Epidemiology of Helicobacter pylori infection in six Latin American countries (SWOG Trial S0701)

Abstract

Objective To investigate the potential determinants of Helicobacter pylori infection between adults 21–65 years old. Methods Data are from the initial screening visit of a randomized clinical trial of three antibiotic regimens to eradicate H. pylori, conducted in seven sites (Santiago–Chile, Túquerres–Colombia, Guanacaste–Costa Rica, Copán–Honduras, Obregón and Tapachula–México, León–Nicaragua). Thousand eight hundred and fifty-nine adults from the general population were screened for H. pylori infection using an urea breath test (UBT) and were interviewed to assess socioeconomic-, demographic-, and symptom-related characteristics. Logistic regression was used to assess the relationship between these characteristics and H. pylori positivity at enrollment. Results Among the 1,852 eligible participants for whom a conclusive UBT result was obtained, H. pylori prevalence was 79.4 %, ranging from 70.1 to 84.7 % among the seven centers. Prevalence did not differ by sex (female: 78.4, male: 80.9; p = 0.20) or age (p = 0.08). H. pylori positivity increased with increasing number of siblings (p trend <0.0001). Participants with education beyond 12 years were less likely to be UBT-positive (OR 0.4: 0.3–0.6, compared to participants with 0–6 years of schooling) as were those employed outside the home (OR 0.7: 0.6–1.0). Odds of H. pylori infection increased with the presence of certain living conditions during childhood including having lived in a household with an earth floor (OR 1.8: 1.4–2.4), lack of indoor plumbing (OR 1.3: 1.0–1.8) and crowding (OR 1.4: 1.0–1.8, for having more than two persons per bedroom). Regarding current household conditions, living with more than 3 children in the household (OR 1.7: 1.2–2.5) and crowding (OR 1.8: 1.3–2.3) were associated with H. pylori infection. Conclusions The prevalence of H. pylori in adults was high and differed significantly among the six Latin American countries studied (p < 0.001). Our findings confirm the strong link between poor socioeconomic conditions and H. pylori infection.

Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A population‐based study

“…This study reports that Mexican Americans and non‐Hispanic Blacks (52%) had a significantly higher seroprevalence of H. pylori when compared to non‐Hispanic Whites even after adjusting for country of origin (not US born vs US born) and socioeconomic status 9. In Central and South America, H. pylori seroprevalence, as determined by ELISA, has been reported to range from 50.7% to 84.7% depending on the region 12, 26, 27, 28. The observation that the seroprevalence detected among Hispanics living in Puerto Rico is more similar to estimates in general population from the US, rather than estimates from other Latin American countries, may be attributed to the US (and Puerto Rico as a US territory) having more developed living conditions compared to less developed regions in Latin America that have high H. pylori seropositivity, such as Honduras and Nicaragua 29.…”

“…In the US, the prevalence of H. pylori infection is approximately 31%, with variable prevalence among diverse racial/ethnic groups: 21% in Whites, 52% in African Americans, and 64% in Mexican Americans 6, 9. Marked differences in H. pylori infection have also been reported among Hispanic individuals from different regions of Central and South America 10, 11, 12. Individuals with low levels of education and low socioeconomic status have reported to have more than 5.5‐ and 6.6‐times higher odds of being infected with H. pylori 13…”

Rapid evolution of distinct Helicobacter pylori subpopulations in the Americas

“…The prevalence of H. pylori infection remains high in Latin American countries, ranging from 70,1 % to 84,7 % of adults in a recent multi-country study [16]. In the US, the prevalence has been declining from high levels and according to data from the end of the 1990's, is around 32,5 % [17].…”

Genes de patogenicidade de Helicobacter pylori, polimorfismos de citocinas e fatores ambientais afetam o desenvolvimento de doenças gástricas: uma visão geral

“…Besides, factors as smoking, eating habits and alcohol consumption have been associated with a higher risk of the development of peptic ulcer and gastric cancer in people infected by H. pylori. [18][19][20] The aim of this review is to provide an overview of bacterial, environmental, and host factors that influence susceptibility to severe outcomes of H. pylori infection.…”