OBJECTIVES:

Infected siblings, mothers, and fathers have all been suggested to be major sources forHelicobacter pyloriacquisition among children, but few studies have addressed the potential role of various family members simultaneously.

METHODS:

A systematic review was performed on studies investigating intrafamilial transmission of childhoodH. pyloriinfection. Within the Ulm Birth Cohort Study, which consists of 1,066 healthy newborns, born between November 2000 and November 2001 and followed up to age 4, and their siblings and parents, the independent role of the infection status of parents and siblings in transmission ofH. pyloriamong children at age 4 was assessed.

RESULTS:

Among four studies reporting infected mothers and siblings as independent risk factors for childhoodH. pyloriinfection, odds ratios (ORs) for childhood infection given an infected sibling decreased meaningfully after adjustment for maternal infection status. Within the Ulm Birth Cohort Study, the prevalence of infection was 3.0% among index children at age 4. In bivariate analyses, maternal, paternal, and sibling infection were all strongly and significantly related to infection of the child. However, after multivariate adjustment, only maternal infection persisted as the single strong and significant risk factor (OR 13.0, 95% confidence interval 3.0-55.2).

CONCLUSIONS:

These patterns suggest that mutual control forH. pyloristatus of other family members is crucial for estimating the role of mothers, fathers, and siblings in the transmission of childhoodH. pyloriinfection. In populations with lowH. pyloriprevalence the infected mother is likely to be the main source for childhoodH. pyloriinfection.