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Yang H, Zhang M, Li H, Huang Z, Sun Y, Li W, Li C, Qin X, Wang Y, Zhang X, Zhao Z, Wang L, Wang L, Qian J. Prevalence of common upper gastrointestinal diseases in Chinese adults aged 18-64 years. Sci Bull (Beijing) 2024; 69:3889-3898. [PMID: 39562185 DOI: 10.1016/j.scib.2024.07.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 07/16/2024] [Accepted: 07/24/2024] [Indexed: 11/21/2024]
Abstract
To investigate the prevalence of gastroesophageal reflux disease (GERD), reflux esophagitis (RE), digestive ulcer gastric ulcer (GU), duodenal ulcer (DU), and Helicobacter pylori infection in Chinese adults aged 18-64 years and their associated factors, a community-based cross-sectional study using a stratified multistage sampling method was conducted. A standardized questionnaire survey, the 13C-urea breath test, and gastroscopy were performed. Weighted methods were used to estimate the prevalence of diseases or infection mentioned above and their risk factors. Finally, 27,637 participants aged 18-64 years were enrolled from 2017 to 2018. The prevalence (95% confidence interval) of GERD, RE, GU, DU, and H. pylori infection was estimated to be 10.5% (7.8%-14.2%), 5.4% (3.9%-7.3%), 2.5% (1.7%-3.7%), 4.5% (3.6%-5.4%), and 41.5% (36.7%-46.4%), respectively. The fraction of H. pylori infection reached 58.6% and 61.1% among the GU and DU patients, respectively. Weighted multivariable logistic regression models showed that GERD, RE, and GU shared the common risk factors of age and obesity. Dose-response relationships were observed between smoking and all four diseases, as well as alcohol consumption and GERD and H. pylori infection. Northwest China had the highest prevalence of GERD (23.9%), RE (8.7%), GU (7.8%), DU (7.3%), and H. pylori infection (63.6%); however, the southwest region had the highest prevalence of GU but the lowest of DU, RE, and H. pylori infection. Non-steroidal anti-inflammatory drugs were positively associated with GERD risk. On the contrary, a reduced risk of GU was observed among H. pylori-infected patients taking this drug. In summary, the prevalence of GERD, RE, and H. pylori infection still appears high in China. H. pylori infection eradication remains the priority to reduce the burden of peptic ulcer disease. The aging population, high prevalence of overweight or obesity, smoking, and drinking in China could explain the high burden of these diseases, thus suggesting the targeted preventive measures for upper gastrointestinal diseases in the future.
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Affiliation(s)
- Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Mei Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Hui Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Zhengjing Huang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yuanyuan Sun
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Wenbo Li
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Chun Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xuzhen Qin
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yanhong Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Xiao Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Zhenping Zhao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Li Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
| | - Jiaming Qian
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
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Tallman PS, Miller AA, Brandley SR, Lee CC, Cepon-Robins TJ, Gildner TE, Collins SM. Helicobacter pylori exposure among the Awajún of the Peruvian Amazon: Prevalence and environmental, social, and biological associations. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 184:e24941. [PMID: 38615180 DOI: 10.1002/ajpa.24941] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/15/2024] [Accepted: 04/02/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVES Helicobacter pylori (H. pylori)-a gastric bacteria affecting almost 50% of the global population and leading to ulcers and cancer in severe cases-is a growing health concern among Indigenous populations who report a high burden of reported poor general health and gastrointestinal distress. We test hypothesized associations between H. pylori exposure patterns and environmental, social, and biological conditions among a sample of 212 Indigenous Awajún adults (112 males, 100 females, ages 18-65 years) living in the northern Peruvian Amazon. MATERIALS AND METHODS Dried blood spots were analyzed for H. pylori-specific IgG using a recently developed enzyme-linked immunosorbent assay. Resulting seropositivity rates and antibody concentrations, proxying past exposures to H. pylori were analyzed in relation to relevant environmental (toilet type, floor material, reported water quality), social (household size and education level), and biological (age, sex, BMI, blood pressure, immune and metabolic biomarkers) factors using multivariable regression analyses. RESULTS We found near ubiquitous seropositivity for H. pylori exposure in our sample (99.1% seropositive). In the regression analyses, elevations in H. pylori antibody concentrations were significantly higher among males compared to females (β = 0.36, p = 0.01). No associations were found with any other factors. DISCUSSION Anthropological research in the study communities suggests that the male bias in elevations of H. pylori antibody concentrations is related to cultural and biological factors. Future research is needed to further unravel these biocultural dynamics and determine whether elevations in H. pylori antibody concentrations have clinical relevance for gastrointestinal health outcomes in this population.
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Affiliation(s)
- Paula S Tallman
- Department of Anthropology, Loyola University Chicago, Chicago, Illinois, USA
| | - Aaron A Miller
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Sophea R Brandley
- Department of Anthropology, Loyola University Chicago, Chicago, Illinois, USA
| | - Cassie C Lee
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Tara J Cepon-Robins
- Department of Anthropology, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
| | - Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Shalean M Collins
- Department of International Health and Sustainable Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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Kebede T, Ashenafi H. The Burden and Risk Factors of Helicobacter Pylori Infection Among Government Employees Who Clinically Complain of Indigestion but Allergic Diseases in Southeastern Ethiopia: A Multi-Institution Cross-Sectional Study. Res Rep Trop Med 2024; 15:25-49. [PMID: 38406662 PMCID: PMC10885702 DOI: 10.2147/rrtm.s447203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Background Helicobacter pylori (H. pylori) is believed to have spread from East Africa, but its burden is still unknown in less privileged regions of Ethiopia. Indigestion is an upset stomach, upper abdomen discomfort, heartburn, and bloating. This study evaluated the burden and risk factors for H. pylori infection among government employees who clinically complained of indigestion but allergic diseases in five public health institutions in Southeastern Ethiopia. Methods A health facilities-based cross-sectional survey study was conducted in Southeastern Ethiopia from March to November 2022, employing cluster sampling. Blood specimens, clinical data, and semi-structured questionnaires about risk factors were collected. Data analysis was conducted using descriptive, bivariate, and multivariable logistic regression in STATA software, Windows version 16.1. Results The overall prevalence of infection was found to be 77.6%. The sampled health institution (ρ-value < 0.05), engagement in sideline business (ρ-value < 0.05), sharing local spoon on meal [AOR = 39.30; CI:19.52 -78.31; ρ-value < 0.001], admitting "Gursha" during meal [AOR = 71.48; CI:3.99 -1279.77; ρ-value < 0.05], the toilet type [AOR = 1410.98; CI:121.16 -16,431.19; ρ-value < 0.001], alcohol drinking [AOR = 15.15; CI:1.90 -120.62; ρ-value < 0.05], sleeping hours length [AOR = 15.01; CI:13.48-55.96; ρ-value < 0.001], chewing Khat [AOR = 76.73; CI:8.57-687.07; ρ-value < 0.001], and regular hand washing before eating [AOR = 0.15; CI:0.12-0.19; ρ-value < 0.05] were the independent predictors of H. pylori infection. Conclusion The prevalence rate of H. pylori infection in Southeastern Ethiopia is agonizingly high, exceeding the world average by 27.6%, the first report, and seems to be one of the neglected infectious diseases. Hence, the Oromia Region Health Bureau should reinvigorate the basic infectious disease control methods, establish routine laboratory diagnostic platforms, and intervene in selected societal practices spreading infections.
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Affiliation(s)
- Taye Kebede
- Department of Biomedical Sciences and Immunology, Madda Walabu University, Bale-Robe, Oromia Regional State, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Addis Ababa Administration City, Ethiopia
| | - Hagos Ashenafi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Addis Ababa Administration City, Ethiopia
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She X, Zhao J, Cheng S, Shi H, Dong L, Zhao P. Prevalence of and risk factors for Helicobacter pylori infection in rural areas of Northwest China: A cross-sectional study in two villages of Yan'an city. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023. [DOI: 10.1016/j.cegh.2023.101294] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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Yu XC, Shao QQ, Ma J, Yu M, Zhang C, Lei L, Zhou Y, Chen WC, Zhang W, Fang XH, Zhu YZ, Wu G, Wang XM, Han SY, Sun PC, Ding SZ. Family-based Helicobacter pylori infection status and transmission pattern in central China, and its clinical implications for related disease prevention. World J Gastroenterol 2022; 28:3706-3719. [PMID: 36161052 PMCID: PMC9372799 DOI: 10.3748/wjg.v28.i28.3706] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/09/2022] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) has characteristics of family cluster infection; however, its family-based infection status, related factors, and transmission pattern in central China, a high-risk area for H. pylori infection and gastric cancer, have not been evaluated. We investigated family-based H. pylori infection in healthy households to understand its infection status, related factors, and patterns of transmission for related disease prevention.
AIM To investigate family-based H. pylori infection status, related factors, and patterns of transmission in healthy households for related disease prevention.
METHODS Blood samples and survey questionnaires were collected from 282 families including 772 individuals. The recruited families were from 10 selected communities in the greater Zhengzhou area with different living standards, and the family members’ general data, H. pylori infection status, related factors, and transmission pattern were analyzed. H. pylori infection was confirmed primarily by serum H. pylori antibody arrays; if patients previously underwent H. pylori eradication therapy, an additional 13C-urea breath test was performed to obtain their current infection status. Serum gastrin and pepsinogens (PGs) were also analyzed.
RESULTS Among the 772 individuals examined, H. pylori infection rate was 54.27%. These infected individuals were from 246 families, accounting for 87.23% of all 282 families examined, and 34.55% of these families were infected by the same strains. In 27.24% of infected families, all members were infected, and 68.66% of them were infected with type I strains. Among the 244 families that included both husband and wife, spouse co-infection rate was 34.84%, and in only 17.21% of these spouses, none were infected. The infection rate increased with duration of marriage, but annual household income, history of smoking, history of alcohol consumption, dining location, presence of gastrointestinal symptoms, and family history of gastric disease or GC did not affect infection rates; however, individuals who had a higher education level showed lower infection rates. The levels of gastrin-17, PGI, and PGII were significantly higher, and PGI/II ratio was significantly lower in H. pylori-infected groups than in H. pylori-negative groups.
CONCLUSION In our study sample from the general public of central China, H. pylori infection rate was 54.27%, but in 87.23% of healthy households, there was at least 1 H. pylori-infected person; in 27.24% of these infected families, all members were infected. Type I H. pylori was the dominant strain in this area. Individuals with a higher education level showed significantly lower infection rates; no other variables affected infection rates.
