Helicobacter pylori seroprevalence in selected groups of Albanian volunteers

Helicobacter pylori infection: association with dietary habits and socioeconomic conditions

INTRODUCTION

Few studies have investigated factors possibly related to the source of Helicobacter pylori infection in humans.

MATERIALS AND METHODS

This was a retrospective study including a population of 201 H.pylori positive patients and 259 H. pylori negative subjects observed at a tertiary referral center in Apulia. The H. pylori status was assessed by urea breath test. Data on socio-demographic characteristics and the consumption of different foods and beverages in the last year were collected by a questionnaire.

RESULTS

No significant relationship was found between H. pylori infection and gender or age, type of employment, working in direct contact with the public, residence, level of education or exposure to pets. No association between H.pylori status and the consumption of fish, fruits, legumes, honey, spices, meats, milk and milk products including some typical product of our area was found. The same was true for the consumption of several kind of beverage including green tea and wine. Cigarette smoking and living in the same house with H.pylori positive relatives were significantly associated with H. pylori positivity. The intake of uncooked seafood (mussels and other molluscs) as well as some uncooked vegetables such as tomatos,pepper,and chicory,municipal water and the number of cups of coffee consumed per week correlated significantly with H. pylori status. The consumption of raw vegetables purchased from street vendors and the consumption of meals outside home were also associated with H.pylori infection.

CONCLUSIONS

Foods may represent an important route in the transmission of H. pylori among humans.

Contemporary migration patterns in the prevalence of Helicobacter pylori infection: A systematic review

BACKGROUND

A rapid growth in the number of international migrants over the past years has occurred with most traveling to more affluent settings. As Helicobacter pylori infects over half of the adult population and its prevalence is higher in developing countries, understanding the prevalence of infection in migrants can provide insight into future trends in the burden and management of infection. We aimed to describe the prevalence of H. pylori among migrants through a systematic literature review.

METHODS

We searched PubMed^® from inception to September 2015 to identify studies reporting the prevalence of H. pylori in international migrants according to country of birth for first-generation, and country of birth and parents' nationality for successive generations. Comparable data from origin and destination populations were obtained from the same studies or, when not present, from a previous systematic review on H. pylori worldwide.

RESULTS

A total of 28 eligible studies were identified with data for 29 origin and 12 destination countries. Two studies that evaluated refugees presented prevalences of infection higher than both the origin and destination countries. Otherwise, the prevalences among migrants were generally similar or below that of the origin and higher than the destination. Second- or more generation had lower prevalences compared to first-generation migrants.

CONCLUSIONS

Our study findings are consistent with what would be expected based on the prevalence of H. pylori worldwide. The results of this review show that migrants are particularly at risk of infection and help to identify gaps in the knowledge of migrants' prevalence of infection globally.

Reciprocal impact of host factors and Helicobacter pylori genotypes on gastric diseases

AIM: To assess the impact of Helicobacter pylori (H. pylori) genotypes and patient age and sex on the development of gastric diseases.

METHODS: H. pylori-infected patients (n = 233) referred to the endoscopy unit at Tehran University of Medical Sciences (Tehran, Iran) were diagnosed with chronic gastritis (CG), gastric ulcer (GU), or duodenal ulcer (DU). Brucella blood agar was used for biopsy cultures and H. pylori isolation under microaerobic conditions. H. pylori isolates were confirmed with biochemical tests and through amplification of the 16S rRNA gene. DNA was extracted from fresh cultures of the H. pylori isolates and used for amplification of vacA alleles and the cagA gene. Statistical analysis was performed to determine the association between H. pylori genotypes, age (< 40 years vs > 40 years) and sex of the patient, and gastric diseases.

