Published online Nov 14, 2019. doi: 10.3748/wjg.v25.i42.6365
Peer-review started: September 2, 2019
First decision: September 19, 2019
Revised: October 10, 2019
Accepted: October 18, 2019
Article in press: October 18, 2019
Published online: November 14, 2019
Epidemiologic studies have revealed a decrease in the prevalence of Helicobacter pylori (H. pylori) infection in Western Europe. Conversely, little is known regarding its prevalence in Central Europe, in which a substantial population resides in rural areas.
The last Hungarian epidemiologic studies on H. pylori were carried out approximately two decades ago and showed high seroprevalence rates. Therfore we aimed to obtain new data and to test whether it decreases similarly to the Western European tendencies.
The aims of the present study were to obtain data regarding the prevalence of H. pylori in Csongrád and Békés Counties in Hungary, evaluate the differences in its prevalence between urban and rural areas, and establish factors associated with positive seroprevalence.
One-thousand and one healthy blood donors were enrolled. Data collection was performed using an anonymous questionnaire including 26 questions associated with demographic parameters and medical status. All subjects were tested for H. pylori IgG antibody positivity using IgG enzyme-linked immunosorbent assay.
The overall seropositivity of H. pylori was 32%. The prevalence of H. pylori was significantly higher in rural areas than in urban areas. Residence in rural areas for at least one year was associated with a significantly higher H. pylori prevalence than continuous urban residency. A significant positive association was observed between age, occupation, coffee consumption, pet or domesticated animal rearing and H. pylori positivity. Three age groups were formed for further analysis, in the youngest group, the presence of epigastric pain was an independent risk factor for H. pylori positivity.
The prevalence of H. pylori infection decreased in recent decades in Southeast Hungary, it remains high in middle-aged rural populations. Generally accepted risk factors for H. pylori positivity appeared to be valid for the studied population. Furthermore, a new original finding is that people who lived in rural conditions for at least one year also had an increased risk for H. pylori seropositivity.
The results of this study seems to consider the subsequent changes in seropositivity of H. pylori in Hungary. It would be interesting to test whether the significant positive association between age and H. pylori positivity continuous observed after 10 or 15 years or rather not, “new” infected will appear, or in the older age will stay low seropositivity. The other experience of this study is the link between epigastric pain and H. pylori seropositivity among young subjects, which supports the recommendation in countries with high H. pylori seropositivity, that patients with dyspeptic symptoms should be examined for H. pylori infection (Rome IV diagnostic protocol).