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Affiliation(s)
- Xue-Chun Yu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Qiao-Qiao Shao
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Jing Ma
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Miao Yu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Chen Zhang
- Department of Gastroenterology and Hepatology, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Lei Lei
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Yang Zhou
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Wen-Chao Chen
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Wei Zhang
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Xin-Hui Fang
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Yuan-Zeng Zhu
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Gang Wu
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Xue-Mei Wang
- Department of Traditional Chinese Medicine, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Shuang-Yin Han
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Pei-Chun Sun
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Song-Ze Ding
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
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Wu Y, Zeng H, Zhang M, Li C, Tang Y, Li X, Yuan S, Wei Q, Wang J, Ning X, Zhang X. Sex-Specific Risk Factors Associated with Helicobacter pylori Infection Among Individuals Undergoing Health Examinations in China. Int J Gen Med 2022; 15:5861-5868. [PMID: 35791315 PMCID: PMC9250778 DOI: 10.2147/ijgm.s367142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Helicobacter pylori is one of the most common causes of peptic ulcers, gastritis, and gastric cancers. This study investigated sex-specific differences in the prevalence of H. pylori infection and its associated factors among individuals undergoing hospital-based health examinations in southern China. Methods This study enrolled consecutive healthy individuals who underwent regular health examinations at a hospital physical examination center between September 2020 and September 2021. Anthropometric characteristics and biochemical profiles were measured. All individuals underwent carbon-13 urea breath tests. Univariate and multivariate analyses were used to evaluate the factors associated with H. pylori infection. Results A total of 5035 individuals (men, 59.1%; women, 40.9%) were included in the analyses. The total rate of H. pylori infection was 35.0% (men, 35.5%; women, 34.3%). In the multivariate analysis, the risk factors identified for H. pylori infections were high fasting blood glucose levels and blood pressure ≥160 mmHg in men and older age, high body mass index, and low albumin levels in women. Conclusion These findings suggest that physicians must be aware of the metabolic factors associated with H. pylori infections in the Chinese population. Early detection of these factors and timely intervention are expected to reduce H. pylori infections and provide a theoretical basis for the primary prevention of several gastrointestinal diseases.
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Affiliation(s)
- Yumei Wu
- Department of Gastroenterology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Hui Zeng
- Department of Health Management, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Meiping Zhang
- Department of Gastroenterology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Chunyan Li
- Department of Health Management, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Yuanlin Tang
- Department of Health Management, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Xiufen Li
- Department of Gastroenterology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Shanyou Yuan
- Department of Orthopedics, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Qifeng Wei
- Department of Orthopedics, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Jinghua Wang
- Centre of Clinical Epidemiology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Xianjia Ning
- Centre of Clinical Epidemiology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Xiaoyin Zhang
- Department of Gastroenterology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
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Zhang F, Pu K, Wu Z, Zhang Z, Liu X, Chen Z, Ye Y, Wang Y, Zheng Y, Zhang J, An F, Zhao S, Hu X, Li Y, Li Q, Liu M, Lu H, Zhang H, Zhao Y, Yuan H, Ding X, Shu X, Ren Q, Gou X, Hu Z, Wang J, Wang Y, Guan Q, Guo Q, Ji R, Zhou Y. Prevalence and associated risk factors of Helicobacter pylori infection in the Wuwei cohort of north-western China. Trop Med Int Health 2020; 26:290-300. [PMID: 33159827 DOI: 10.1111/tmi.13517] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate the prevalence of Helicobacter pylori infection and risk factors and to serotype the strains in Wuwei, located in north-western China, which has a high incidence of gastric cancer. METHODS Helicobacter pylori infection was analysed in 21 291 adults by 14 C-urea breath test, and H. pylori antibody were detected in 9183 serum samples by latex immunoturbidimetric method. The correlation of H. pylori infection with demographic-economic, lifestyle factors and medical history among the participants was determined by questionnaire. The antibodies against H. pylori urease, VacA and CagA in serum were determined by dot immunobinding assay. RESULTS The infection rate of H. pylori was 53.0%, and 90.1% of strains were type I strains. The H. pylori infection rate was higher among farmers (OR = 1.34, 95% CI: 1.19-1.50) and individuals who had a junior high school or higher education level (OR = 1.10, 95% CI: 1.06-1.15), and was lower in older individuals (OR = 0.86, 95% CI: 0.83-0.90), individuals with high income (OR = 0.93, 95% CI: 0.90-0.95), individuals with a habit of eating quickly (OR = 0.93, 95% CI: 0.87-0.99) and individuals who consumed more fruit and vegetables (OR = 0.90, 95% CI: 0.85-0.95). Individuals with history of cholecystitis/cholecystolithiasis, hypertension and asthma were negatively correlated with H. pylori infection (P < 0.05). CONCLUSION The prevalence of H. pylori infection is high in Wuwei. The major prevalent strain is type I strain. Age, education, occupation, household income, consumption of fruit and vegetables, and habit of eating quickly are independent risk factors for H. pylori infection, which is also associated with individuals with a history of extragastric diseases.
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Affiliation(s)
- Fuhua Zhang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Ke Pu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Zhengqi Wu
- Department of Gastroenterology, Gansu Province Wuwei Cancer Hospital, Wuwei, China
| | - Zhiyi Zhang
- Department of Gastroenterology, Gansu Province Wuwei Cancer Hospital, Wuwei, China
| | - Xin Liu
- Department of Gastroenterology, Hospital 940, Joint Logistic Support Force of PLA, Lanzhou, China
| | - Zhaofeng Chen
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yuwei Ye
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yuping Wang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Ya Zheng
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Jinhua Zhang
- Department of Gastroenterology, Affiliated Hospital of Northwest Minzu University, Lanzhou, China
| | - Feng An
- Department of Gastroenterology, Wuwei People's Hospital, Wuwei, China
| | - Shijun Zhao
- Department of Gastroenterology, Wuwei Liangzhou Hospital, Wuwei, China
| | - Xiaobin Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Youpeng Li
- Department of Gastroenterology, Minqin County People's Hospital, Wuwei, China
| | - Qiang Li
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Min Liu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Hong Lu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Hongling Zhang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yue Zhao
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Hao Yuan
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Xiangping Ding
- Department of Gastroenterology, Affiliated Hospital of Northwest Minzu University, Lanzhou, China
| | - Xiaochuang Shu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Qian Ren
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Xi Gou
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Zenan Hu
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Jun Wang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yuling Wang
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Quanlin Guan
- Department of Oncology Surgery, the First Hospital of Lanzhou University, Lanzhou, China
| | - Qinghong Guo
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Rui Ji
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
| | - Yongning Zhou
- Department of Gastroenterology, First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases, Gansu Province, First Hospital of Lanzhou University, Lanzhou, China
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Helicobacter pylori seroprevalence in Spain: influence of adult and childhood sociodemographic factors. Eur J Cancer Prev 2020; 28:294-303. [PMID: 30489354 DOI: 10.1097/cej.0000000000000483] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Helicobacter pylori (H. pylori) chronic infection causes severe digestive diseases, including gastric cancer, and certain strains entail a higher risk. Risk factors for this infection are still not fully understood. The aim of this study was to describe the association of adult and childhood sociodemographic factors with the seroprevalence of H. pylori, and with CagA and VacA antigen-specific seropositivity among H. pylori-seropositive individuals in the Spanish adult population. Serum antibody reactivity to H. pylori proteins was evaluated using multiplex serology in 2555 population-based controls enrolled in the MCC-Spain study, a multicase-control study recruiting participants from 2008 to 2013 in different areas of Spain. H. pylori seroprevalence was defined as seropositivity against at least four bacterial proteins. Information on sociodemographics, lifestyles, and environmental exposures was collected through personal interviews. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression models to assess the association of lifetime sociodemographic factors with H. pylori seroprevalence and with seropositivity for CagA and VacA. H. pylori seroprevalence was 87.2%. Seropositivity was statistically significantly higher in men, increased with age, BMI, and number of siblings, and decreased with education and socioeconomic family level at birth. Among H. pylori-seropositive individuals, seropositivity was 53.3% for CagA, 61.4% for VacA, and 38.8% for both CagA and VacA. Ever smokers had lower seroprevalence for CagA and VacA than never smokers. H. pylori seroprevalence among this Spanish adult population was high and one third of the population was seropositive for two well-known markers of gastric cancer risk: CagA and VacA. Sex, age, education, and BMI were associated with H. pylori seroprevalence.
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Russo GS, Eftim SE, Goldstone AE, Dufour AP, Nappier SP, Wade TJ. Evaluating health risks associated with exposure to ambient surface waters during recreational activities: A systematic review and meta-analysis. WATER RESEARCH 2020; 176:115729. [PMID: 32240845 DOI: 10.1016/j.watres.2020.115729] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/13/2020] [Accepted: 03/15/2020] [Indexed: 05/26/2023]
Abstract
Recreational water quality guidelines protect the public from health risks associated with water recreation by helping to prevent unacceptable concentrations of pathogenic organisms in ambient water. However, illness risk is associated with both the concentration of pathogens in the water and the degree of contact with those pathogens. Different recreational activities can result in different levels of contact with ambient water containing water-borne pathogens. We conducted a systematic literature review and meta-analysis to evaluate risks of illness associated with different recreational activities and different levels of contact to ambient surface waters. We screened 8,618 potentially relevant studies for quantitative measures of risk using inclusion/exclusion criteria established in advance. We categorized recreational activities as swimming, sports-related contact, minimal contact, and sand contact. We combined relative risks using a random effects meta-analysis for adverse health outcome categories representing gastrointestinal illness, respiratory illness, skin, eye, ear, nose, throat, and cold/flu illness. We identified 92 studies meeting our inclusion criteria. Pooled risk estimates indicate significant elevation of gastrointestinal illness with the recreational activity categories swimming (2.19, 95% CI: 1.82, 2.63) and sports-related contact (2.69, 95% CI: 1.04, 6.92), and nonsignificant elevation of gastrointestinal illness with minimal contact (1.27, 95% CI: 0.74, 2.16). We also found a significant elevation of respiratory illness with swimming (1.78, 95% CI: 1.38, 2.29) and sports-related contact (1.49, 95% CI: 1.00, 2.24), and no elevation of respiratory illness with minimal contact (0.90, 95% CI: 0.71, 1.14). This study suggests that exposures associated with different types of recreational activities are important characteristics of the exposure pathway when assessing illness risk associated with recreation in ambient surface waters.
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Affiliation(s)
- Gary S Russo
- U.S. Environmental Protection Agency, Office of Water, Office of Science and Technology, Standards and Health Protection Division, 1200 Pennsylvania Avenue, NW, Mail Code 4305T, Washington, DC, 20460, USA.
| | | | | | - Alfred P Dufour
- U.S. Environmental Protection Agency, National Exposure Research Laboratory, 26 West Martin Luther King Drive, Mail Code 587, Cincinnati, OH, 45268, USA
| | - Sharon P Nappier
- U.S. Environmental Protection Agency, Office of Water, Office of Science and Technology, Health and Ecological Division, 1200 Pennsylvania Avenue, NW, Mail Code 4304T, Washington, DC, 20460, USA
| | - Timothy J Wade
- U.S. Environmental Protection Agency, National Health and Environmental Effects Research Laboratory, 109 T.W. Alexander Drive, Mail Code 58C, Research Triangle Park, NC, 27709, USA
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10
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Erkut M, Uzun DY, Kaklıkkaya N, Fidan S, Yoğun Y, Coşar AM, Akyıldız E, Topbaş M, Özgür O, Arslan M. Sociodemographic characteristics and clinical risk factors of Helicobacter pylori infection and antibiotic resistance in the Eastern Black Sea region of Turkey. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2020; 31:221-233. [PMID: 32343234 PMCID: PMC7197933 DOI: 10.5152/tjg.2020.18631] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 04/16/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS The aim of this study was to assess the clinical and sociodemographic risk factors of Helicobacter pylori infection and antibiotic resistance in the eastern Black Sea region of Turkey. MATERIALS AND METHODS In total, 344 patients with dyspeptic symptoms who completed an extended questionnaire were enrolled in the study. Diagnosis of H. pylori infection was made by rapid urease test, histopathological investigation, and culture. Susceptibility of H. pylori strains was assessed by agar dilution (amoxicillin, tetracycline, metronidazole, levofloxacin) and E-test (clarithromycin) methods. RESULTS The H. pylori positivity rate was 40.4% (139/344). Logistic regression analysis indicated that age and the presence of duodenal ulcer were independent risk factors associated with H. pylori positivity (odds ratio (OR): 0.96, 95% CI: 0.93-0.99, p=0.013; OR: 5.42, 95% CI: 1.96-14.98, p=0.001, respectively). Of 104 H. pylori-positive cultures, 43 strains (41%) were susceptible to all antibiotics, whereas 61 (59%) were resistant to at least one antibiotic. H. pylori resistance rates were 34% for levofloxacin, 31.1% for metronidazole, 28.2% for clarithromycin, 2.9% for amoxicillin, and 1% for tetracycline. Logistic regression analysis indicated that previous use of clarithromycin was the only independent risk factor for H. pylori resistance (OR: 6.25, 95% CI: 1.59-24.52, p=0.009). CONCLUSION An understanding of the risk factors for H. pylori positivity and antibiotic resistance in an extended anamnesis may affect treatment choice and facilitate H. pylori eradication. In regions where antibiotic resistance rates are elevated, performing antibiotic susceptibility tests may lead to effective eradication treatment.
