Prevalence Of Helicobacter Pylori Infection Research Articles

Prevalence of Helicobacter pylori Infection, Its Virulent Genotypes, and Epstein-Barr Virus in Peruvian Patients With Chronic Gastritis and Gastric Cancer.

PURPOSEHelicobacter pylori (HP) and Epstein Barr virus (EBV) infections induce chronic gastritis (CG) and are accepted carcinogenics of gastric cancer (GC). Our objective for this study was to determine the prevalence of these agents and clinicopathological features of GC and CG associated with the infection.PATIENTS AND METHODSA single-center cohort of 375 Peruvian patients with GC and 165 control subjects with CG were analyzed. Evaluation of HP and EBV genes was performed through quantitative polymerase chain reaction.RESULTSPrevalence of HP was 62.9% in the whole population and 60.8% in the GC subset. The cagA gene was detected in 79.9%; vacAs1 and vacAm1 alleles in 41.6% and 60.7%, respectively; and concurrent expression of vacAs1 and vacAm1 in 30.4% of infected patients in the whole series. The prevalence of EBV was 14.1% in the whole population and was higher in GC (P < .001). Coinfection of HP and EBV was found in 7.8% and was also higher in GC in univariate (P < .001) and multivariate (P = .011) analyses. Infection rates of HP and EBV were not associated with a geographic location in the whole series. Few clinicopathological features have been associated with infectious status.CONCLUSIONPrevalence of HP infection and virulent strains are high in the Peruvian population. Infection by EBV was more frequent in patients with GC.

Application of Helicobacter pylori stool antigen test to survey the updated prevalence of Helicobacter pylori infection in Taiwan.

The reported prevalence of Helicobacter pylori infection in Taiwan was 54.4% in 1992. An updated prevalence of H.pylori infection in asymptomatic adults is lacking in Taiwan. We aimed to assess the updated age-standardized prevalence of H.pylori infection in asymptomatic subjects and in patients with dyspepsia and to assess the accuracy of H.pylori stool antigen (HpSA) test for screening of H.pylori in Chinese population. Asymptomatic adult subjects (N=189) were screened for H.pylori infection using HpSA, serology, and 13 C-urea breath test (13 C-UBT) in 2016-2017. Adult patients with dyspepsia (N=145) were screened for H.pylori using 13 C-UBT, HpSA, serology, rapid urease test, and histology during 2016-2018. Two types of HpSA, including the Diagnostec HpSA ELISA Kit (HpSA ELISA) and Rapid Test Kit (HpSA Rapid), were used in this study. Sensitivity, specificity, and accuracy of the HpSA tests were calculated using the 13 C-UBT as golden standard test. The unadjusted prevalence of H.pylori was 21.2% in asymptomatic adults and 37.9% in patients with dyspepsia (P<0.001). The age-standardized prevalence of H.pylori was 28.9% in asymptomatic adults in Taiwan. Of the 334 patients included for analysis, the area under the curve of HpSA ELISA test was 0.978, and the optimal cutoff value of optical density was 0.03. The sensitivity, specificity, and accuracy of the HpSA ELISA were 0.929, 0.983, and 0.967, respectively. The sensitivity, specificity, and accuracy of the HpSA Rapid were 0.929, 0.958, and 0.949, respectively. The prevalence of H.pylori infection has decreased in Taiwan. HpSA test is an accurate tool for screening of H.pylori in Chinese population.

Review: Helicobacter pylori in pediatrics.

Despite a decrease in the prevalence of Helicobacter pylori infection, it still poses a significant health burden worldwide. This review summarizes important pediatric studies on Hpylori published from April 2018 to March 2019. Epidemiologic studies have reported different prevalences in different parts of the world and have mainly confirmed traditional risk factors. Several studies on pathophysiology attempted to identify risk markers in childhood for gastric cancer development later in life. One of the most interesting studies evaluated the relationship between eosinophilic esophagitis and Hpylori infection; however, an inverse relationship was not confirmed. The high resistance of Hpylori and, consequently, low eradication rates, is still a major concern and susceptibility testing before treatment has again been highlighted. Potassium-competitive acid blockers are promising new acid-suppressant drugs but their role in Hpylori eradication schemes is still to be determined.

