Abstract
Abstract
Objectives
This study, comprising a systematic review and meta-analysis, was conducted to assess the association between
Helicobacter pylori
infection and the risk of iron deficiency anemia (IDA) in children.
Methods
We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant published studies were searched in the databases. Retrieved studies were assessed for quality using the Modified Newcastle-Ottawa Scale for quality assessment. The “meta” package of statistical software “R 4.0.3 was used for statistical analysis.
Results
Overall, 22 eligible studies (eight cross-sectional, six randomized control trials, five case-control, two surveys, and one cohort), including nine (40.9%) from Asia, four (18.1%) from America, four (18.1%) from Africa, four (18.1%) from Europe, and one (4.5%) from Australia with a total of 3,434 cases and 4,455 controls were included in this systematic review and meta-analysis. We found that
H. pylori
infection was associated with a high risk of IDA (odds ratio 1.70, 95% confidence interval 1.21 − 2.38) in a random-effects model. Meta-regression analysis showed that none of the investigated factors that may affect the prevalence of IDA reached statistical significance. There was statistically significant difference between results when studies were categorized according to the methods used to diagnose
H. pylori
and level of incomes based on World Bank classification. The GRADEpro Guideline Development Tool evidence for the risk of IDA was of a “moderate certainty.”
Conclusions
This meta-analysis with a “moderate certainty” of evidence showed an association between
H. pylori
infection and a high risk of developing IDA in children.