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Affiliation(s)
- Murat Erkut
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Doğan Yusuf Uzun
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Neşe Kaklıkkaya
- Department of Medical Microbiology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Sami Fidan
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Yaşar Yoğun
- Clinic of Gastroenterology, Gebze Fatih State Hospital, Kocaeli, Turkey
| | - Arif Mansur Coşar
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Esma Akyıldız
- Department of Medical Microbiology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Murat Topbaş
- Department of Public Health, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Orhan Özgür
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Mehmet Arslan
- Department of Gastroenterology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
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Mukherjee S, Madathil SA, Ghatak S, Jahau L, Pautu JL, Zohmingthanga J, Pachuau L, Nicolau B, Kumar NS. Association of tobacco smoke-infused water (tuibur) use by Mizo people and risk of Helicobacter pylori infection. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:8580-8585. [PMID: 31904095 DOI: 10.1007/s11356-019-07543-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 12/29/2019] [Indexed: 06/10/2023]
Abstract
The study aims to understand the influence of environmental and lifestyle factors and more specifically the role of tobacco smoke-infused water (tuibur) on Helicobacter pylori infection. It was a cross-sectional study to measure the epidemiological risk factors associated with H. pylori infection among the tribal population in Northeast India. Endoscopic samples were collected from the antrum region of the stomach from 863 participants with gastritis. H. pylori infection was confirmed in 475 samples by the rapid urease test and PCR-based methods. Information on demographic and lifestyle factors was collected using a validated and standardized questionnaire. Logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (CI) for the association between the various factors and H. pylori. The use of tuibur was associated with an increased OR of H. pylori infection (OR = 3.32, 95% Cl = 1.95-5.83). Tobacco chewers (OR = 1.49, 95% Cl = 1.06-2.09), smokers (OR = 1.81, 95% Cl = 1.26-2.61), and alcohol consumers (OR = 1.81, 95% Cl = 1.19-2.76) were also infected with H. pylori. The results were not attenuated after adjusting for major well-known risk factors of H. pylori infection. The habit of tuibur consumption may be a contributing factor to the high prevalence of H. pylori infection and in turn, may contribute to the high prevalence of gastritis among the Mizo population.
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Affiliation(s)
- Subhajit Mukherjee
- Department of Biotechnology, Mizoram University, Aizawl, Mizoram, 796004, India
| | | | - Souvik Ghatak
- Department of Biotechnology, Mizoram University, Aizawl, Mizoram, 796004, India
| | | | - Jeremy L Pautu
- Mizoram State Cancer Institute, Zemabawk, Aizawl, Mizoram, 796017, India
| | | | | | - Belinda Nicolau
- Faculty of Dentistry, McGill University, 2001 McGill College Ave, Montreal, Quebec, H3A 1G1, Canada
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Wang W, Jiang W, Zhu S, Sun X, Li P, Liu K, Liu H, Gu J, Zhang S. Assessment of prevalence and risk factors of helicobacter pylori infection in an oilfield Community in Hebei, China. BMC Gastroenterol 2019; 19:186. [PMID: 31726980 PMCID: PMC6857281 DOI: 10.1186/s12876-019-1108-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 11/04/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Only a paucity of large-scale perspective and cross-sectional studies on H. pylori infection in China have been published. The purpose of this study was to investigate the prevalence and risk factors for H. pylori infection among residents of Jidong community located in Hebei Province of China. METHODS A perspective, cross-sectional study was conducted in Jidong community. Questionnaires and 13C-urea breath test were performed, and 10-ml blood samples were obtained for laboratory tests. RESULTS Four thousand seven hundred ninety-six subjects were enrolled in this study, and 2506 (52.25%) were H. pylori positive. There was no difference in prevalence between both sexes (P = 0.5974). Age (P = 0.004) and education level (P = 0.0128) were significantly associated with H. pylori infection, and there were statistical trends in the prevalence across five age subgroups (χ2 test for trend = 23.5; P < 0.001) and education levels (χ2 test for trend = 19.50; P < 0.001). H. pylori infection was also associated with marital status (P = 0.0243), source of drinking water (P = 0.0433), frequency of eating raw garlic (P = 0.0310), alcohol drinking (P = 0.0207), knowledge about H. pylori transmission route (P = 0.0125) and related diseases (P = 0.0257). Age, alcohol drinking and knowledge about transmission route were found to be independent predictors of H. pylori infection. CONCLUSIONS More than half of the population was infected with H. pylori in Jidong community. The socio-demographic profiles, socio-economic factors and lifestyle are worthy taking into consideration to prevent diseases associated with H. pylori infection. Understanding the prevalence and risk patterns for H. pylori infection in China will help in prioritizing public health efforts to better manage the H. pylori infection.
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Affiliation(s)
- Wenhai Wang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
- Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Wei Jiang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
- Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Shengtao Zhu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
- Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Xiujing Sun
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
- Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Peng Li
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
- Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Kejia Liu
- Beijing Rec data Technology Co, Ltd, Beijing, China
| | - Henghui Liu
- Beijing Rec data Technology Co, Ltd, Beijing, China
| | - Junchao Gu
- Department of Gastroenterology, Beijing Pinggu Hospital, Capital Medical University, Beijing, 101200, China
| | - Shutian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
- Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing, 100050, China.
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China.
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Zou J, Xiao YQ, Cheng YF, Ren XY, Li SW, Gang D. Investigation of Helicobacter pylori Infection and Its Related Factors in the Tianjin Binhai Area, China. Jundishapur J Microbiol 2019; 12. [DOI: 10.5812/jjm.94845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2025] Open
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Prevalence and Risk Factors of Helicobacter pylori Infection among Children Aged 1 to 15 Years at Holy Innocents Children's Hospital, Mbarara, South Western Uganda. J Trop Med 2019; 2019:9303072. [PMID: 30984271 PMCID: PMC6431523 DOI: 10.1155/2019/9303072] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 02/20/2019] [Indexed: 02/07/2023] Open
Abstract
Background Helicobacter pylori infection affects more than half of the world's population. The infection is generally acquired during childhood but can remain asymptomatic, with long-term clinical sequelae including gastritis, peptic ulcer disease, and stomach cancer. Methods The study was approved by Institutional Review Committee of Mbarara University of Science and Technology. After obtaining informed consent from parents/legal guardians, illegible children who presented with gastrointestinal complaints at Holy Innocents Children's Hospital were recruited; structured questionnaires were administered to the parents/guardians to collect information on sociodemographic data and risk factors of H. pylori infection. Four (4) millilitres of blood was collected from each child and tested for H. pylori blood Antibody test and stool specimens were used for H. pylori antigen test. Results The prevalence of H. pylori infection among the study participants was 24.3%. The infection rate increased with increase in age of the participants, from 16.2% among 1to 5 years old to 27.2% among 6 to 10 years. Infections were higher among school going children (68/74, p=0.003, OR 3.9; CI: 1.5 to 10.6) and children from crowded households (59/74, p<0.001, OR 2.6, and CI 1.3 to 5.0), unsafe source of drinking water at schools (46/74, p=0.003), and lack of sanitary facility at homes (57/74, p=0.001, and OR 1.6 CI 0.7 to 3.6). Conclusion The prevalence of H. pylori infection among children aged 1 to 15 years at Holy Innocents Children's Hospital was high and increases with age. School attendance, lack of sanitary facility, lack of safe drinking water, and overcrowding were the risk factors associated with H. pylori infection.
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15
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Kouitcheu Mabeku LB, Noundjeu Ngamga ML, Leundji H. Potential risk factors and prevalence of Helicobacter pylori infection among adult patients with dyspepsia symptoms in Cameroon. BMC Infect Dis 2018; 18:278. [PMID: 29907086 PMCID: PMC6003128 DOI: 10.1186/s12879-018-3146-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 05/11/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Helicobacter pylori is a Gram negative bacterium that colonizes the stomach of approximately two-thirds of the human population and it is involved in the pathogenesis of gastroduodenal diseases. This study sought to determine potential risk factors associated with seroprevalence of H. pylori among dyspepsia patients in Cameroon for a better management of the disease. METHODS The study was carried out from August to December 2014 at Laquintinie Hospital and District Hospital of Bonassama in Douala metropolis. 205 patients (127 women and 78 men; mean age, 53.79 ± 11.11 years; range, 35-75 years) were enrolled. Each subject gave a written consent. The study was approved by the local Ethical Committee of Medical Sciences. A structured questionnaire was used to collect information on sociodemographic parameters and predisposing risk factors for Helicobacter pylori infection. For each patient, body mass index (BMI) and direct inquiry about dyspeptic symptoms were done. Blood samples were tested for H. pylori antibodies, and ABO/Rhesus blood group antigen typing was performed. RESULTS The overall prevalence was 64.39%. All patients with upper abdominal pains and frequent burping were H. pylori seropositive. We found that infection takes place early in childhood and adolescence, and reaches its peak at adulthood at 35 to 44 years. Sixty-two percent of women over 68 of men were infected. 80.39% of patients with family history of gastric cancer were seropositive, while 19.60% were seronegative (p = 0.001). Prevalence of 79.09 and 47.4% was recorded respectively for subjects with low, middle and high income levels (p = 0.001). H. pylori infection rate was 60.48% in blood group O patients compared with 70.37% in other blood groups (p = 0.203). 73% of infected subjects over 59% of uninfected ones currently take NSAIDs (p = 0.0509). Overcrowded households have a higher rate of 65.32% seropositivity in contrast with a lower rate of 33.33% from norm household (p = 0.197). 69.29% of obese and overweight patients versus 58.24% of subjects with normal weight were seropositive (P = 0.215). CONCLUSION The results of this study demonstrate that low income, family history of gastric cancer, clinical symptoms of nausea/vomiting and flatulence/bloating were risk factors of H. pylori infection in this population.
