OBJECTIVES. Rural Alaska Natives have a high prevalence of iron deficiency and Helicobacter pylori infection. The objective of this study was to estimate the prevalence of iron deficiency, iron-deficiency anemia, and active H pylori infection among school-aged children in rural Alaska.METHODS. We enrolled 68% (688) of the 7-to 11-year-old children from 10 predominantly Alaska Native villages in southwestern Alaska. We collected venous blood samples to assess iron deficiency and anemia. Each child was tested for active H pylori infection by 13 C-urea breath test (UBT). Evaluated risk factors included age, gender, village of residence, number of household members, number of household members who were younger than 5 years, recent antibiotic use, and household water source.RESULTS. Of 688 enrolled children, iron deficiency was present in 38%, iron-deficiency anemia was present in 7.8%, and H pylori infection by UBT was present in 86%. Iron deficiency was independently associated with living in a household with Ͼ6 people and village of residence. H pylori infection by UBT was independently associated with child's age Ն10 years and village of residence. Ninety-one percent of children with iron deficiency had H pylori infection by UBT, and children with active H pylori infection were more likely to be iron deficient than uninfected children. Children with H pylori infection by UBT were also more likely to have iron-deficiency anemia than uninfected children.CONCLUSIONS. In this study of nearly 700 children in 10 different villages in Alaska, we confirmed that the high prevalence of iron deficiency persists among schoolaged children. We found that active H pylori infection was independently associated with iron deficiency and iron-deficiency anemia among children in this region. H pylori infection may account for a portion of the iron deficiency and iron-deficiency anemia in rural Alaska and other areas with high prevalences of both conditions. Innovative approaches are critically needed to address the iron deficiency in high prevalence areas such as rural Alaska and most of the developing world. Dr Baggett assisted with study design, was the primary person responsible for study implementation during the first study year, conducted all data analysis, and was the primary manuscript author. Dr Gessner was the study primary investigator, wrote the study protocol, was the primary person responsible for study implementation during the second study year, and assisted with data analysis and preparing the manuscript. Dr Parkinson was responsible for all components of laboratory analysis, assisted with study design, and provided critical input into the final manuscript. Ms Muth assisted with study design and writing the study protocol, was the primary person responsible for administrative project management, and reviewed the final manuscript. Dr Gold contributed to the study design, data analysis, and interpretation and provided critical input into the final manuscript. 2 The prevalence of iron deficiency among children...

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In a high-prevalence population, treatment and resolution of H. pylori infection did not improve isolated iron deficiency or mild anemia up to 14 months after treatment initiation.

H. pylori infection is not related to growth among Alaska Native children aged 7-11 years. Growth deficiency should not be considered an indication for H. pylori therapy.