{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:36:13Z","timestamp":1792802173724,"version":"4.5.0"},"update-to":[{"DOI":"10.12688\/f1000research.148550.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000}}],"reference-count":39,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"This research was partially funded by a competitive research grant at University of Sharjah","award":["2201110266"],"award-info":[{"award-number":["2201110266"]}],"id":[{"id":"https:\/\/ror.org\/00engpz63","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    Background\n                    <ns4:italic>Helicobacter pylori<\/ns4:italic>\n                    and intestinal parasites are well-known for their high prevalence in children, especially in developing countries. However, their concomitant infections are poorly documented. In this study, we aimed to evaluate the association between intestinal parasites and\n                    <ns4:italic>H. pylori<\/ns4:italic>\n                    among hospitalized children and adolescents with upper gastrointestinal complaints in Northern Lebanon. Methods A cross-sectional study was conducted involving 297 hospitalized pediatric patients, aged between 1 and 15 years, who presented with gastrointestinal symptoms. The socio-demographic, lifestyle, and gastrointestinal characteristics of all participants were analyzed. Fresh stool samples were collected and screened for the presence of intestinal parasites and\n                    <ns4:italic>H. pylori<\/ns4:italic>\n                    infections. Results 6.4% of the patients were positive for intestinal parasitic infections, 5.4% were positive for\n                    <ns4:italic>H. pylori<\/ns4:italic>\n                    infection, and 11.8% were co-infected. The results of the Chi-square test showed that\n                    <ns4:italic>H. pylori<\/ns4:italic>\n                    infection is significantly associated with parasitic infection but not with a particular species. The most frequent coinfection was\n                    <ns4:italic>H. pylori-Entamoeba histolytica<\/ns4:italic>\n                    (77.1%). Moreover,\n                    <ns4:italic>H. pylori<\/ns4:italic>\n                    infection was associated with overcrowding and infrequent washing of vegetables before eating. The prevalence of co-infections increased in patients of mothers with a primary educational level or less. In regards to clinical characteristics, our findings showed a statistically significant relationship between i) gastric reflux and\n                    <ns4:italic>H. pylori<\/ns4:italic>\n                    , and ii) severe diarrhea and parasitic infection. Conclusion Our data highlighted the association between\n                    <ns4:italic>H. pylori<\/ns4:italic>\n                    and intestinal parasitic infections. Thus,\n                    <ns4:italic>H. pylori<\/ns4:italic>\n                    detection could be taken into consideration while screening for parasitic infections in children and adolescents.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.148550.2","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T11:05:43Z","timestamp":1728990343000},"page":"500","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Concomitant Infection of Helicobacter pylori and Intestinal Parasites: Burden, Sociodemographic and Clinical Characteristics in Hospitalized Children and Adolescents in Northern Lebanon"],"prefix":"10.12688","volume":"13","author":[{"given":"Sara","family":"MINA","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Daher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2477-4583","authenticated-orcid":false,"given":"Nour","family":"Mina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghalia","family":"Khoder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2024,10,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"790-796","DOI":"10.1007\/s12639-021-01362-5","article-title":"Association of Helicobacter pylori and parasitic infections in childhood: impact on clinical manifestations and implications.","volume":"45","author":"Y Abd El Hameed","year":"2021 Sep","journal-title":"J. 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Your insightful comments were highly valuable and helped us to significantly improve the quality of our work. Every comment and concern raised has been meticulously addressed, and we have made all the necessary modifications. These changes have been comprehensively tracked in review mode for your reference. We are hopeful that with these revisions, the manuscript now fulfills the requirements for publication in the F1000Research journal.  \n<b>Comment #1: <\/b> The authors reported limited research in their subject matter, however by searching some authors previously documented this subject with the same details. It would be better to concise limited research to the locality of research and add data concerning the prevalence of the examined pathogen in the research locality. \n<b>Response:<\/b> Thank you for your valuable comments and suggestions. We have now included additional references related to the prevalence of the pathogen in the research locality, as recommended (Naous et al., 2007; Al Kirdy et al., 2020). You may view the revisions made in the track changes mode. The Naous et al. (2007) study was initially omitted from the manuscript because it is an older fecoprevalence study that focused solely on the prevalence of H. pylori in children, without addressing any concurrent intestinal parasites. However, we have reconsidered its relevance and included it as per your suggestion.  \n<b>Comment #2: <\/b> It would be beneficial to have a more detailed background on why the concomitant infection of \n<i>H. pylori<\/i> and intestinal parasites specifically is of interest. \n<b>Response: <\/b>We appreciate the valuable feedback provided by the reviewer. Indeed, the authors have not highlighted enough the interest behind the concomitant infection of \n<i>H. pylori<\/i> and intestinal parasites. Co-infections can modulate disease dynamics through synergistic or antagonistic interactions. Interestingly, the co-existence of \n<i>H. pylori <\/i>and intestinal parasites may alter the disease severity and skew host immune responses (Jaka and Smith, 2024; Krzy\u017cek and Go\u015bciniak, 2017). Changes have been implemented and tracked under review mode.  \n<b>Comment #3: <\/b> The procedures used in stool examinations are limited and inadequate to diagnose all intestinal parasites. Have the authors performed any other techniques or special stains in diagnosis?? \n<b>Response: <\/b>Thank you for your valuable comments. The authors acknowledge the importance of utilizing the most appropriate techniques for diagnosing intestinal parasites. However, given the available resources in our research laboratory and the project\u2019s budget constraints, we primarily relied on wet mount preparations in normal saline and direct-light microscopy (DLM) for detecting intestinal parasites, observing either partial or whole parasite structures. To ensure accuracy, all examinations were conducted in duplicate by two experienced microbiologists. Additionally, a modified Ziehl-Neelsen (MZN) staining technique at 1,000&times; magnification was employed to detect coccidian parasites. For the detection of \n<i>H. pylori<\/i> in stool samples, we utilized the H. PYLORI QUICK CHEK\u2122 kit (TECHLAB, USA), following established methodologies (Halland et al., 2021). Halland M, Haque R, Langhorst J, Boone JH, Petri WA. Clinical performance of the H. PYLORI QUIK CHEK\u2122 and H. PYLORI CHEK\u2122 assays, novel stool antigen tests for diagnosis of Helicobacter pylori. Eur J Clin Microbiol Infect Dis. 2021 May;40(5):1023-1028. doi: 10.1007\/s10096-020-04137-7. Epub 2021 Jan 3. PMID: 33389260; PMCID: PMC7778841.   \n<b>Comment #4: <\/b> Consider whether there should be more detail on the specific laboratory techniques used for detecting \n<i>H. pylori <\/i>and intestinal parasites. \n<b>Response: <\/b>Thank you for your suggestion. It was addressed in the previous response to comment #3.  \n<b>Comment #5: <\/b> It might be useful for the authors to hypothesize why certain sociodemographic factors (e.g., mother's education level) are associated with higher rates of co-infection. \n<b>Response: <\/b>Thank you for your insightful comment. We agree that the relationship between a mother\u2019s education level and higher rates of co-infection was not sufficiently explored in our initial discussion. We hypothesize that a mother\u2019s education level can significantly influence hygiene practices within the household, which may impact the incidence of microbial infections in children. This hypothesis is supported by findings from Wangda et al. (2017), which demonstrated that a mother\u2019s educational background is closely linked to her knowledge and traditional practices regarding the prevention and treatment of diseases in children (Wangda et al., 2017).  \n<b>Comment #6: <\/b> The study's limitations are not explicitly mentioned in the provided snippet. Please, discuss potential limitations and their impact on the findings. \n<b>Response: <\/b>Thank you for highlighting this point. To the best of our knowledge, the present study is the first to report novel assessment and risk data on the association between\n<i> H. pylori<\/i> and intestinal parasites in a Lebanese pediatric population attending tertiary care hospitals. However, the findings may not be generalizable to the Lebanese population. The cross-sectional design did not allow for drawing causal conclusions. In addition, the recruitment of hospitalized patients with gastrointestinal symptoms may affect internal validity. Adding to this, the authors agree that using more appropriate techniques to identify intestinal parasites with more precision could be one of the limitations to be considered in future studies.  \n<b>Comment #7: <\/b> The authors should provide suggestions for future research based on their findings. \n<b>Response: <\/b>Thank you for your suggestion. In this study, we focused on hospitalized children and adolescents in Northern Lebanon. Moving forward, we plan to expand this research to include asymptomatic children and adults, given that \n<i>H. pylori <\/i>infection is often asymptomatic and widespread. To build on our findings, future large-scale, multicenter epidemiological studies with appropriate control groups are needed. These studies should employ a variety of diagnostic methods to further validate our results and investigate the mechanistic interactions between \n<i>H. pylori <\/i>and specific parasitic infections. Additionally, metagenomic analyses of stool samples could help identify distinct pathogenic profiles (including parasites, viruses, and fungi) and their associations with \n<i>H. pylori<\/i> virulence factors, such as CagA, VacA, babA, and others.","URL":"https:\/\/f1000research.com\/articles\/13-500\/v2#referee-comment-12609","order":1,"name":"referee-comment-12609","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.172946.r331970, Steven F Moss, Suvithan Rajadurai, Brown University, Rhode Island, 24 Oct 2024, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/13-500\/v2#referee-response-331970","order":2,"name":"referee-response-331970","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.172946.r345967, Muinah Fowora, Nigerian Institute of Medical Research, Lagos, 26 Dec 2024, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/13-500\/v2#referee-response-345967","order":3,"name":"referee-response-345967","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This research was partially funded by a competitive research grant at University of Sharjah (2201110266).","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}