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Affiliation(s)
- Laure Brigitte Kouitcheu Mabeku
- Department of Biochemistry, Faculty of Science, Microbiology and Pharmacology Laboratory, University of Dschang, P. O. Box 67, Dschang, Cameroon
| | - Michelle Larissa Noundjeu Ngamga
- Department of Biochemistry, Faculty of Science, Microbiology and Pharmacology Laboratory, University of Dschang, P. O. Box 67, Dschang, Cameroon
| | - Hubert Leundji
- Gastroenterology Department, Laquintinie Hospital of Douala, P. O. Box 4035, Douala, Cameroon
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Basílio ILD, Catão MDFC, Carvalho JDDS, Freire-Neto FP, Ferreira LC, Jerônimo SMB. Risk factors of Helicobacter pylori infection in an urban community in Northeast Brazil and the relationship between the infection and gastric diseases. Rev Soc Bras Med Trop 2018; 51:183-189. [DOI: 10.1590/0037-8682-0412-2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 04/18/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
| | | | | | - Francisco Paulo Freire-Neto
- Universidade Federal do Rio Grande do Norte, Brazil; Universidade Federal do Rio Grande do Norte, Brazil; Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, Brasil
| | - Leonardo Capristano Ferreira
- Universidade Federal do Rio Grande do Norte, Brazil; Universidade Federal do Rio Grande do Norte, Brazil; Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, Brasil
| | - Selma Maria Bezerra Jerônimo
- Universidade Federal do Rio Grande do Norte, Brazil; Universidade Federal do Rio Grande do Norte, Brazil; Universidade Federal do Rio Grande do Norte, Brazil; Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, Brasil
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Wongphutorn P, Chomvarin C, Sripa B, Namwat W, Faksri K. Detection and genotyping of Helicobacter pylori in saliva versus stool samples from asymptomatic individuals in Northeastern Thailand reveals intra-host tissue-specific H. pylori subtypes. BMC Microbiol 2018; 18:10. [PMID: 29378521 PMCID: PMC5789744 DOI: 10.1186/s12866-018-1150-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 01/21/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Two-thirds of the world's population is thought to be infected by Helicobacter pylori. Although most people infected with H. pylori are asymptomatic, this pathogen is associated with several gastric pathologies including cancer. The risk factors for colonization are still unclear and the genetic diversity within individual hosts has never been clearly investigated. RESULT This study determined the prevalence of, and explored risk factors for, H. pylori infection directly from paired saliva (n = 110) and stool (n = 110) samples from asymptomatic persons in Northeast Thailand. Samples were subjected to indirect immunofluorescence assay (IFA), 16S rRNA-based real-time PCR and vacA-based semi-nested PCR. Partial vacA gene sequences of H. pylori were compared between saliva and stool samples. The overall prevalence of H. pylori infection in our asymptomatic study population was 64%. Age, gender, occupation and frequency of brushing teeth were not found to be associated with H. pylori colonization. The vacA gene was successfully sequenced from both saliva and stool samples of 12 individuals. For seven of these individuals, saliva and stool sequences fell into different clusters on a phylogenetic tree, indicating intra-host genetic variation of H. pylori. CONCLUSION This study reports a high prevalence of H. pylori infection in asymptomatic persons in this region of Thailand and demonstrates that genotypes (vacA gene sequences) of H. pylori may differ between the oral cavity and intestinal tract.
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Affiliation(s)
- Phattharaphon Wongphutorn
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Liver Fluke and Cholangiocarcinoma Research Center, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Chariya Chomvarin
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Liver Fluke and Cholangiocarcinoma Research Center, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Banchob Sripa
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Wises Namwat
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Kiatichai Faksri
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, 40002, Thailand.
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Genta RM, Turner KO, Sonnenberg A. Demographic and socioeconomic influences on Helicobacter pylori gastritis and its pre-neoplastic lesions amongst US residents. Aliment Pharmacol Ther 2017; 46:322-330. [PMID: 28547755 DOI: 10.1111/apt.14162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 03/25/2017] [Accepted: 05/02/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Gastric infection with Helicobacter pylori (Hp) can lead to chronic inactive gastritis, atrophy and intestinal metaplasia. AIMS To investigate in a cross-sectional study these changes among different socioeconomic and ethnic groups within the USA. METHODS We used the Miraca Life Sciences database, an electronic depository of clinicopathological records from patients distributed throughout the USA, to extract data from 487 587 patients who underwent oesophago-gastro-duodenoscopy with biopsy between 1/2008 and 12/2014. We then classified patients into ethnic and socioeconomic categories using previously validated algorithms, as well as ZIP code-based information derived from the 2011-2012 US Census. RESULTS The prevalence of Hp increased significantly until the age-group 40-49, before it leveled off and started a gradual decrease. The prevalence of chronic inactive gastritis, atrophy, and intestinal metaplasia increased significantly with age. The prevalence of Hp, chronic inactive gastritis, intestinal metaplasia, and atrophy decreased significantly with the percentage of Whites per ZIP code. The prevalence of all four diagnoses also decreased significantly with rising levels of income or college education. Hp, chronic inactive gastritis, atrophy and intestinal metaplasia were more common among Hispanics and the influence of income or college education less pronounced than in the entire population. Hp, chronic inactive gastritis, atrophy, and intestinal metaplasia were also more common among East-Asians, Hp and atrophy decreasing with rising income but remaining unaffected by levels of college education. CONCLUSION Ethnicity and socioeconomic factors influence the occurrence of Hp gastritis, and its progression to chronic inactive gastritis, atrophy or intestinal metaplasia.
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Affiliation(s)
- R M Genta
- Miraca Life Sciences, Irving, TX, USA.,Baylor College of Medicine, Houston, TX, USA
| | - K O Turner
- Miraca Life Sciences, Irving, TX, USA.,Baylor College of Medicine, Houston, TX, USA
| | - A Sonnenberg
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, OR, USA.,Gastroenterology Section, Portland VA Medical Center, Portland, OR, USA
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Detection of Helicobacter pylori in Drinking Water by Loop-Mediated Isothermal Amplification. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.41895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Goto Y, Syam AF, Darnindro N, Hapsari FCP. Prevalence and Risk Factors for Helicobacter Pylori Infection among Healthy Inhabitants in Northern Jakarta, Indonesia. Asian Pac J Cancer Prev 2016; 17:4747-4753. [PMID: 27893207 PMCID: PMC5454627 DOI: 10.22034/apjcp.2016.17.10.4747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: The prevalence of Helicobacter pylori (H. pylori) infection in Indonesia has been reported to be
exceedingly low. The purpose of our study was to confirm whether this is the case in Northern Jakarta using a sensitive
13C-urea breath test (UBT), and to examine any associations with lifestyle/environment factors and potential routes
of transmission. Methods: We recruited a total of 196 subjects from a low-income community in Northern Jakarta,
Indonesia, data from 193 who completed a questionnaire about their lifestyle/environment and had UBT being included
as the final. Odds ratios (ORs) adjusted for sex and age with 95% confidence intervals (CIs) were calculated using a
logistic regression model. Results: The overall H. pylori infection rate was 15.0% (95%CI, 10.3-20.9), with variation
among Javanese (9.1%, total=77), Buginese (40.0%, 35), Betawi (9.1%, 33), Sundanese (3.7%, 27), and Batak (40.0%,
5). On multivariate analysis, the ORs for intake of soybean milk, cucumber more than once a week, infrequent hand
washing practice before meals, and alcohol consumption were 0.10 (95%CI: 0.01-0.97), 6.61 (95%CI: 1.87-23.3), 4.10
(95%CI: 1.15-14.6), and 61.9 (95%CI: 1.67-2300.8), respectively. Rates for Buginese (OR=7.84; 95%CI: 1.82-33.8)
and Batak (OR=20.1; 95%CI: 1.90-213.2) were significantly higher than for Javanese. Conclusions: The H. pylori
infection rate in this study was relatively low, in line with previous studies. Regarding ethnicity factors, Buginese and
Batak reported eating food using fingers more frequently than Javanese, Betawi, and Sundanese. Our study indicated
that person-person transmission is possible in this low prevalence area. The low infection rates for H. pylori among
Javanese, Betawi, and Sundanese ethnics could be partly due to their sanitary practices.
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Affiliation(s)
- Yasuyuki Goto
- Department of Gastroenterology, Nagoya Kyoritsu Hospital, Nagoya, Japan.
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Workineh M, Andargie D. A 5-year trend of Helicobacter pylori seroprevalence among dyspeptic patients at Bahir Dar Felege Hiwot Referral Hospital, Northwest Ethiopia. Res Rep Trop Med 2016; 7:17-22. [PMID: 30050336 PMCID: PMC6028059 DOI: 10.2147/rrtm.s105361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Helicobacter pylori infection is a major public health problem affecting half of the world's population. The prevalence of H. pylori varies in different societies and geographical locations. Thus, timely information on H. pylori epidemiology is critical to combat this infection. This study aimed to determine the seroprevalence and trend of H. pylori infection over a period of 5 years among dyspeptic patients at Bahir Dar Felege Hiwot Referral Hospital, Northwest Ethiopia. Methods A retrospective analysis of consecutive dyspeptic patients' records covering the period between January 2009 and December 2013 was conducted. The hospital laboratory generated the data by a serological method of detecting the antibodies for H. pylori from serum by a one-step rapid test device. Chi-square analysis was used to identify significant predictors. A P-value of <0.05 was considered as statistically significant. Results Among all the study subjects, 2,733 (41.6%) were found to be seropositive. The seroprevalence was significantly higher in males (43.2%) than in females (39.9%) (χ2=9; P=0.002). In terms of age groups of the patients, high rates of H. pylori were found among the participants older than 60 years (57%) (χ2=36.6; P≤0.00001). The trend analysis of H. pylori prevalence revealed a fluctuating prevalence; it was 44.5% in the year 2009 and decreased to 34% and 40% in the years 2010 and 2011, respectively. However, there was an increment to 52.5% in the year 2012, and then it decreased to 30.2% in the year 2013. Conclusion This study showed high seroprevalence of H. pylori among the dyspeptic patients in Bahir Dar Felege Hiwot Referral Hospital. The trend of the seroprevalence varied from year to year in the 5 consecutive years. Considering this, designing appropriate prevention and control strategies is mandatory.
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Affiliation(s)
- Meseret Workineh
- Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar
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Yalçin M, Yalçin A, Bengi G, Nak SG. Helicobacter pylori Infection among Patients with
Dyspepsia and Intrafamilial Transmission. Euroasian J Hepatogastroenterol 2016; 6:93-96. [PMID: 29201737 PMCID: PMC5578573 DOI: 10.5005/jp-journals-10018-1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/19/2016] [Indexed: 11/24/2022] Open
Abstract
Introduction Recurrence is an important problem after Helicobacter pylori infection, and intrafamilial transmission has an important role in recurrence. In this study, we aimed to investigate the significance of intrafamilial transmission for recurrence development after treatment as well as its usefulness in prevention. Materials and methods Of the 109 patients who had dyspepsia and underwent endoscopy, 74 patients had H. pylori infection and were enrolled in this study. Infected family members were also detected. Patients were randomly divided into groups I and II, with each group containing 37 individuals. In group I, patients and their infected family members were treated together at the same time. In group II, only the patients were treated. Treatment success was evaluated at the 1st month and evaluation for recurrence was carried out at the 6th month. Results Helicobacter pylori infection was detected in 67.8% of the patients with dyspepsia. Two patients in each group did not show up at the 1st month control. Eradication was achieved in 63 of the 70 patients (90.0%) who completed their treatment. After 6 months, patients with successful treatment had no recurrence in any of the 32 patients in group I. There were recurrence in 3 of the 31 patients (9.7%) in group II; however, there was no statistically significant difference between the groups (p = 0.113). Conclusion Our study showed that eradication treatment in patients and family members with H. pylori infection resulted in a decrease in the number of recurrences even though it was not statistically significant. How to cite this article Yalçin M, Yalçin A, Bengi G, Nak SG. Helicobacter pylori Infection among Patients with Dyspepsia and Intrafamilial Transmission. Euroasian J Hepato-Gastroenterol 2016;6(2):93-96.
