG (cutoff value 24 U/ml), and pepsinogens (Pg) I and II. Pg cutoff values of PgI/PgII ≤ 3 and PgI ≤ 70 ng/ml were used to assess the prevalence of atrophy of any grade and PgI/PgII ≤ 2 and PgI ≤ 30 ng/m…
Prevalence estimation of celiac disease in the general adult population of Latvia using serology and HLA genotyping
Background: Prevalence estimates for celiac disease (CD) depend on the method used. The role of deamidated gliadin peptide (DGP) and genetic testing in epidemiological studies and diagnostic settings of celiac disease (CD) has still to be established. Objectives: The objective of this article is to assess the prevalence of CD in Latvia by combining serological tests with DQ2.5/ DQ8 testing. Methods: A total of 1444 adults from a randomly selected cross-sectional general population sample were tested by ELISA for tTG IgA, DGP IgA and IgG antibodies (QUANTA Lite, Inova Diagnostics Inc). Samples with tTG IgA 20U were tested for EMA IgA by indirect immunofluorescence assay, and all specimens wi…
1440 Child Mortality Under Five in Latvia, Causal Relationship and Reduction Possibilities in An International Context
Background and aims: To identify the reasons of the continuously highest infant and under five mortality (U5M) rates in Latvia (since restoration of independence) within EU - 25, in order to find solutions to minimize the mortality rate in accordance with Millenium Development Goals (MDG). Methods: Analytical study of statistical data bases was performed by monitoring reports, private publications to find causal relationship in international aspect between U5M in Latvia and following factors: GDP, health budget per capita, Gini coefficient, medical service availability, etc. Results: Structure of U5M in Latvia differs from EU-25, being 2 to 10 times higher by reason of external causes of de…