Association between infection with <i>Helicobacter pylori</i> and platelet indices among school-aged children in central Ethiopia: a cross-sectional study.

Abstract

Previous clinical studies in adults from developed countries have implicated <i>Helicobacter pylori</i> infections in the development of thrombocytopenia. However, studies in children, particularly those from low-income countries, are unusually scarce. We examined the association between <i>H. pylori</i> infection and platelet indices in young Ethiopian school children. Cross-sectional study SETTING: This study was conducted in five elementary schools located in central Ethiopia. Blood and stool samples were collected from 971 children across five elementary schools in Ethiopia. <i>H. pylori</i> infection was diagnosed using stool antigen and serum antibody tests, and haematological parameters were measured using an automated haematological analyser. An interviewer-led questionnaire administered to mothers provided information on demographic and lifestyle variables. The independent effects of <i>H. pylori</i> infection on platelet indices were determined using multivariate linear and logistic regressions. <i>H. pylori</i>-infected children had a lower average platelet count and mean platelet volume than uninfected after adjusting the potential confounders (adjusted mean difference: -20.80×10⁹/L; 95% CI -33.51 to -8.09×10⁹, p=0.001 and adjusted mean difference: -0.236 fL; 95% CI -0.408 to -0.065, p=0.007, respectively). Additionally, <i>H. pylori-</i>infected children had lower red blood cell counts (adjusted mean difference: -0.118×10¹²/L; 95% CI -0.200 to -0.036, p=0.005) compared with non-infected. Our study from a developing country provides further support for an association between <i>H. pylori</i> infections and reduced platelet indices in young Ethiopian school children, after controlling for potential confounders. Further research is needed, particularly longitudinal studies, to establish causality.