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Affiliation(s)
- Mustafa Yalçin
- Department of Gastroenterology, Dokuz Eylul University Medical Faculty, Ege, Turkey
| | - Ayla Yalçin
- Department of Gastroenterology, Uludağ University Medical Faculty, Bursa, Turkey
| | - Göksel Bengi
- Department of Gastroenterology, Dokuz Eylul University Medical Faculty, Ege, Turkey
| | - Selim G Nak
- Department of Gastroenterology, Uludağ University Medical Faculty, Bursa, Turkey
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Pan KF, Zhang L, Gerhard M, Ma JL, Liu WD, Ulm K, Wang JX, Zhang L, Zhang Y, Bajbouj M, Zhang LF, Li M, Vieth M, Liu RY, Quante M, Wang LH, Suchanek S, Zhou T, Guan WX, Schmid R, Classen M, You WC. A large randomised controlled intervention trial to prevent gastric cancer by eradication of Helicobacter pylori in Linqu County, China: baseline results and factors affecting the eradication. Gut 2016; 65:9-18. [PMID: 25986943 DOI: 10.1136/gutjnl-2015-309197] [Citation(s) in RCA: 136] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 04/24/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To clarify the full range of benefits and adverse consequences of Helicobacter pylori eradication as a strategy for gastric cancer prevention, the community-based intervention trial was launched in Linqu County, China. DESIGN A total of 184,786 residents aged 25-54 years were enrolled in this trial and received (13)C-urea breath test. H. pylori positive participants were assigned into two groups, either receiving a 10-day quadruple anti-H. pylori treatment or lookalike placebos together with a single dosage of omeprazole and bismuth. RESULTS The prevalence of H. pylori in trial participants was 57.6%. A total of 94,101 subjects completed the treatment. The overall H. pylori eradication rate was 72.9% in the active group. Gender, body mass index, history of stomach disease, baseline delta over baseline-value of (13)C-urea breath test, missed medication doses, smoking and drinking were independent predictors of eradication failure. The missed doses and high baseline delta over baseline-value were important contributors in men and women (all Ptrend<0.001). However, a dose-response relationship between failure rate and smoking or drinking index was found in men (all Ptrend<0.001), while high body mass index (Ptrend<0.001) and history of stomach disease were significant predictors in women. The treatment failure rate increased up to 48.8% (OR 2.87, 95% CI 2.24 to 3.68) in men and 39.4% (OR 2.67, 95% CI 1.61 to 4.42) in women with multiple factors combined. CONCLUSIONS This large community-based intervention trial to eradicate H. pylori is feasible and acceptable. The findings of this trial lead to a distinct evaluation of factors influencing eradication that should be generally considered for future eradication therapies. TRIAL REGISTRATION NUMBER ChiCTR-TRC-10000979 in accordance with WHO ICTRP requirements.
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Affiliation(s)
- Kai-feng Pan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lian Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | | | - Jun-ling Ma
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | | | - Kurt Ulm
- Technische Universität München, Munich, Germany
| | | | - Lei Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yang Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | | | | | - Ming Li
- Healthy Bureau of Linqu County, Weifang, China
| | - Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
| | | | | | - Le-hua Wang
- Healthy Bureau of Linqu County, Weifang, China
| | - Stepan Suchanek
- Department of Medicine, 1st Faculty of Medicine, Military University Hospital, Charles University, Prague, Czech Republic
| | - Tong Zhou
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei-xiang Guan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | | | - Meinhard Classen
- Technische Universität München, Munich, Germany International Digestive Cancer Alliance, Germany
| | - Wei-cheng You
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
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Amiri N, Abiri R, Eyvazi M, Zolfaghari MR, Alvandi A. The frequency of Helicobacter pylori in dental plaque is possibly underestimated. Arch Oral Biol 2015; 60:782-8. [PMID: 25766471 DOI: 10.1016/j.archoralbio.2015.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 01/08/2015] [Accepted: 02/10/2015] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The commonest bacteria, causing infection across the world is Helicobacter pylori, which colonizes the human stomach. This bacteria has also been detected in some extra-gastric ecological niches such as the oral cavity and water. However, the results of H. pylori detection in extra-gastric ecological niche are controversial. The improvement of the sensitivity and the specificity of the detection methods appear to be some of the main bottleneck issues in providing compelling evidence. The aim of this study was to detect the presence of this organism in dental plaque samples using an analytically sensitive and specific Polymerase Chain Reaction (PCR) as well as a new nucleic acid detection method termed the Loop-mediated Isothermal Amplification (LAMP). DESIGN In a descriptive cross-sectional study 45 participants enrolled and dental plaque samples were collected from at least two teeth surfaces (one anterior and one posterior tooth) using a sterile periodontal curette. The DNA content was extracted from the samples and the presence of H. pylori was determined by PCR and LAMP reactions. RESULTS The frequency of detection of H. pylori in the dental plaque samples were 44% (20/45), 66.67% (30/45) and 77.78% (35/45) using PCR, LAMP and positivity for both tests, respectively. CONCLUSION The high frequency of H. pylori was detected in the dental plaque samples of the participants, which concurs with the high prevalence of this bacteria in the population. This is one of the highest reported rates around the world. The results reveal that dental plaque can be one of the main causes of re-infection and also be the cause of oral-oral transmission.
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Affiliation(s)
- Negin Amiri
- Department of Microbiology, Qom Branch, Islamic Azad University, Qom, Iran.
| | - Ramin Abiri
- Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Masoumeh Eyvazi
- Department of Periodontics, Faculty of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | | | - Amirhooshang Alvandi
- Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Xu C, Yan M, Sun Y, Joo J, Wan X, Yu C, Wang Q, Shen C, Chen P, Li Y, Coleman WG. Prevalence of Helicobacter pylori infection and its relation with body mass index in a Chinese population. Helicobacter 2014; 19:437-442. [PMID: 25256639 DOI: 10.1111/hel.12153] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Helicobacter pylori infection is highly prevalent worldwide. The association between obesity and H. pylori infection is controversial in the literature. This study aims to investigate the prevalence of H. pylori infection and its relation with body mass index (BMI) in a Chinese population. MATERIALS AND METHODS A cross-sectional study was performed among adults who underwent health checkups at the First Affiliated Hospital, College of Medicine, Zhejiang University in 2013. The prevalence of H. pylori infection was examined by (13)C urea breath tests, and the association between prevalence of H. pylori infection and BMI was analyzed. RESULTS Of the 8820 participants enrolled, 3859 (43.8%) were positive for H. pylori infection. H. pylori-positive participants had a more unfavorable metabolic profile than H. pylori-negative participants. Overweight/obese participants showed a higher prevalence of H. pylori infection than that of lean participants, and a positive linear correlation between BMI and prevalence of H. pylori infection was observed. Both unadjusted and adjusted analysis revealed that BMI was significantly associated with risk factors of H. pylori infection. CONCLUSIONS Our results showed that BMI was significantly and positively associated with H. pylori infection, and a high BMI was associated with an increased risk of the infection.
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Affiliation(s)
- Chengfu Xu
- Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Cancer Cluster, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA; Laboratory of Biochemistry and Genetics, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
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Zheng Y, Liu M, Shu H, Chen Z, Liu G, Zhang Y. Relationship between oral problems and Helicobacter pylori infection. Arch Oral Biol 2014; 59:938-43. [DOI: 10.1016/j.archoralbio.2014.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 04/17/2014] [Accepted: 05/16/2014] [Indexed: 01/19/2023]
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Abebaw W, Kibret M, Abera B. Prevalence and Risk Factors of H. pylori from Dyspeptic Patients in Northwest Ethiopia: A Hospital Based Cross-sectional Study. Asian Pac J Cancer Prev 2014; 15:4459-63. [DOI: 10.7314/apjcp.2014.15.11.4459] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mynepalli SKC, Maureen O, Mumuni A. Prevalence of <i>Helicobacter pylori</i> and hygiene practices among public secondary school students in Ikeja local government area, Lagos, Nigeria. Health (London) 2014. [DOI: 10.4236/health.2014.64037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Osman HA, Hasan H, Suppian R, Bahar N, Hussin NSC, Rahim AA, Hassan S, Andee DZ, Zilfalil BA. Evaluation of the Atlas Helicobacter pylori stool antigen test for diagnosis of infection in adult patients. Asian Pac J Cancer Prev 2014; 15:5245-5247. [PMID: 25040982 DOI: 10.7314/apjcp.2014.15.13.5245] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) is one of the most important causes of dyspepsia and gastric cancer and diagnosis can be made by invasive or non-invasive methods. The Atlas Helicobacter pylori antigen test is a new rapid non-invasive method which is simple to conduct. The aim of this study was to determine its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. MATERIALS AND METHODS This prospective study was conducted between July 2012 and December 2013. Stool samples of 59 dyspeptic patients who underwent upper endoscopy were evaluated for H. pylori stool antigen. RESULTS From the 59 patients who participated in this study, there were 36 (61%) males and 23 (39%) females. H. pylori was diagnosed in 24 (40.7%) gastric biopsies, 22 (91.7 %) of these being positive for the Atlas H. pylori antigen test. The sensitivity, specificity, PPV, NPV and accuracy were 91.7%, 100%, 100%, 94.6% and 96.6% respectively. CONCLUSIONS The Atlas H. pylori antigen test is a new non-invasive method which is simple to perform and avails reliable results in a few minutes. Thus it can be the best option for the diagnosis of H. pylori infection due to its high sensitivity and specificity.
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Affiliation(s)
- Hussein Ali Osman
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia E-mail :
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Zhao Y, Wang JW, Tanaka T, Hosono A, Ando R, Tokudome S, Soeripto, Triningsih FXE, Triono T, Sumoharjo S, Achwan EYWA, Gunawan S, Li YM. Association between TNF-α and IL-1β genotypes vs Helicobacter pylori infection in Indonesia. World J Gastroenterol 2013; 19:8758-8763. [PMID: 24379597 PMCID: PMC3870525 DOI: 10.3748/wjg.v19.i46.8758] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 10/22/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the correlation between the Helicobacter pylori (H. pylori) infection and host genetic background of healthy populations in Indonesia.
METHODS: In March 2007, epidemiological studies were undertaken on the general population of a city in Indonesia (Mataram, Lombok). The participants included 107 men and 187 women, whose ages ranged from 6 to 74 years old, with an average age of 34.0 (± 14.4) (± SD). The H. pylori of subject by UBT method determination, and through the polymerase chain reaction with confronting two-pair primers (PCR-CTPP) method parsing the single nucleotide polymorphism of interleukin (IL)-8, IL-4, IL-1β, CD14, tumor necrosis factor (TNF-α) and tyrosine-protein phosphates non-receptor type 11 (PTPN11) genotypes. The experimental data were analyzed by the statistical software SAS.
RESULTS: The H. pylori infection rates in the healthy Indonesian population studied were 8.4% for men and 12.8% for women; no obvious differences were noted for H. pylori infection rates by sex or age. TC genotypes of IL-4, TC and CC genotypes of TNF-α, and GA genotypes of PTPN11, were higher in frequency. Both CC and TC genotype of TNF-α T-1031C loci featured higher expressions in the healthy Indonesian population Indonesia studied of (OR = 1.99; 95%CI: 0.67-5.89) and (OR = 1.66; 95%CI: 0.73-3.76), respectively. C allele of IL-1β T-31C gene locus was at a higher risk (OR = 1.11; 95%CI: 0.70-1.73) of H. pylori infection, but no statistical significance was found in our study.
CONCLUSION: We reveal that the association between the TNF-α and IL-1β genotypes may be the susceptibility of H. pylori in the studied population.
