Association of Helicobacter pylori in Children With Self-Hand Hygiene, Maternal Hand Hygiene, Cooking, and Feeding Practices.

Background and objective Helicobacter pylori infection is widely prevalent, but its route of transmission is not clear. Person-to-person transmission seems plausible, with hand hygiene being one of the many factors that play a role. The objective of this study was to study the effect of the children's and their mother's hand hygiene and feeding practices on the prevalence of H. pylori in children. Methodology This cross-sectional study involved 475 children and their mothers. A questionnaire was administered to mothers to gather information about maternal hygiene practices, specifically handwashing before food handling and after using the toilet. Additionally, both mothers and children underwent assessments for nail length (whether cut or uncut) and the presence or absence of dirt under their nails, if nails were uncut. The association of these parameters with H. pylori seropositivity in children was comprehensively examined. Furthermore, children were divided into two distinct groups: a younger age group (one month to two years and 11 months) and an older age group (three years to 15 years). For one specific parameter - the presence of dirt under mothers' nails (i.e., if nails were uncut) - the association was further analyzed separately within these age groups. The chi-square test was applied to all variables. P  < 0.05 was considered significant Results The association of all variables with H. pylori seropositivity in children was tested. Association with H. pylori seropositivity was not present in mothers with uncut nails ( P = 0.050315), mothers with uncut nails harboring dirt under their nails within the entire sample of 475 mothers ( P = 0.39476), and mothers with uncut nails harboring dirt under their nails in the older age group (three years to 15 years) of children ( P = 0.760071). Association with H. pylori seropositivity was present in mothers with dirt under their uncut nails belonging to the younger age group of children (one month to two years and 11 months ( P = 0.014127) and mothers who did not wash their hands before food handling ( P  = 0.003032) and after using the toilet ( P = 0.003082). In all 475 children, association with H. pylori seropositivity was significant with dirt under the uncut nails of children ( P  = 0.015194) and was not significant for children with merely grown nails but not harboring dirt under them ( P  = 0.355967).  Conclusions Mother-to-child transmission is one of the likely routes of transmission of H. pylori , and poor hand hygiene seems to play a major role in this process.