The Loiano‐Monghidoro population‐based study of Helicobacter pylori infection: prevalence by ¹³C‐urea breath test and associated factors

Abstract

Objectives: As part of a cross‐sectional study on cholelithiasis, 1533 out of 1840 residents in Loiano/Monghidoro, a rural area in Northern Italy (792 men, 741 women, age range 28–80 years), agreed to be further evaluated in relation to their Helicobacter pylori status. Methods: Each participant performed a 13C‐urea breath test (13C‐UBT) and provided information on sociodemographic, lifestyle and clinical characteristics. Results: The 13C‐UBT was positive in 1041 subjects (67.9%; men: 69%; women: 67%) and was positively associated with increasing age (P < 0.001), alcohol consumption (P < 0.01), a higher number of siblings (P < 0.001) and a personal history of peptic ulcer (P < 0.01), but inversely with a nonmanual occupation (P < 0.001). Overall, H. pylori infection was unrelated to smoking, house pets, and a family history of gastroduodenal diseases. The prevalence of H. pylori infection was 72% in subjects reporting one or more dyspeptic symptoms and 65% among asymptomatic participants (P < 0.001); a multivariate analysis showed that only epigastric pain was significantly, although weakly, associated with 13C‐UBT positivity. Conclusions: This large population‐based study showed a prevalence of H. pylori infection higher than that reported by serologic surveys in urban areas. Current H. pylori infection was strongly associated with indicators of lower socioeconomic status, alcohol consumption and increasing age. A role of H. pylori infection in determining epigastric pain was suggested.

Prevalence of Helicobacter pylori infection in the general adult population of the province of Ourense

“…We have not detected any differences in prevalence according to gender, which is consistent with the majority of studies in the literature (9,(13)(14)(15)(16)20). In terms of age, our data also coincide with most published studies conducted in developed countries, in which prevalence is seen to rise until it peaks in middle-aged individuals, around 50-60 years (9,14,15,18,20).…”

“…In terms of age, our data also coincide with most published studies conducted in developed countries, in which prevalence is seen to rise until it peaks in middle-aged individuals, around 50-60 years (9,14,15,18,20). In developing countries such as Nigeria, a very high prevalence rate is observed in the young -82% in children aged 2 to 9 years, with a slight subsequent increase until it affects 100% of individuals with 50-59 years of age (33).…”

“…Other relevant epidemiological studies, such as those performed by Gasbarrini et al (13) in San Marino, Bazzoli et al (14) in Italy, and Murray et al (15) in Northern Ireland, report participation rates of 77, 67.9, and 58.4%, respectively. It is possible that the higher participation rates achieved by these authors versus our study was made possible by the fact the they were carried out in geographically smaller areas with smaller target populations than in our case, making it easier to locate the individuals and to establish a closer relationship between the selected individuals and the investigating physicians.…”

Risk factors associated with Helicobacter pylori infection: A population-based study conducted in the province of Ourense

“…Insofar as the risk factors studied are concerned, there is a direct association between infection and age in both the univariate and multivariate analyses. An increase in prevalence is observed, which peaks in the middle-aged cohort and subsequently falls, a finding that is consistent with reports by other researchers (9)(10)(11)(12)(13). This growing prevalence rate is generally deemed to be a cohort effect and to denote worse socioeconomic conditions and poorer hygiene in the past, which fostered infection (14); some authors such as Veldhuyzen van Zaten et al (15) suggest that there is a continued risk of infection though.…”

Gastro‐oesophageal reflux symptoms and health‐related quality of life in the adult general population – the Kalixanda study

“…28 This community-based study applied endoscopy and a validated symptom questionnaire in two villages in northern Italy (n ¼ 1069), in a population that had previously been identified in a study of gall-bladder disease. 29 In our study, approximately one-third of individuals with oesophagitis were asymptomatic (compared with 20% in the Italian study), and the implications of this finding for potential GERD progression are discussed in a separate study reporting the prevalence of Barrett's oesophagus. 5 Mean SF-36 scores tended to be lower in subjects with oesophagitis than those without, but these differences were not clinically meaningful.…”