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Lin YH, Tseng YH, Chen YC, Lin MH, Chou LF, Chen TJ, Hwang SJ. The rural - urban divide in ambulatory care of gastrointestinal diseases in Taiwan. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2013; 13:15. [PMID: 23497027 PMCID: PMC3599496 DOI: 10.1186/1472-698x-13-15] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 02/28/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND The utilization of medical care for gastrointestinal diseases increased over the past decade worldwide. The aim of the study was to investigate the difference between rural and urban patients in seeking medical service for gastrointestinal diseases at ambulatory sector in Taiwan. METHODS From the one-million-people cohort datasets of the National Health Insurance Research Database, the utilization of ambulatory visits for gastrointestinal diseases in 2009 was analyzed. Rural patients were compared with urban and suburban patients as to diagnosis, locality of visits and choice of specialists. RESULTS Among 295,056 patients who had ambulatory visits for gastrointestinal diseases in 2009, rural patients sought medical care for gastrointestinal diseases more frequently than urban and suburban patients (1.60 ± 3.90 vs. 1.17 ± 3.02 and 1.39 ± 3.47). 83.4% of rural patients with gastrointestinal diseases were treated by non-gastroenterologists in rural areas. Rural people had lower accessibility of specialist care, especially for hepatitis, esophageal disorders and gastroduodenal ulcer. CONCLUSION The rural-urban disparity of medical care for gastrointestinal diseases in Taiwan highlighted the importance of the well communication between rural physicians and gastroenterologists. Besides the establishment of the referral system, the medical teleconsultation system and the arrangement of specialist outreach clinics in rural areas might be helpful.
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Affiliation(s)
- Yi-Hsuan Lin
- Department of Family Medicine, Kaohsiung Veterans General Hospital Pingtung Branch, Pingtung, No. 1. Anping Lane 1, Jausheng Rd., Pingtung, Neipu Shiang, 91245, Taiwan
| | - Yen-Han Tseng
- Respiratory Therapy Department, Taipei Veterans General Hospital, Taipei, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan
| | - Yi-Chun Chen
- Department of Family Medicine, Taitung Veterans Hospital, Taitung, No. 1000, Gengsheng Rd., Taitung City, Taitung County, 95050, Taiwan
| | - Ming-Hwai Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City 11217, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan
| | - Li-Fang Chou
- Department of Public Finance, National Chengchi University, Taipei, No. 64, Sec. 2, ZhiNan Rd., Wenshan District, Taipei City, 11605, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City 11217, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan
| | - Shinn-Jang Hwang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City 11217, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan
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Zhao Y, Wang J, Tanaka T, Hosono A, Ando R, Soeripto S, Ediati Triningsih FX, Triono T, Sumoharjo S, Astuti EYW, Gunawan S, Tokudome S. Association between HLA-DQ genotypes and haplotypes vs Helicobacter pylori infection in an Indonesian population. Asian Pac J Cancer Prev 2013; 13:1247-51. [PMID: 22799313 DOI: 10.7314/apjcp.2012.13.4.1247] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Helicobacter pylori is an important gastrointestinal pathogen related to the development of not only atrophic gastritis and peptic ulcer, but also gastric cancer. Human leukocyte antigens (HLA) may play particular roles in host immune responses to bacterial antigens. This study aimed to investigate the association between HLA-DQA1 and DQB1 genotypes and haplotypes vs H. pylori infection in an Indonesian population. METHODS We selected 294 healthy participants in Mataram, Lombok Island, Indonesia. H. pylori infection was determined by urea breath test (UBT). We analyzed HLA-DQA1 and DQB1 genotypes by PCR-RFLP and constructed haplotypes of HLA-DQA1 and DQB1 genes. Multiple comparisons were conducted according to the Bonferroni method. RESULTS The H. pylori infection rate was 11.2% in this Indonesian population. The DQB1*0401 genotype was noted to be associated with a high risk of H. pylori infection, compared with the DQB1*0301 genotype. None of the HLA-DQA1 or DQB1 haplotypes were related to the risk of H. pylori infection. CONCLUSIONS The study suggests that HLADQB1 genes play important roles in H. pylori infection, but there was no statistically significant association between HLA-DQA1 or DQB1 haplotypes and H.pylori infection in our Lombok Indonesian population.
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Affiliation(s)
- Yang Zhao
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Daoud Z, Sura M, Abdel-Massih RM. Pectin shows antibacterial activity against <i>Helicobacter pylori</i>. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/abb.2013.42a037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lim SL, Canavarro C, Zaw MH, Zhu F, Loke WC, Chan YH, Yeoh KG. Irregular Meal Timing Is Associated with Helicobacter pylori Infection and Gastritis. ISRN NUTRITION 2012; 2013:714970. [PMID: 24967249 PMCID: PMC4045282 DOI: 10.5402/2013/714970] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 12/09/2012] [Indexed: 01/05/2023]
Abstract
Helicobacter pylori (HP) is associated with chronic gastritis and gastric cancer, and more than half of the world's population is chronically infected. The aim of this retrospective study was to investigate whether an irregular meal pattern is associated with increased risk of gastritis and HP infection. The study involved 323 subjects, divided into three groups as follows: subjects with HP infection and gastritis, subjects with gastritis, and a control group. Subjects were interviewed on eating habits and meal timing. Multivariate logistic regression was used to compare groups. Adjusted odds ratios (OR) were derived controlling for gender, age, stress, and probiotic consumption. Subjects who deviated from their regular meals by 2 hours or more had a significantly higher incidence of HP infection with gastritis (adjusted OR = 13.3; 95% CI 5.3–33.3; P < 0.001) and gastritis (adjusted OR = 6.1; 95% CI 2.5–15.0; P < 0.001). Subjects who deviated their meals by 2 hours or more, twice or more per week, had an adjusted OR of 6.3 and 3.5 of acquiring HP infection with gastritis (95% CI 2.6–15.2; P < 0.001) and gastritis (95% CI 1.5–8.5; P < 0.001), respectively. Frequent deviation in meal timing over a prolonged period appears associated with increased risk of developing HP infection and gastritis.
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Affiliation(s)
- Su-Lin Lim
- Dietetics Department, National University Hospital, 5 Lower Kent Ridge Road, Main Building, Level 1, Singapore 119074
| | - Claudia Canavarro
- Dietetics and Nutrition Department, Alexandra Hospital, Jurong Health, Level 1, 378 Alexandra Road, Singapore 159964
| | - Min-Htet Zaw
- Research and Strategic Planning Division, Research and Evaluation Department, Health Promotion Board, 3 Second Hospital Avenue, Singapore 168937
| | - Feng Zhu
- Department of Gastroenterology and Hepatology, National University Hospital, 5 Lower Kent Ridge Road Tower Block, Level 10, Singapore 119074
| | - Wai-Chiong Loke
- Global Healthcare Practice, KPMG, 16 Raffles Quay No. 22-00, Hong Leong Building, Singapore 048581
| | - Yiong-Huak Chan
- Biostatistics Unit, Clinical Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Block MD 11, Level 1, Singapore 117597
| | - Khay-Guan Yeoh
- Department of Gastroenterology and Hepatology, National University Hospital, 5 Lower Kent Ridge Road Tower Block, Level 10, Singapore 119074
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L. Bodhank S, Ghosh P, A. Pandit V, Karandikar Y, G. Diwan A. A Cross Sectional Study to Determine Risk Factors Associated with Prevalence of H. pylori Infection in Salivary Samples of Acid Peptic Disease Patients in Western India. ACTA ACUST UNITED AC 2012. [DOI: 10.5567/pharmacologia.2012.554.564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Smith CD, Ashbolt NJ. The Fate of Helicobacter pylori Phagocytized by Acanthamoeba polyphaga Demonstrated by Fluorescent In Situ Hybridization and Quantitative Polymerization Chain Reaction Tests. Curr Microbiol 2012; 65:805-12. [DOI: 10.1007/s00284-012-0232-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 08/25/2012] [Indexed: 12/19/2022]
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Epplein M, Cohen SS, Sonderman JS, Zheng W, Williams SM, Blot WJ, Signorello LB. Neighborhood socio-economic characteristics, African ancestry, and Helicobacter pylori sero-prevalence. Cancer Causes Control 2012; 23:897-906. [PMID: 22527167 PMCID: PMC3475203 DOI: 10.1007/s10552-012-9960-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 04/06/2012] [Indexed: 12/25/2022]
Abstract
PURPOSE The authors recently reported high Helicobacter pylori sero-prevalence among African-Americans of high African ancestry. We sought to determine whether neighborhood-level socio-economic characteristics are associated with H. pylori prevalence and whether this helps explain the link between African ancestry and H. pylori. METHODS Antibodies to H. pylori proteins were assessed in the serum of 336 African-American and 329 white Southern Community Cohort Study participants. Prevalence odds ratios (ORs) and 95 % confidence intervals (CIs) for CagA+ and CagA- H. pylori were calculated using polytomous logistic regression in relation to 10 Census block group-level measures of socio-economic status. RESULTS After adjusting for individual-level characteristics, three neighborhood-level factors were significantly inversely related to CagA+ H. pylori: percent completed high school; median house values; and percent employed (comparing highest to lowest tertile, OR, 0.47, 95 % CI, 0.26-0.85; OR, 0.56, 95 % CI, 0.32-0.99; and OR, 0.59, 95 % CI, 0.34-1.03, respectively). However, accounting for these measures did not attenuate the association between African ancestry and CagA+ H. pylori, with African-Americans of low, medium, and high African ancestry maintaining two-, seven-, and ninefold increased odds, respectively, compared to whites. CONCLUSIONS Neighborhood-level measures of education, employment, and house values are associated with CagA+ H. pylori sero-prevalence, but do not explain the persistent strong relationship between African ancestry level and CagA+ H. pylori. The findings suggest that neighborhood socio-economic status can help to highlight high-risk areas for prevention and screening efforts and that the link between African ancestry and H. pylori may have a biological basis.
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Affiliation(s)
- Meira Epplein
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, 2525 West End Avenue, 6th floor, Nashville, TN 37203-1738, USA.
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Oleastro M, Pelerito A, Nogueira P, Benoliel J, Santos A, Cabral J, Lopes AI, Ramalho PM, Monteiro L. Prevalence and incidence of Helicobacter pylori Infection in a healthy pediatric population in the Lisbon area. Helicobacter 2011; 16:363-72. [PMID: 21923682 DOI: 10.1111/j.1523-5378.2011.00858.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Helicobacter pylori is mainly acquired in childhood. Although adult studies reported a high prevalence of H. pylori infection in Portugal, the actual rate in children remains unknown. This study aimed to determine the prevalence and the incidence of H. pylori infection in an asymptomatic pediatric population of the Lisbon area and to correlate prevalence with sociodemographic determinants. MATERIALS AND METHODS Helicobacter pylori infection was determined by stool antigen test in 844 asymptomatic children (age 0-15 years; 49.4% boys). For the incidence study, H. pylori-negative children in the prevalence study were followed-up every 6 months over a 3-year period. RESULTS The global prevalence of H. pylori infection was 31.6%, increasing with age (19.9, 37.0 and 51.5%, in age groups 0-5, 6-10, and 11-15, respectively), but was similar among genders (34.5% in boys and 28.4% in girls). Older age and attendance of nursery/kindergarten during preschool constituted independent risk factors. The overall estimated incidence was 11.6 per 100 child-years (CY). Although 47.5% of children acquired H. pylori infection before 5 years of age, the mean age of acquisition was 6.3. The incidence of infection was similar among the three age groups (11.5, 13.0, and 10.5 per 100 CY, in age groups 0-5, 6-10, and 11-15, respectively). CONCLUSIONS The prevalence of H. pylori infection in the Portuguese pediatric population is still high. Although this study confirmed that the highest acquisition rate occurs at young age, it showed that in high-prevalence populations, older children can also acquire H. pylori infection at a rate similar to that of young children.