Primary antimicrobial resistance rates and prevalence of Helicobacter pylori infection in the north of Spain. A 13-year retrospective study

ObjectiveHelicobacter pylori resistance to antimicrobial agents is on the rise and it is thus imperative to be aware of local resistance rates. The main objective of the present study was to describe the evolution of primary antimicrobial resistance in H. pylori, analysing its antibiotic susceptibility over a 13-year period in a region of northern Spain, as well as host-related factors. Patients and methodsBetween 2004 and 2016 a total of 3426 patients who met the H. pylori eradication criteria underwent gastroscopy. The gastric biopsies were processed and those testing positive for H. pylori were identified and tested for clarithromycin, metronidazole and levofloxacin susceptibility using E-test. ResultsH. pylori was isolated in 1604 (47%) patients, ranging from 63% (133/212) in 2004 to 39% (137/347) in 2016. Primary resistances to clarithromycin, metronidazole and levofloxacin were on average 19% (278/1116), 40% (572/865) and 17% (137/669), respectively. Clarithromycin resistance was 24% (167/686) in females and 15% (11/753) in males (p=0.0002); metronidazole resistance was 29% (72/246) in patients over 70 years compared to 42% (499/1190) in younger patients (p=0.0396); levofloxacin resistance increased with age, being 13% (57/439) in patients ≤55 years, 19% (46/236) for those between 56 and 70, and 26% (34/130) in patients >70 years (p=0.0087). DiscussionA decline in the prevalence of H. pylori infection was observed over the years, along with relatively high rates of primary resistance to clarithromycin, metronidazole and levofloxacin. Variations in resistance rates were found with sex and age.

Linked color imaging confers benefits in profiling H. pylori infection in the stomach.

Abstract Background and study aims There is a high prevalence of Helicobacter pylori infection. White light endoscopy (WLE) can be used for evaluating the mucosal lesions, but it does not have high diagnostic efficiency. Linked color imaging (LCI) is a newly developed endoscopic imaging technique. The aim of this study was to compare LCI with WLE in detecting and staging H. pylori infection in the stomach in a randomized controlled clinical trial. Patients and methods A total of 253 patients who had indications for gastroduodenoscopy were enrolled and randomized into Group A (n = 127), who underwent WLE followed by LCI, and Group B (n = 126), who underwent LCI followed by WLE. Clinical data were collected and the diagnostic accuracy of WLE and LCI was calculated and compared. Results The overall diagnostic accuracy of WLE and LCI for H. pylori infection was 31.5 % (n = 40) and 50.4 % (n = 64) in Group A (P = 0.001), and 36.5 % (n = 46) and 49.2 % (n = 62) in Group B (P = 0.029). In both groups, LCI had higher sensitivity, specificity, and Youden index scores than WLE. Four stages were defined in the course of H. pylori infection in the stomach. LCI staging results were more highly consistent with pathological staging than were WLE staging results (kappa value 0.772 vs. 0.516). The LCI observations were closely correlated with the pathology. Conclusion LCI had a higher diagnostic efficacy for H. pylori infection in the stomach. Endoscopic color features under LCI can help to stage and profile H. pylori-associated gastritis.

Prevalence of helicobacter pylori in diabetes patients and health workers at a tertiary hospital in south west Nigeria

Objective: Helicobacter Pylori (H.P) is a common bacterial infection that has been associated with diabetes mellitus (DM). The aim of the study was to determine the prevalence of Helicobacter pylori infection in patients with DM and the association with anthropometry, duration of DM and medication.Method: A cross sectional study involving consecutive recruitment of 193 subjects; 99 diabetics attending the outpatient clinic and 94 controls from hospital staffs. The Heliprobe urea breath test was used in the detection of H.P.Results: The prevalence of H.P was 96.8% in the controls and 85.6% in the diabetics (X2 =7.56, P =0.006) with significant female preponderance among the diabetics (X2 =7.01, P=0.008). H.P had no significant association among the diabetics with regards to BMI, duration of DM and medication.Conclusion: The prevalence of Helicobacter pylori was higher in the control than the diabetics.Keywords: Helicobacter pylori, diabetes mellitus, tertiary hospital

Prevalence of Helicobacter pylori infection and antibiotic resistance profile in Armenia

