Omar Sidow Zubair, Abdifitah Ibrahim Nor, Abdulwahed Nor Abdi, Abdikani Yasin Haji Ali, Farhia Mohamed Mire, Safia Mohamud, Nimco Mohamed Ahmed, Mohamed Hassan Mohamud, Dunia Haji Ali
Approximately one in three children attending these referral hospitals was infected with H. pylori. Infection was independently associated with rural residence, lower parental education, and food-related exposures. Prevention strategies may benefit from system-level responses combining improved water and sanitation infrastructure, targeted caregiver education, and promotion of safe food-handling practices.
BACKGROUND: Helicobacter pylori (H. pylori) infection is a major cause of peptic ulcer disease and gastric cancer, with the highest global prevalence in Africa. Despite this, pediatric data from Somalia remain critically scarce. This study determined the prevalence and independent risk factors of H. pylori infection among children attending two referral hospitals in Mogadishu, Somalia.
METHODS: A facility-based cross-sectional study was conducted from 14, February 2026 to 16, April, 2026 (two months) at Mercy Pediatric Hospital and Royal Hospital, Mogadishu. Sociodemographic and risk-factor data were collected through structured caregiver interviews, and H. pylori infection status was determined by stool antigen testing using an immunochromatographic assay. Univariable and multivariable logistic regression analyses were performed using SPSS version 20.0.
RESULTS: Using consecutive sampling, 175 children were enrolled (Mercy: 117; Royal: 58), 65 (37.1%; 95% CI: 30.0%-44.3%) were positive for H. pylori infection. On multivariable analysis, four factors were independently associated with infection: rural residence (aOR = 3.09; 95% CI: 1.20-7.96; p = 0.020), low parental education (aOR = 2.34; 95% CI: 1.03-5.35; p = 0.043), failure to wash fruits and vegetables before serving (aOR = 2.40; 95% CI: 1.06-5.46; p = 0.036), and street food consumption (aOR = 2.66; 95% CI: 1.29-5.51; p = 0.008). The model demonstrated good fit (Hosmer-Lemeshow χ 2 = 5.44; p = 0.709). Soap use, which was strongly associated in univariable analysis, was attenuated to non-significance after multivariable adjustment, a pattern consistent with confounding.
CONCLUSION: Approximately one in three children attending these referral hospitals was infected with H. pylori. Infection was independently associated with rural residence, lower parental education, and food-related exposures. Prevention strategies may benefit from system-level responses combining improved water and sanitation infrastructure, targeted caregiver education, and promotion of safe food-handling practices.