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Affiliation(s)
- Mónica Oleastro
- Departamento de Doenças Infecciosas, Instituto Nacional Saúde Dr Ricardo Jorge, Lisboa, Portugal.
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den Hoed C, Vila A, Holster I, Perez-Perez G, Blaser M, de Jongste J, Kuipers E. Helicobacter pylori and the birth cohort effect: evidence for stabilized colonization rates in childhood. Helicobacter 2011; 16:405-9. [PMID: 21923687 PMCID: PMC3177156 DOI: 10.1111/j.1523-5378.2011.00854.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The prevalence of Helicobacter pylori has declined over recent decades in developed countries. The increasing prevalence with age is largely because of a birth cohort effect. We previously observed a decline in H. pylori prevalence in 6- to 8-year-old Dutch children from 19% in 1978 to 9% in 1993. Knowledge about birth-cohort-related H. pylori prevalence is relevant as a predictor for the future incidence of H. pylori-associated conditions. AIM The aim of this study was to investigate whether the birth cohort effect of H. pylori observed between 1978 and 1993 continued in subsequent years. METHODS Anti-H. pylori IgG antibodies and anti-CagA IgG antibodies were determined in serum samples obtained in 2005/2006 from 545 Dutch children aged 7-9 years who participated in the Prevention and Incidence of Asthma and Mite Allergy birth cohort. The H. pylori and CagA antibodies were determined by enzyme-linked immunosorbent assays that have been extensively validated in children, with a 94% sensitivity for H. pylori colonization and a 92.5% sensitivity for colonization with a cagA-positive strain. RESULTS Of the 545 children (M/F 300/245), most (91.5%) were of Dutch descent. The H. pylori positivity rate was 9% (95% CI 6.6-11.4%). The prevalence of CagA antibodies was 0.9% (95% CI 0.1-1.6%). No significant differences were demonstrated in H. pylori and cagA prevalence in relation to gender or ethnicity. CONCLUSION The prevalence of H. pylori in childhood has remained stable in the Netherlands from 1993 to 2005, suggesting a stabilization of the previously decreasing trend in subsequent birth cohorts. This finding may reflect stabilization in determinants such as family size, housing, and hygienic conditions (or offset by day care). If confirmed in other populations in developed countries, it implies that colonization with H. pylori will remain common in the coming decades. Remarkably however, the rate of colonization with cagA(+) H. pylori strains has become very low, consistent with prior observations that cagA(+) strains are disappearing in Western countries.
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Affiliation(s)
- C.M. den Hoed
- Department of Gastroenterology and Hepatology, University Medical Center, Rotterdam, The Netherlands
| | - A.J. Vila
- Department of Gastroenterology and Hepatology, University Medical Center, Rotterdam, The Netherlands
| | - I.L. Holster
- Department of Gastroenterology and Hepatology, University Medical Center, Rotterdam, The Netherlands
| | - G.I. Perez-Perez
- Department of Medicine, New York University Langone Medical Center, New York, New York, US
| | - M.J. Blaser
- Department of Medicine, New York University Langone Medical Center, New York, New York, US
| | - J.C. de Jongste
- Department of Paediatrics, Sophia Children’s Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - E.J. Kuipers
- Department of Gastroenterology and Hepatology, University Medical Center, Rotterdam, The Netherlands,Department of Internal Medicine Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Al Faleh FZ, Ali S, Aljebreen AM, Alhammad E, Abdo AA. Seroprevalence rates of Helicobacter pylori and viral hepatitis A among adolescents in three regions of the Kingdom of Saudi Arabia: is there any correlation? Helicobacter 2010; 15:532-7. [PMID: 21073610 DOI: 10.1111/j.1523-5378.2010.00800.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The seroprevalence rate of Helicobacter pylori in the Kingdom of Saudi Arabia (KSA) was reported to be in the range of 50-80% among mostly symptomatic patients in non-community-based studies. However, the seroprevalence of viral hepatitis A (HAV) underwent a marked decline in the last two decades from over 50% in 1989 to 25% in 1997 among Saudi children under the age of 12 years. The aim of this paper was to study seroprevalence rates of H. pylori and HAV among the adolescent population in three regions of KSA and to determine whether there was any correlation between them. MATERIALS AND METHODS We randomly selected 1200 16-18-year-old students from three regions around KSA. Demographic data, including socioeconomic status (SES), were recorded, and each student was tested for the presence of H. pylori-IgG antibodies and anti-HAV-IgG. RESULTS The results indicate a high H. pylori infection rate (47%) among this age group. Boys had a higher prevalence than girls (p = .03), and the Al-Qaseem region had the highest prevalence (51%, p = .002). SES did not contribute to the high prevalence rates (p = .83). A cross-tabulation of data showed that 88 (8%) of the teenagers were seropositive and that 512 (44%) were negative for both H. pylori and HAV antibodies (χ(2) = 0.03, OR = 0.97, CI = 0.70-1.34). The agreement between H. pylori and HAV seropositivity was lower than would be predicted by chance (κ = -0.03). The variables that were independently associated with seropositivity to H. pylori were being female (OR = 0.75, 95% CI = 0.60-0.95) and living in the Madinah region (OR = 0.72, 95% CI = 0.55-0.94). CONCLUSION The prevalence of H. pylori in this group of adolescents was high. However, there was no correlation between H. pylori and HAV infection rates. Hence, factors contributing to the transmission source and route seem to be different.
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Affiliation(s)
- Faleh Z Al Faleh
- Department of Medicine (Gastroenterology Unit), College of Medicine, Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia.
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Wen D, Zhang N, Shan B, Wang S. Helicobacter pylori infection may be implicated in the topography and geographic variation of upper gastrointestinal cancers in the Taihang Mountain high-risk region in northern China. Helicobacter 2010; 15:416-21. [PMID: 21083747 DOI: 10.1111/j.1523-5378.2010.00790.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUNDS Helicobacter pylori infection is prevalent in China. Chronic infection of the bacterial not only causes distal stomach cancer, but also confers risk to gastric cardia adenocarcinoma. Because H. pylori infection is inversely associated with esophageal adenocarcinoma, globally the infection rate is significantly correlated with the ratio of squamous carcinoma to adenocarcinoma of the esophagus. These agree with the topography of upper gastrointestinal cancer observed in the Taihang Mountain high-risk region where both gastric cardia and non-cardia adenocarcinoma coincide with esophageal squamous cancer, but with almost no distal esophageal adenocarcinoma. Moreover, as altitude increases from plain to mountains, we observed progressively increasing incidence rates of gastric adenocarcinomas in recent years in the region. Because H. pylori infection is a definite carcinogen to gastric adenocarcinoma and is more prevalent in the mountain than in plain areas due to undeveloped living conditions, the observation gives the impression as though H. pylori infection is implicated. AIMS This article aims to note the role of H. pylori infection in upper gastrointestinal cancer in the Taihang Mountain high-risk region in northern China. MATERIALS AND METHODS First the unique topography and geographic variation of upper gastrointestinal cancer in the region is described to indicate a possible role of H. pylori infection, then we review studies on prevalence of H. pylori infection in the high-risk region and describe difference in socioeconomic development and water hygiene between the plains and the mountains as related to the prevalence of H. pylori infection. RESULTS Coincidence of gastric cancer in the region and a progressively increasing rate of the cancer from the plain towards the mountains indicate H. pylori infection may be implicated in upper gastrointestinal cancer. CONCLUSION International collaboration is needed to study H. pylori and upper gastrointestinal cancer in the region when rapid industrialization is just beginning.
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Affiliation(s)
- Denggui Wen
- Department of Epidemiology, 4th Hospital of Hebei Medical University, Shijiazhuang, China
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Cardenas VM, Mena KD, Ortiz M, Karri S, Variyam E, Behravesh CB, Snowden KF, Flisser A, Bristol JR, Mayberry LF, Ortega YR, Fukuda Y, Campos A, Graham DY. Hyperendemic H. pylori and tapeworm infections in a U.S.-Mexico border population. Public Health Rep 2010; 125:441-7. [PMID: 20433039 DOI: 10.1177/003335491012500313] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE A higher incidence of infectious disease has been documented in U.S. regions bordering Mexico compared with non-border areas. We assessed the prevalence of important gastrointestinal infections in Ciudad Juarez, Mexico, and El Paso, Texas, the largest binational community along the U.S.-Mexico border. METHODS Fecal specimens from a sample of the asymptomatic population representing all ages were tested for Helicobacter pylori (H. pylori), Cryptosporidium spp., Giardia spp., and other intestinal parasitic pathogens using flotation, immunoassays, and/or polymerase chain reaction. We also measured indicators of microbiological contamination of drinking water, hands of food preparers, and kitchen surfaces. RESULTS Overall, of the 386 participants, H. pylori was present in 38.2%, Taenia spp. in 3.3%, Giardia spp. in 2.7%, Cryptosporidium spp. in 1.9%, Entamoeba dispar in 1.3%, and Ascaris lumbricoides and Necator americanus in 0.3% of the study subjects; Cyclospora spp. and Entamoeba histolytica were not found. H. pylori infection was associated with handwashing (prevalence ratio [PR] = 1.3, 95% confidence interval [CI] 1.0, 1.8). Taenia spp. was found more often on the U.S. side (PR=8.6, 95% CI 2.3, 30.8). We did not find an association between these infections and the occurrence of total coliforms or fecal coliforms on kitchen surfaces. In addition, Escherichia coli was not found in any drinking water sample. CONCLUSION The study results indicated that H. pylori and Taenia spp. infections may be highly prevalent along the U.S.-Mexico border. Additional research is necessary to adequately characterize the prevalence, as well as determine whether interventions that reduce these infections are warranted.
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Affiliation(s)
- Victor M Cardenas
- University of Texas Health Science Center at Houston, School of Public Health, El Paso, TX 79902, USA.
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Vale FF, Vítor JMB. Transmission pathway of Helicobacter pylori: does food play a role in rural and urban areas? Int J Food Microbiol 2010; 138:1-12. [PMID: 20122750 DOI: 10.1016/j.ijfoodmicro.2010.01.016] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2009] [Revised: 01/13/2010] [Accepted: 01/14/2010] [Indexed: 01/03/2023]
Abstract
Helicobacter pylori is a Gram-negative microaerophilic bacterium that has colonized the human gastric mucosa. This infection is very common and affects more than half of the human population. The prevalence is however unbalanced between rural developing areas (more than 80%) and urban developed areas (less than 40%). H. pylori is responsible for several pathologies, such as gastritis, peptic ulcer and gastric cancer but its transmission pathway is still not clear. The risk factors for H. pylori infection include poor social and economic development; poor hygienic practices; absence of hygienic drinking water; and unsanitary prepared food. There is evidence supporting a gastro-oral, oral-oral and faecal-oral transmission, but no predominant mechanism of transmission has been yet identified. Transmission may occur in a vertical mode (e.g. from parents to child) or in a horizontal mode (across individuals or from environmental contamination). In either case, the involvement of water and food cannot be excluded as vehicles or sources of infection. Indirect evidence of presence of H. pylori in water and food, namely the detection of its DNA and survival studies after artificial contamination of food and water has been described. This paper reviews data both favourable and against the role of water and food in the transmission of H. pylori, exploring their role as a potential transmission vehicle for person-to-person and food-chain transmission. The likelihood of the transmission pathway in developing rural and developed urban areas appears to be different. In developed areas, person-to-person transmission within families appears to be dominant, while in the rural developing areas the transmission pathway appears to be more complex. In this later case, the transmission by contaminated food, water, or via intensive contact between infants and non-parental caretakers may have a greater influence than within-family transmission.