BackgroundThe prevalence of Helicobacter pylori infection was never assessed in Armenia, nor was the prevalence of H. pylori resistance against the main antibiotics concerned, despite the fact that these data are fundamental to establish evidence-based recommendations for management of this infection. We aimed to fill this gap by assessing prevalence of H. pylori among adult population in Armenia and resistance of H. pylori strains to clarithromycin and levofloxacin.MethodsHelicobacter pylori seroprevalence was determined in 217 asymptomatic adult subjects submitted to a health checkup using an ELISA. Molecular methods were used to detect H. pylori in gastric biopsies from 91 adult dyspeptic patients [55 (60.4%) were positive] as well as the mutations associated with clarithromycin resistance by real-time PCR and with levofloxacin by sequencing the gyrA QRDR.ResultsHelicobacter pylori seropositivity was found to be 41.5% globally and increased with age from 13.6% (age 18–25 years) to 83.3% (age > 65 years). Only two cases were found with a A2142/43G mutation causing clarithromycin resistance, and 6 cases showed mutations associated with levofloxacin resistance.ConclusionsHelicobacter pylori infection is estimated to be about 42% among adults in Armenia and the low clarithromycin resistance allows the use of the standard triple therapy as a first line therapy.

Helicobacter pylori Infection in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis.

Background/AimsInsufficient systematic reviews were conducted in the previous meta-analyses about the prevalence of Helicobacter pylori infection in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the prevalence of H. pylori infection in patients with CKD.MethodsA systematic review of studies that evaluated the prevalence of H. pylori infection in patients with CKD compared to a control group was performed. Only studies with adult patients were included, and studies with renal transplant recipients or diabetic nephropathy patients were excluded. Random-effects model meta-analyses with sensitivity analyses and subgroup analyses were conducted to confirm the robustness of the main result. A meta-regression analysis was conducted to explore the influence of potential heterogeneity on the outcomes. The methodological quality of the included publications was evaluated using the Risk of Bias Assessment tool for Nonrandomized Studies. Publication bias was also assessed.ResultsIn total, 47 studies were identified and analyzed. The total prevalence of H. pylori infection was 48.2% (1,968/4,084) in patients with CKD and 59.3% (4,097/6,908) in the control group. Pooled analysis showed a significantly lower prevalence of H. pylori infection in patients with CKD (vs control group: odds ratio, 0.64; 95% confidence interval, 0.52 to 0.79). Sensitivity analyses revealed consistent results, and meta-regression analysis showed no significant confounders. No publication bias was detected.ConclusionsThe results of this study suggest a lower prevalence of H. pylori infection in patients with CKD.

Sex differences in the prevalence of Helicobacter pylori infection: an individual participant data pooled analysis (StoP Project).

Helicobacter pylori (H. pylori) infection is more frequent among men, though the magnitude of the association might be inaccurate due to potential misclassification of lifetime infection and publication bias. Moreover, infection is common, and most studies are cross-sectional. Thus, prevalence ratios (PRs) may be easier to interpret than odds ratios (ORs). The aim of this study was to quantify the association between sex and H. pylori infection using controls from 14 studies from the Stomach Cancer Pooling (StoP) Project. H. pylori infection was defined based on IgG serum antibody titers or multiplex serology. Participants were also classified as infected if gastric atrophy was present, based on histological examination or serum pepsinogen (PG) levels (PG I≤70 and PG I/II ratio≤3). Summary ORs and PRs, adjusted for age, social class and smoking, and corresponding 95% confidence intervals (CIs), were estimated through random-effects meta-analysis. Men had significantly higher OR (OR: 1.33, 95% CI: 1.04-1.70) and PR (PR: 1.05, 95% CI: 1.00-1.10) of infection, with stronger associations among hospital-based or older controls. Results were similar when considering the presence of gastric atrophy to define infection status, particularly among participants older than 65 years. This collaborative pooled-analysis supports an independent effect of sex on the prevalence of H. pylori infection, while minimizing misclassification of lifetime infection status and publication bias.

Su1262 – Prevalence of Helicobacter Pylori Infection in Patients with Functional Dyspepsia and Effects of Eradication on Symptoms- Urban Indian Scenario

Su1262 – Prevalence of Helicobacter Pylori Infection in Patients with Functional Dyspepsia and Effects of Eradication on Symptoms- Urban Indian Scenario

Relationship between type II diabetes mellitus and Helicobacter pylori infection in Erbil city

