Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2019; 25(42): 6365-6372
Published online Nov 14, 2019. doi: 10.3748/wjg.v25.i42.6365
Epidemiologic characteristics of Helicobacter pylori infection in southeast Hungary
Lenke Bálint, Andrea Tiszai, Gábor Kozák, Ilona Dóczi, Veronika Szekeres, Orsolya Inczefi, Georgina Ollé, Krisztina Helle, Richárd Róka, András Rosztóczy
Lenke Bálint, Andrea Tiszai, Orsolya Inczefi, Georgina Ollé, Krisztina Helle, Richárd Róka, András Rosztóczy, Division of Gastroenterology, First Department of Medicine, University of Szeged, Szeged 6720, Hungary
Gábor Kozák, Department of Physiology, University of Szeged, Szeged 6720, Hungary
Ilona Dóczi, Department of Clinical Microbiology, University of Szeged, Szeged 6725, Hungary
Veronika Szekeres, Hungarian National Blood Transfusion Service, Szeged 6722, Hungary
Author contributions: Bálint L, Rosztóczy A designed research, performed research, and wrote the paper; Tiszai A performed research; Kozák G designed research and analyzed data; Dóczi I contributed analytic tools; Szekeres V performed research; Inczefi O performed research; Ollé G performed research; Helle K performed research; Róka R performed research.
Institutional review board statement: The study was approved by the institutional review board of University of Szeged.
Informed consent statement: The institutional review board of University of Szeged waived the requirement to obtain informed consents from patients.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Data sharing statement: No additional data are available.
STROBE statement: This study adopted the guidelines of the STROBE Statement.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: András Rosztóczy, MD, PhD, Associate Professor, Division of Gastroenterology, First Department of Medicine, University of Szeged, Korányi fasor 8-10, Szeged 6720, Hungary. rosztoczy.andras@med.u-szeged.hu
Telephone: +36-62-545186 Fax: +36-62-545185
Received: September 2, 2019
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
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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).