RESULTS: CG was the most prevalent gastric disease (113/233; 48.5%), compared to GU (64/233; 27.5%) and DU (56/233; 24%). More patients were male, and gastric diseases were more frequent in patients > 40 years (P < 0.05). The percentage of CG and GU patients that were male and female did not show a significant difference; however DU was more common in males (P < 0.05). Interestingly, a diagnosis of CG in patients > 40 years was more common in females (18.5%) than males (11.6%) (P = 0.05), whereas a diagnosis of GU or DU in patients > 40 years was more frequent in males (14.6% vs 10.7% and 12.4% vs 4.3%, respectively). Overall, genotyping of the H. pylori isolates revealed that the vacA s1 (82%), vacA m2 (70%), and cagA⁺ (72.5%) alleles were more frequent than vacA s2 (18%), vacA m1 (29.2%), and cagA^- (all P < 0.05). The vacA s1m2cagA⁺ genotype was the most prevalent within the three disease groups. vacA s1m2 frequency was 56.2% with a similar occurrence in all diagnoses, while vacA s1m1 appeared more often in DU patients (33.9%). A genotype of vacA s2m2 occurred in 15% of isolates and was more common in CG patients (21.2%); vacA s2m1 was the least common genotype (3%). The vacA s1 allele was found to be a risk factor for DU, vacA s2 for CG, and vacA s1 and vacA s2 for GU (all P < 0.05). The vacA s2m2 genotype was associated with the development of CG and GU compared to DU (P < 0.05). No correlation was found between vacA m or cagA and gastric diseases.

CONCLUSION: The outcome of H. pylori infection is the result of interaction between bacterial genotypes and the age and sex of infected individuals.

Oral and gastric Helicobacter pylori: effects and associations

Introduction

This study consisted in the comparison of the prevalence of Helicobacter pylori (H. pylori) present in the stomach and in saliva of a sample of Portuguese adolescents and the assessment of the association between H. pylori infection with socio-demographic variables and prevalence of dental caries.

Materials and Methods

A cross-sectional study was designed including a sample of 447 adolescents aged 12 to 19 years old, attending a public school in Sátão, Portugal. A questionnaire about socio-demographic variables and oral health behaviors was applied. Gastric H. pylori infection was determined using the urease breath test (UBT). Saliva collection was obtained and DNA was extracted by Polymerase Chain Reaction (PCR) in order to detect the presence of oral H. pylori.

Results

The prevalence of gastric H. pylori detected by UBT was 35.9%. Within the adolescents with a gastric UBT positive, only 1.9% were positive for oral H. pylori. The presence of gastric H. pylori was found to be associated with age (>15years, Odds ratio (OR)=1.64,95%CI=1.08-2.52), residence area (urban,OR=1.48,95%CI=1.03-2.29) and parents´ professional situation (unemployed,OR=1.22,95%CI=1.02-1.23). Among those with detected dental caries during the intra-oral observation, 37.4% were positive for gastric H. pylori and 40.2% negative for the same bacterial strain (p=0.3).

Conclusions

The oral cavity cannot be considered a reservoir for infection of H. pylori. Gastric H. pylori infection was found to be associated with socio-demographic variables such as age, residence area and socioeconomic status.

Epidemiology of Helicobacter pylori in Bhutan: the role of environment and Geographic location

BACKGROUND

Bhutan is small mountainous country bordering India and China and consists of four geographic regions, west, east, central, and south. The epidemiology of Helicobacter pylori infection and risk factors associated with in Bhutan are not previously studied. The World Health Organization reported the incidence of stomach cancer to be very high in Bhutan.

AIM

We conducted a cross-sectional study to determine the seroepidemiologic pattern of H. pylori among Bhutanese from the four regions with emphasis on water source and household sanitation.

METHODS

Between June and November 2012, blood samples from patients with complaints of dyspepsia were collected after obtaining an informed consent. Demographic information, occupation, family size living in the same household, consumption of betel nut, and aspects of household environment including type of latrines, source of drinking water were collected. All serum samples were tested for H. pylori immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA) using MAGIWELL ELISA kit from United Biotech, USA.