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Affiliation(s)
- F F Vale
- Faculty of Engineering Catholic University of Portugal, Estrada Octávio Pato, Rio de Mouro, Portugal.
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Dube C, Nkosi TC, Clarke AM, Mkwetshana N, Green E, Ndip RN. Helicobacter pylori antigenemia in an asymptomatic population of Eastern Cape Province, South Africa: public health implications. REVIEWS ON ENVIRONMENTAL HEALTH 2009; 24:249-255. [PMID: 19891122 DOI: 10.1515/reveh.2009.24.3.249] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Helicobacter pylori is a major cause of such upper gastrointestinal diseases as gastritis, peptic ulcer, and gastric cancer. The risk of infection is increased in those living in the developing world, which has been ascribed to precarious hygiene standards, crowded households, and deficient sanitation common in this part of the world. Fecal samples were collected from 356 apparently healthy subjects, consisting of 168 males and 188 females aged from 3 months to > or = 60 years (Mean = 31 years). A standardized questionnaire describing demographic characteristic including age, sex, household hygiene, socioeconomic status, and so on was applied. A sandwich-type enzyme immunoassay amplification technology (Amplified IDEIA Hp StAR, Oxoid, UK) was used to analyze the fecal samples for the detection of H. pylori antigens using monoclonal antibodies specific for H. pylori antigens. Fisher's exact test was used to assess the univariate association between H. pylori infection and the possible risk factors. Odds ratio (OR) and the corresponding 95% confidence interval (CI) were calculated to measure the strength of association using EPI INFO 3.41 package. P values of < .05 were required for significance. H. pylori antigen was detected in 309 of the 356 subjects giving an overall prevalence of 86.8%. Prevalence increased with age from 75.9% in children < 12 years age to 100% in young adults aged 25-47 years and subjects aged > or = 60 years (P < .05). H. pylori prevalence was higher in females than in males. Of 188 females who participated in the study, H. pylori antigen was detected in 172 (91.5%) versus 144 (85.7%) 168 males (P > .05). Interestingly, H. pylori antigen was detected more often (100%) in the high socioeconomic group than in those of low socioeconomic group (85.9%) (P > .05). The results of this study have revealed a high prevalence of H. pylori antigens in fecal samples of asymptomatic individuals in the Nkonkobe municipality, an indication of active infection. Socioeconomic status, contaminated water, and poor sanitation may play a role in H. pylori transmission in this population. This finding is of public health and epidemiologic significance.
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Affiliation(s)
- C Dube
- Department of Biochemistry and Microbiology, Faculty of Science and Agriculture, University of Fort Hare, Alice, South Africa
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Cheng H, Hu F, Zhang L, Yang G, Ma J, Hu J, Wang W, Gao W, Dong X. Prevalence of Helicobacter pylori infection and identification of risk factors in rural and urban Beijing, China. Helicobacter 2009; 14:128-33. [PMID: 19298340 DOI: 10.1111/j.1523-5378.2009.00668.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The prevalence of Helicobacter pylori is higher in developing countries such as China. The aim of this study was to investigate the prevalence of H. pylori in one rural and one urban region of Beijing, China. MATERIALS AND METHODS Healthy individuals in rural Pinggu and urban Haidian voluntarily participated in this study. The diagnosis of H. pylori infection was reached using the (13)C-urea breath test. Associations between H. pylori and sex, age, living area (i.e. rural vs urban), education level, smoking, and alcohol consumption were evaluated. RESULTS Of the 1232 included subjects, 54.7% of tested individuals residing in Pinggu and 41.3% in Haidian were positive for H. pylori. In urban region, more individuals were negative for H. pylori (429 of 731), whereas in the rural region, more individuals were positive for H. pylori (p < .05). Univariate analysis identified geographic area and lower education and annual income as significant factors associated with H. pylori. Men in rural areas were more likely than women in rural areas to be infected, and both men and women in the rural area were more likely to be positive for H. pylori than men and women in the urban area (all p < .05). CONCLUSIONS H. pylori infection is common in both rural and urban regions of Beijing. Residing in a rural area, having a lower family income, and lower education level are significant risk factors associated with infection.
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Affiliation(s)
- Hong Cheng
- Department of Gastroenterology, Peking University First Hospital, Beijing, China
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Chen X, Zhu LR, Hou XH, Hou KH. The characteristics of Barrett's esophagus: an analysis of 4120 cases in China. Dis Esophagus 2009; 22:348-53. [PMID: 19191861 DOI: 10.1111/j.1442-2050.2008.00924.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Our objective was to investigate the endoscopic and clinico-pathological characteristics in patients with Barrett's esophagus (BE) in China. Using the terms 'Barrett's esophagus' and 'Barrett's esophagus, China' as key words, literatures published in Chinese and English journals were searched in Chinese data banks, as well as PubMed and ISI Web of Science from 1989 to 2007. An analysis was carried out with the standard inclusion and exclusion criteria. A total of 4120 cases were included in this study. BE was found in 2.44% of patients undergoing endoscopy for various symptoms of upper gastrointestinal tract diseases; the male : female ratio was 2.09 : 1, the average age of detection of BE was 53.15 years old, and 51% of patients with BE had typical symptoms for gastroesophageal reflux disease (GERD). The island-type BE was predominant (56.80%), and the occurrence of BE with special intestinal metaplasia (SIM) was 36.58%, but SIM was more common in tongue-type BE than island-type and circumferential-type BE (both P < 0.001), as well as in long segment BE (LSBE) than in short segment BE (SSBE) (P < 0.001). A total of 46.39% of patients had Helicobacter pylori infection. The mean length of follow up was 2 years in 492 patients. The incidence of adenocarcinoma was 0.61% patient-years of total follow up. In China, the endoscopic prevalence of BE is lower, but the average age of diagnosis is younger; a high proportion of H. pylori infection is found in patients with BE, and about half of the patients have no typical symptoms of GERD; the tongue-type BE and the LSBE are apt to SIM.
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Affiliation(s)
- Xia Chen
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Dube C, Tanih NF, Ndip RN. Helicobacter pylori in water sources: a global environmental health concern. REVIEWS ON ENVIRONMENTAL HEALTH 2009; 24:1-14. [PMID: 19476289 DOI: 10.1515/reveh.2009.24.1.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Helicobacter pylori are Gram-negative micro-aerophilic motile curve rods that inhabit the gastric mucosa of the human stomach. The bacterium chronically infects billions of people worldwide and is one of the most genetically diverse of bacterial species. More than half of the world population in both developed and developing countries are infected with this organism. Infection usually occurs without overt clinical symptoms, particularly in poor communities. If untreated, the infection can last for decades without causing symptoms. In some communities, however, infection with the organism causes peptic and duodenal ulcers, gastritis, duodenitis, and gastric cancers. How H. pylori initially enters the stomach is not known, but contaminated food particles and water are suspected, with the former physically shielding it from stomach acid. Similarly, the route of transmission of this pathogen is unknown. Several reports have suggested the possibility of waterborne transmission as the organism can survive for a few days in fresh cold water, salt water, distilled water, and tap water. Knowledge of the epidemiology and mode of transmission of H. pylori is important to prevent its spread and may be useful in identifying high risk populations.
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Affiliation(s)
- C Dube
- Microbial Pathogenicity and Molecular Epidemiology Research Group, Department of Biochemistry and Microbiology, Faculty of Science and Agriculture, University of Fort Hare, Private Bag X1314, Alice 5700, South Africa
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48
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Volk J, Parsonnet J. Epidemiology of Gastric Cancer and Helicobacter pylori. THE BIOLOGY OF GASTRIC CANCERS 2009:25-57. [DOI: 10.1007/978-0-387-69182-4_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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49
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Yeh JM, Kuntz KM, Ezzati M, Goldie SJ. Exploring the cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer in China in anticipation of clinical trial results. Int J Cancer 2009; 124:157-66. [PMID: 18823009 PMCID: PMC2597699 DOI: 10.1002/ijc.23864] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Gastric cancer is the second leading cause of cancer-related deaths worldwide. Treatment for Helicobacter pylori infection, the leading causal risk factor, can reduce disease progression, but the long-term impact on cancer incidence is uncertain. Using the best available data, we estimated the potential health benefits and economic consequences associated with H. pylori screening in a high-risk region of China. An empirically calibrated model of gastric cancer was used to project reduction in lifetime cancer risk, life-expectancy and costs associated with (i) single lifetime screening (age 20, 30 or 40); (ii) single lifetime screening followed by rescreening individuals with negative results and (iii) universal treatment for H. pylori (age 20, 30 or 40). Data were from the published literature and national and international databases. Screening and treatment for H. pylori at age 20 reduced the mean lifetime cancer risk by 14.5% (men) to 26.6% (women) and cost less than $1,500 per year of life saved (YLS) compared to no screening. Rescreening individuals with negative results and targeting older ages was less cost-effective. Universal treatment prevented an additional 1.5% to 2.3% of risk reduction, but incremental cost-effectiveness ratios exceeded $2,500 per YLS. Screening young adults for H. pylori could prevent one in every 4 to 6 cases of gastric cancer in China and would be considered cost-effective using the GDP per capita threshold. These results illustrate the potential promise of a gastric cancer screening program and provide rationale for urgent clinical studies to move the prevention agenda forward.
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Affiliation(s)
- Jennifer M Yeh
- Department of Health Policy and Management, Program in Health Decision Science, Harvard School of Public Health, Boston, MA 02115, USA.
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Vergueiro CSV, Cordiolli R, Martucci D, Peres V, Kiyamu AR, Ribeiro KDCB, Chiattone CS. Soroprevalência e fatores associados à infecção pelo Helicobacter pylori em doadores de medula óssea de São Paulo. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2008. [DOI: 10.1590/s1415-790x2008000200002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVOS: Estimar a prevalência da infecção pelo Helicobacter pylori (HP) e determinar os fatores associados, em adultos saudáveis, doadores voluntários de medula óssea em São Paulo, Brasil. MÉTODOS: 248 indivíduos saudáveis, residentes na zona urbana de São Paulo, responderam a um questionário relatando condições sociais e domiciliares na infância e na vida adulta, assim como antecedentes gastrintestinais e principais fatores associados à infecção. Amostras de sangue foram coletadas e o soro foi analisado utilizando um teste de ELISA previamente validado. RESULTADOS: A prevalência da infecção pelo HP em 248 doadores foi de 48,8%, IC95%= [45,6; 52,0]. Na análise univariada, a infecção pelo HP esteve significativamente associada à ausência de água encanada (p=0,040), a escolaridade da mãe (p=0,005) e do indivíduo (p<0,001). Na análise múltipla, os fatores independentes foram a escolaridade da mãe e do indivíduo. CONCLUSÕES: A prevalência de infecção de 48,8% mostra que na região urbana de São Paulo, onde há água tratada e esgoto encanado, temos uma prevalência semelhante à encontrada em países industrializados. O fator de maior significância para a aquisição do HP foi a escolaridade, seja individual ou materna, o que sugere que os hábitos higiênicos e comportamentais possam ser determinantes da infecção.
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