Clinical Profile, Risk Factors, and Eradication Outcomes of Pediatric Helicobacter pylori Infection in Gharyan, Libya: A 2-Year Retrospective Study of 100 Cases

Abstract

Helicobacter pylori (H. pylori) infection is a primary driver of upper gastrointestinal morbidity among children in developing nations. This study aims to evaluate the clinical presentations, associated secondary complications, and therapeutic eradication outcomes of pediatric H. pylori cases within the municipality of Gharyan, Libya. A retrospective, cross-sectional cohort study was conducted on 100 consecutive pediatric patients (aged 1–15 years) diagnosed with H. pylori infection in Gharyan, Libya, over a period spanning from January 2023 to December 2024. Comprehensive clinical records were analysed to extract data on demographics, primary gastrointestinal complaints, risk factors, compliance diaries, and definitive post-treatment eradication success, verified by monoclonal stool antigen testing performed 4–8 weeks after treatment cessation. The study cohort comprised 55% females and 45% males. The predominant age demographic was school-age children (6–11 years) at 48%, followed by adolescents (12–15 years) at 30%, and toddlers (1–5 years) at 22%. Non-invasive monoclonal stool antigen testing served as the primary clinical diagnostic modality (94%). Epigastric pain was identified as the most prevalent primary complaint (66%), followed by chronic vomiting (21%) and growth failure (13%). Notably, 37% of the infected children suffered from documented iron deficiency anaemia (IDA), which demonstrated a statistically significant correlation with a symptom duration exceeding 6 months. Following empiric first-line standard triple therapy, the final eradication success rate was 76.0%, revealing a substantial treatment failure rate of 24.0%. The findings demonstrate a high therapeutic failure rate (24%) for standard empiric triple therapy in Gharyan, dropping significantly below the globally accepted 90% eradication benchmark. The high prevalence of extra-gastric complications, such as iron deficiency anaemia, emphasises the critical need for early non-invasive screening. Pediatric clinicians practising in western Libya should transition from empiric standard triple therapy to bismuth-containing quadruple regimens to counteract regional resistance.