RESULTS

Two hundred and forty-four patients between 17 and 75 years of age participated in the study, of them, 102 were men, and the mean age was 38 (±14.2) years. The overall prevalence of H. pylori among patients was 86% with no difference between men and women (90 vs 83%, respectively, p = .12). The prevalence was almost identical among all age groups: 81% at 17-20, 84% at 20-29, 93% at 30-39, 82% at 40-49, 87% at 50-59, and 82% at ≥60 years (p = .51). H. pylori prevalence was lower in the southern region of Bhutan (78%) compared with the central region (97%) (OR = 8.6; 95% CI = 1.1-55; p = .02), eastern region (91%) (OR = 2.7; 95% CI = 1.1-7.2, p = .004) or the western region (83%) (OR = 1.4, 95% CI = 0.8-3.1, p = .07). The prevalence of H. pylori was significantly lower among household with less than 4 persons living in the same household. Source of drinking water, type of occupation, type of latrines, or consumption of betel nut showed no association with H. pylori prevalence. Logistic regression analysis revealed that residing region was the only significant variable.

CONCLUSIONS

The high prevalence of antibodies to H. pylori among patients and in all groups could contribute to the high incident rate of gastric cancer in Bhutan. Crowded living condition and the residing region contribute to the variation of the prevalence of the infection. The lowest prevalence in southern part of the country could be due to the difference in the ethnicity as most of its population is of Indian and Nepal origin. Further data regarding H. pylori in Bhutan are critical to developing surveillance and prevention strategies for gastric cancer.

Helicobacter pylori is a major public health priority in western Balkans: an endoscopy referral center experience

BACKGROUND

Helicobacter pylori infection is a highly prevalent community infection. The prevalence of H.pylori infection has been reported to vary worldwide by geographical area and by social and economic conditions.

AIM

To investigate possible differences regarding the prevalence of H. pylori infection and related gastritis in Greek and Albanian patients undergoing routine endoscopy.

MATERIALS AND METHODS

Single referral endoscopy center retrospective analysis for the period of 2005-2008. For each of the first 101 consecutive Albanian patients, one age and sex matched Greek patient was included. No patient was previously treated for H. pylori. Endoscopic and pathology findings were recorded for H. pylori infection and the presence of active gastritis.

RESULTS

In total 101 Albanians and 101 Greek patients were analyzed. A significantly higher prevalence of H. pylori in Albanians compared to Greeks was observed (54% vs 34%, p=0.005, OR 2.3, 95%CI 1.3-4.0). There were no differences in H. pylori prevalence among sex or age groups. Active gastritis was significantly more frequent in Albanians compared to Greeks (48% vs 32%, p=0.02, OR 2.0, 95%CI 1.3-2.6).

CONCLUSION

This is the first attempt in western Balkans to demonstrate by routine gastroscopy and biopsy that there is a significantly higher prevalence of H. pylori and active gastritis in Albanians as compared to Greeks.

The epidemiology of Helicobacter pylori and public health implications

This article presents a review of the literature on the epidemiology and public health implications of Helicobacter pylori infection published from April 2008 through to March 2009. The authors used MeSH terms "Helicobacter infections epidemiology,""Helicobacter infections prevention and control" to search multiple databases (PubMed, Embase, Cochrane, Cochrane Library, EBMR, BIOSIS), and independently searched PubMed using the term "Helicobacter" with "Epidemiology,""Transmission,""Prevalence" or "Environment." Articles without topical relevance were excluded. Two additional papers known to the authors were added. The identified literature is summarized by subtopic: reviews; prevalence; incidence; transmission; risk factors; and public health policy.

Differences in peptic ulcer between the East and the West

PUD affects both the East and the West. The magnitude of the problem, however, varies within these regions. The study of peptic ulcer epidemiology is impeded by the paucity of general population-based data, invasiveness of diagnostic tests, and variable access to testing facilities. As such, direct comparisons of PUD epidemiology between the East and the West are difficult. The prevalence rates of H pylori are highly variable and depend greatly on the local sanitation conditions. The use of NSAIDs and aspirin is ubiquitous and increasing especially for the antiplatelet activity of aspirin in the prophylaxis of cardiovascular events. There is evidence that pharmacogenetics play a role in susceptibility to the ulcerogenic properties of NSAIDs. The prevalence of PUD parallels the risk factors, but emerging in both the East and the West is idiopathic PUD, now a substantial proportion of ulcers in areas of declining H pylori infection. Genetic polymorphisms affect the efficacy of treatment using PPIs. Local H pylori resistance rates also influence the eradication success rates.