Helicobacter pylori Antigenemia in an Asymptomatic Population of Eastern Cape Province, South Africa: Public Health Implications

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.

Epidemiology of Helicobacter pylori Infection and Related Gastric Pathologies in Moroccan Population

“…Similar result was observed in some developing countries, in Africa (e.g. South Africa: 87% [16], Egypt: 72% [17]), in Latin America (e.g. Bolivia: 78% [18]) and in some Asian countries (e.g.…”

“…Unlike, in the United Kingdom, a large cross-sectional survey of adults has shown that male gender was significantly associated with positive H. pylori serology [21]. Other studies, conducted in South Africa [16] and Albanian, demonstrated that female gender was correlated with the incidence of infection.…”

Non-invasive detection of Helicobacter pylori virulence genotypes ureA, vacA, cagA and babA2 among asymptomatic Egyptian infants

“…This supports results obtained by meta-analysis of 10 studies conducted over the last 20 years which found no sex difference regarding prevalence of H. pylori among children (de Martel and Parsonnet, 2006). Higher prevalence in males or in females was reported in different other studies (Klein et al, 1994;Ndip et al, 2004;Dube et al, 2009). …”

“…The high prevalence among asymptomatic infants observed in this study (88.9%) parallels that reported in asymptomatic Colombian children (80.2%) (Sicinschi et al, 2012) and an overall prevalence of 86.8% in asymptomatic subjects in South Africa (Dube et al, 2009).…”

A South African perspective on Helicobacter pylori: Prevalence, epidemiology and antimicrobial chemotherapy

“…The variations seen in the prevalence of infection between and among populations may point to the fact that parameters such as age, cultural background, genetic predisposition, socio-economic status and environmental factors all play a role in the acquisition and transmission of H. pylori (Segal et al, 2001;Dube et al, 2009b). Attracting attention is the high prevalence of H. pylori infection in developing countries which does not commensurate the low prevalence of gastric cancer unlike in developed nations with a generally low prevalence of infection and yet a high prevalence of gastric cancer (Holcombe, 1992).…”