Abstract
Most of the Helicobacter pylori infections occur in developing countries. The risk factors for H. pylori infections are poverty, overcrowding, and unhygienic conditions, which are common problems in under-privileged countries such as Nepal. Despite having a high risk of H. pylori infections, no national level study has been conducted to assess prevalence and correlates of H. pylori infection in Nepal. Therefore, we hypothesized that micronutrients such as iron, vitamin B12 deficiency, socio-economic status, and nutritional status correlate with the prevalence of H. pylori infection in Nepal. We studied prevalence and correlates of H. pylori infection among under-five children, adolescents aged 10-19 years and married non-pregnant women aged 20-49 years using data from the Nepal National Micronutrient Status Survey 2016 (NNMSS-2016). H. pylori infection was examined in stool of 6-59 months old children and 20-49 years old non-pregnant women whereas the rapid diagnostic kit using blood sample was used among adolescent boys and girls. Prevalence of H. pylori infection was 18.2% among 6-59 months old children, 14% among adolescent boys and 16% among adolescent girls aged 10-19 years; and 40% among 20-49 years non-pregnant women. Poor socioeconomic status, crowding, and unhygienic condition were found to be positively associated with higher incidence of H. pylori infections. No significant correlation was observed between nutritional and micronutrients status (iron or risk of folate deficiency) with H. pylori infection. Findings from this study suggest that poverty-associated markers are primary contributors of H. pylori infections in Nepalese communities. To control acquisition and persistence of H. pylori infection in Nepal, we suggest improved management of safe drinking water and implementation of sanitation and hygiene programs, with a focus on those of lower socioeconomic status.
Highlights
Helicobacter pylori, a gram-negative spiral-shaped bacterium previously known as Campylobacter pyloridis, was first isolated and identified by Warren and Marshall in 1982[1]
Study findings revealed a higher prevalence of H. pylori infection among participants aged 4–5 years (26%), a lower prevalence observed among participants aged below one year (9%), and that the prevalence of H. pylori increases increased with age
The higher prevalence of H. pylori infection was observed in Muslims and Dalits as compared to Brahmins/Chhettris
Summary
Helicobacter pylori, a gram-negative spiral-shaped bacterium previously known as Campylobacter pyloridis, was first isolated and identified by Warren and Marshall in 1982[1]. It colonizes the gastric milieu of more than half of the global population and is associated with gastric diseases such as peptic ulcer, chronic gastritis, gastric cancer, and mucosa associated lymphoid tissue (MALT) lymphoma[2, 3]. H. pylori is responsible for iron deficiency anemia, thrombocytopenia, fetal malformation, and fetal growth retardation in pregnant women. Epidemiological studies suggest that anemia due to iron deficiency is correlated with H. pylori infection. H. pylori infection associated as a protective factor for the diseases such as asthma, osteoporosis, inflammatory bowel disease, and esophageal cancer[4, 11, 12]
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