Brief Article
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World J Gastroenterol. Aug 28, 2012; 18(32): 4412-4418
Published online Aug 28, 2012. doi: 10.3748/wjg.v18.i32.4412
Significant decrease in prevalence of Helicobacter pylori in the Czech Republic
Jan Bureš, Marcela Kopáčová, Ilona Koupil, Bohumil Seifert, Miluška Škodová Fendrichová, Jana Špirková, Viktor Voříšek, Stanislav Rejchrt, Tomáš Douda, Norbert Král, Ilja Tachecí
Jan Bureš, Marcela Kopáčová, Miluška Škodová Fendrichová, Stanislav Rejchrt, Tomáš Douda, Ilja Tachecí, Second Department of Medicine Gastroenterology, Charles University in Praha, Faculty of Medicine at Hradec Králové, University Teaching Hospital, 50005 Hradec Králové, Czech Republic
Ilona Koupil, Centre for Health Equity Studies, Karolinska Institute, Stockholm University, 17177 Stockholm, Sweden
Bohumil Seifert, Norbert Král, First Faculty of Medicine, Institute of General Practice, Charles University, 12108 Praha, Czech Republic
Jana Špirková, Viktor Voříšek, Institute of Clinical Biochemistry and Diagnostics, Charles University in Praha, Faculty of Medicine at Hradec Králové, University Teaching Hospital, 50005 Hradec Králové, Czech Republic
Author contributions: Bureš J, Kopáčová M, Koupil I, Seifert B, Škodová Fendrichová M, Špirková J, Voříšek V, Rejchrt S, Douda T, Král N and Tachecí I contributed equally to this work.
Supported by Research Project PRVOUK P37-08 from Faculty of Medicine at Hradec Králové, Charles University in Praha, Czech Republic
Correspondence to: Jan Bureš, MD, PhD, Professor, Second Department of Medicine Gastroenterology, Charles University in Praha, Faculty of Medicine at Hradec Králové, University Teaching Hospital, Sokolská 581, 50005 Hradec Králové, Czech Republic. bures@lfhk.cuni.cz
Telephone: +420-495-834240 Fax: +420-495-834785
Received: July 3, 2012
Revised: August 13, 2012
Accepted: August 16, 2012
Published online: August 28, 2012
Abstract

AIM: To study possible decrease in prevalence of Helicobacter pylori (H. pylori) infection in the Czech Republic within a 10-year period.

METHODS: A total of 22 centres entered the study. The catchment areas of these centres covered cities and towns with more than 20 000 inhabitants, smaller towns (≤ 20 000 inhabitants) with surrounding villages and rural areas, and were spread over the whole country, corresponding well to the geographical distribution of the Czech population. A total of 1 837 subjects (aged 5-98 years) took part in the study, randomly selected out of 38 147 people from the general population. H. pylori infection was investigated by means of a 13C-urea breath test. Breath samples in duplicates were analysed using isotope ratio mass spectrometry. The cut-off point was 3.5. Social and demographic characteristics were based on data from self-completed questionnaires.

RESULTS: The overall prevalence of H. pylori infection was 23.5% (430/1826), and 4.8% (20/420) in children aged 15 or less. There was no statistically significant difference in prevalence between males (24.3%; 208/857) and females (22.9%, 222/969, P = 0.494). H. pylori infection was strongly associated with higher age, among subjects aged 55+ years, prevalence of H. pylori infection was 39.8% (252/633, P < 0.001). The highest prevalence of H. pylori infection was found among persons aged 55-64 years (43.9%, 97/221) and 75+ years (37.9%, 58/153). Among study subjects aged 15+ years, prevalence of H. pylori infection was significantly increased in those with lowest education (odds risk 3.19, 95% CI 1.87-5.47). Compared to never married (14.1%), the prevalence of H. pylori infection was statistically significantly higher among married (35.4%, 246/694, P < 0.001), divorced (36.8%, 49/133, P < 0.001) and widowed study subjects (40.2%, 45/112, P < 0.001), both in minimally and fully adjusted analysis. There was no significant difference in the prevalence of H. pylori infection between married and widowed subjects (35.4%, 246/694 vs 40.2%, 45/112, P = 0.389). There was little variation in smoking prevalence across categories of smoking and there was no evidence of an increased risk of H. pylori infection among current or past smokers in our data (odds risk 1.04 with 95% CI 0.78-1.40 for current smokers; odds ratio 0.83 with 95% CI 0.60-1.16 for former smokers). The current prevalence of H. pylori in 2011 was significantly lower compared to the prevalence reported from identical geographical areas in 2001 (23.5% vs 41.7%, P < 0.001).

CONCLUSION: The overall prevalence of H. pylori infection in the general population has fallen substantially in the Czech Republic over the past 10 years.

Keywords: Epidemiology, Helicobacter pylori, Czech Republic, 13C-urea breath test, Decline of prevalence