Helicobacter pylori is difficult to remove naturally in children after being infected with it. Due to differences in sample size and features, design and setting, there is little consistency between studies on epidemiology of Helicobacter pylori infection and its affecting factors in children from China, a country with high prevalence of Helicobacter pylori. Therefore, a comprehensive and objective understanding of the prevalence and risk factors of Helicobacter pylori infection among Chinese children is of great significance for the prevention of Helicobacter pylori infection in this group.

To systematically review the prevalence and risk factors of Helicobacter pylori infection among Chinese children.

In June 2021, We searched for studies on Helicobacter pylori infection and its risk factors among Chinese children in databases of PubMed, EmBase, the Cochrane Library, CNKI, CQVIP and Wanfang Data from inception to June 2021. Two reviewers independently screened the literature, extracted data, and evaluated the quality of included studies. Meta-analysis was performed using R 4.1.0.

Thirty-seven articles were included with a total sample size of 40 786 cases, of whom 11 267 were infected with Helicobacter pylori. Meta-analysis showed that the overall prevalence of Helicobacter pylori infection was 30.31%〔95%CI= (25.72%, 35.10%) 〕. Subgroup analysis showed that the prevalence of Helicobacter pylori infection significantly varied by geographical region of participants, the year of the publication of the article, and Helicobacter pylori detection method (P<0.05) . With the city economic decline, the prevalence of Helicobacter pylori infection in children was on the rise (χ²_trend=465.955, P<0.001) . Univariate meta-regression results showed that the city economic level had a significant impact on the prevalence of Helicobacter pylori infection in children (P<0.05) . Meta-analysis further indicated that poor living conditions〔OR (95%CI) =1.47 (1.09, 2.00) 〕, history of premastication〔OR (95%CI) =2.88 (1.80, 4.60) 〕, children〔OR (95%CI) =1.56 (1.01, 2.43) 〕or family members〔OR (95%CI) =2.23 (1.68, 2.98) 〕with gastrointestinal symptoms, gnawing fingers or toys〔OR (95%CI) =3.64 (2.10, 6.32) 〕, and use of shared bathroom utensils〔OR (95%CI) =2.54 (2.54, 5.73) 〕 were all risk factors for Helicobacter pylori infection in children. In contrast, living in urban areas〔OR (95%CI) =0.63 (0.56, 0.71) 〕and washing hands frequently〔OR (95%CI) =0.36 (0.18, 0.69) 〕were associated with decreased risk of Helicobacter pylori infection. In addition, the prevalence of Helicobacter pylori infection increased with the age of the children (χ²_trend=416.923, P<0.001) .

The overall prevalence of Helicobacter pylori infection among Chinese children is high, which may be higher in children living in rural and economically lagging areas, and with poor hygiene habits of individuals or family members. Strengthening Helicobacter pylori screening in children in rural areas and the education of associated risk factors will help to effectively prevent Helicobacter pylori infection in children.

我国是幽门螺杆菌的高感染国家。幽门螺杆菌进入儿童体内后，很难被自然清除。受样本量、研究方案设计、调查地域、调查对象群体特征等因素的影响，我国儿童幽门螺杆菌感染状况及影响因素研究结果不一。全面客观地了解、分析我国儿童幽门螺杆菌感染现状及其影响因素，对其预防具有重要意义。

系统评价我国儿童幽门螺杆菌的感染现状及其影响因素。

于2021年6月，计算机检索PubMed、EmBase、the Cochrane Library、中国知网、维普中文科技期刊全文数据库和万方数据知识服务平台，获取有关中国儿童幽门螺杆菌感染现状及其影响因素的研究，检索时限均为建库至2021年6月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用R 4.1.0软件进行Meta分析。

共纳入37篇文献，总样本量为40 786例，其中11 267例儿童感染幽门螺杆菌。儿童幽门螺杆菌感染率的Meta分析结果显示，我国儿童幽门螺杆菌感染率为30.31%〔95%CI（25.72%，35.10%）〕；亚组分析结果显示，不同地理区域、文献发表时间段、检测方法（下）儿童幽门螺杆菌感染率比较，差异有统计学意义（P<0.05），且随着城市经济水平的下降，儿童幽门螺杆菌感染率呈上升趋势（χ²_趋势=465.955，P<0.001）；单因素Meta回归结果显示，城市经济水平对儿童幽门螺杆菌感染率水平有影响（P<0.05）。儿童幽门螺杆菌感染影响因素的Meta分析结果显示：较差的居住条件〔OR（95%CI）=1.47（1.09，2.00）〕、口嚼食物喂养史〔OR（95%CI）=2.88（1.80，4.60）〕、儿童有消化道症状〔OR（95%CI）=1.56（1.01，2.43）〕、家庭成员有消化道症状〔OR（95%CI）=2.23（1.68，2.98）〕、有啃食手指/玩具的习惯〔OR（95%CI）=3.64（2.10，6.32）〕、共用洗漱用具〔OR（95%CI）=2.54（2.54，5.73）〕是儿童感染幽门螺杆菌的危险因素，居住地为城市〔OR（95%CI）=0.63（0.56，0.71）〕、勤洗手〔OR（95%CI）=0.36（0.18，0.69）〕是儿童感染幽门螺杆菌的保护因素。随着儿童年龄的增长，儿童幽门螺杆菌感染率呈升高趋势（χ²_趋势=416.923，P<0.001）。

我国儿童幽门螺杆菌感染率较高，农村和经济发展滞后地区的儿童，以及个人或家庭成员卫生习惯不良的儿童感染幽门螺杆菌的可能性更大。应加强对此类（地区）儿童的幽门螺杆菌感染筛查工作，并针对相关危险因素开展宣传教育工作，这将有助于儿童有效预防幽门螺杆菌感染。