# Helicobacter pylori and Impaired Early Childhood Development—Evidence From a Birth Cohort Study From Ghana and Côte d'Ivoire

## TL;DR

This study finds that Helicobacter pylori infection in early childhood is linked to impaired motor development in high-prevalence, low-resource regions of Africa.

## Contribution

The study provides novel evidence from sub-Saharan Africa linking H. pylori infection to early childhood motor development delays.

## Key findings

- H. pylori infection was significantly associated with a 7-point reduction in motor domain scores at the 75th percentile.
- Infected children showed a 10-point reduction in total developmental milestone scores at the upper quantile.
- No significant associations were found in language or personal-social domains.

## Abstract

Helicobacter pylori
(
H. pylori
) infection is highly prevalent in low‐resource settings and has been implicated in adverse health outcomes beyond the gastrointestinal tract, including potential effects on early neurodevelopment. However, data from sub‐Saharan Africa is limited.

We conducted a prospective cohort study among 229 mother–child dyads from Ghana and Côte d'Ivoire to assess the association between
H. pylori
infection and early child development at 12 months of age. Child development was evaluated using the Developmental Milestones Checklist (DMC), encompassing locomotor, fine motor, language, and personal–social domains.
H. pylori
infection status was determined by stool antigen testing. Quantile regression models, adjusted for socioeconomic status and sex, were applied to analyze associations between
H. pylori
infection and DMC scores.

Among 229 children, 38 (16.6%) tested positive for
H. pylori
. The median total motor score was higher in
H. pylori
‐negative children (45, IQR 41–50) compared to positive children (43, IQR 40–45; p = 0.031). At the 75th percentile,
H. pylori
infection was significantly associated with a 7‐point reduction in the motor domain score (estimate = −7; 95% CI: −11.1 to −2.9; p = 0.001; FDR‐adjusted p = 0.003) and a 10‐point reduction in total DMC score (estimate = −10; 95% CI: −17.5 to −2.6; p = 0.009; FDR‐adjusted p = 0.027) after multivariable adjustment. No significant associations were observed at lower or median quantiles, nor in language or personal‐social domains.

H. pylori
infection at 12 months of age is significantly associated with impaired motor development among children performing in the upper range of developmental achievement. These findings underscore the potential neurodevelopmental impact of early‐life
H. pylori
infection in high‐prevalence, resource‐limited settings and highlight the importance of integrating infection control strategies into early childhood development programs. Further research is warranted to elucidate infection‐related neurodevelopmental risks in early childhood.