Helicobacter pylori and the birth cohort effect: evidence of a continuous decrease of infection rates in childhood

Am J Gastroenterol. 1997 Sep;92(9):1480-2.


Objective: To investigate whether the decrease in rate of Helicobacter pylori infection in subsequent birth cohorts has continued during the last decades.

Methods: Determination by ELISA of IgG H. pylori antibodies in 314 serum samples from Dutch children (age 6-8 yr, n = 154) and young adolescents (age 12-15 yr, n = 160), collected in 1978 and 1993.

Results: The prevalence of H. pylori declined from 19% to 9% at age 6-8 yr and from 23% to 11% at age 12-15 yr. For the whole study population, a decline from 21% to 10% (p = 0.01) was observed between 1978 and 1993. On the basis of these data and an incidence of infection with H. pylori of 0.3% per year during the same period, a model for both past and future prevalence rates of H. pylori in the Dutch population was calculated. The outcome demonstrates a decrease from more than 50% around World War II to less than 20% for the whole population around year 2040.

Conclusions: H. pylori infection rates in childhood have continued to decline until recent decades, demonstrating a persistent birth cohort effect. This decline will result in a very low prevalence of H. pylori infection in the Dutch population during the next decades, becoming even lower as the observed decline in children and young adolescents continues.

MeSH terms

  • Adolescent
  • Antibodies, Bacterial / blood
  • Child
  • Cohort Effect
  • Cohort Studies
  • Enzyme-Linked Immunosorbent Assay
  • Forecasting
  • Helicobacter Infections / epidemiology*
  • Helicobacter Infections / immunology
  • Helicobacter Infections / prevention & control
  • Helicobacter pylori* / immunology
  • Humans
  • Immunoglobulin G / blood
  • Incidence
  • Netherlands / epidemiology
  • Outcome Assessment, Health Care
  • Population Surveillance
  • Prevalence


  • Antibodies, Bacterial
  • Immunoglobulin G