Background and objective: Type 2 diabetes mellitus is a metabolic disorder characterized by the increase in blood glucose due to insulin resistance or deficiency of insulin. The subjects are more likely to be prone to infection. So, it could be correlated with Helicobacter pylori infection, which means that gastrointestinal inflammation might be affected by uncontrolled glycemic level. This study aimed to examine the correlation of type II diabetes and infection of gastrointestinal in order to illustrate such complication of diabetes mellitus apart from others. Methods: A total of 64 persons from Erbil city participated in this cross-sectional study. They were divided into two groups, each group involving 32 persons. The cases group included those suffering from type II diabetes and were selected by simple random sampling method. The other group included those not possessing any types of disease including diabetes mellitus. Examination of Helicobacter pylori, glycated hemoglobin (HbA1c), besides measuring blood pressure and body mass index were performed for all individual subjects in both groups. Chi-Square and unpaired t-test were used for data analysis. Results: There was a 59% positively Helicobacter pylori in diabetes group whereas there was a 31% positively Helicobacter pylori in non-diabetes mellitus. The difference between the rates of Helicobacter pylori in both groups was statistically significant (P <0.05). Conclusion: The prevalence of Helicobacter pylori infection in diabetics was significantly higher than the non-diabetics.

Initial Trials With Susceptibility-Based and Empiric Anti-H. pylori Therapies in Mongolia.

Background: Mongolia has a high prevalence of Helicobacter pylori infection and gastric cancer. We conducted a prospective, randomized, single-blind study to evaluate the efficacy of common regimens in Mongolia and to obtain specimens for susceptibility testing.Methods: Empiric treatments: 270 patients with confirmed H. pylori infection were randomized to receive 10 days clarithromycin-triple therapy (Clari-TT) (n = 90), modified bismuth quadruple therapy (M-BQT) (n = 90), or sequential therapy (ST) (n = 90). A second group of 46 patients received susceptibility-based Clari-TT. H. pylori was cultured from 131 patients and susceptibility testing was performed. H. pylori eradication was confirmed by stool antigen 4 weeks after the therapy.Results: Intention-to-treat (ITT) analysis cure rates were 71.1% (95% CI = 61.7–80.5%) for Clari-TT, 87.8% (95% CI = 81–94.6%) for M-BQT, 67.8% (95% CI = 58.1–77.5%) for ST vs. 89.1% (95% CI = 86–98.2%) for susceptibility-based Clari-TT. Per-protocol (PP) analysis results for these therapies were 72.7% (63.4–82%), 89.8% (83.5–96.1%), 68.5% (58.8–78.2%), and 97.6% (89.5–99.8%), respectively. Among 131 cultured H. pylori, resistance rates to amoxicillin, clarithromycin, and metronidazole were 8.4, 37.4, and 74%, respectively.Conclusion: In Mongolia, the prevalence of H. pylori resistance is high requiring bismuth quadruple therapy or susceptibility-based therapy to obtain acceptable cure rates.

Gastric Cancer in Northern Canadian Populations: A Focus on Cardia and Non-Cardia Subsites.

In northern Canada where there is a high prevalence of Helicobacter pylori infection, there is a paucity of information on gastric cancer by the topographical subsites cardia (CGC) and non-cardia (NCGC). Here we describe the incidence of CGC and NCGC, separately, among northern Canadian populations. We used data from the Cancer Incidence in Five Continents Volumes X (CI5X) and XI (CI5XI) to obtain CGC and NCGC incidence for Canada and for Yukon (YT), a northern Canadian territory. Using these data with those provided by the Government of the Northwest Territories (NT), we estimated standardized incidence ratios comparing northern populations to Canada as a whole. We also estimated age-standardized incidence rates to permit comparisons across populations globally. NT and YT populations were disproportionately impacted by gastric cancer, particularly NCGC. This was especially true for Indigenous populations: NCGC incidence rates among NT Indigenous men were 2.7 times the rates among all men in Canada, while rates among NT Indigenous women were 3.1 times the rates among all women in Canada. Similarly, age-standardized rates of NCGC among Indigenous NT residents were comparable to global regions where there is a high burden of NCGC. This study has, for the first time, quantified the incidence of CGC and NCGC for the NT and YT, providing new insights into the burden of these cancers among northern Canadian populations.

Prevalence rate of Helicobacter pylori infection among population of Ryazan region

Aim. Determination of the prevalence of Helicobacter pylori (H. pylori) infection among the population of the Ryazan region.&#x0D; Materials and Methods. 833 individuals (809 adults and 24 children) were examined for presence of IgG class antibodies using the enzyme immunoassay (2017-2018). The criteria for inclusion into the study were: a desire of a patient to undergo examination for the presence of antibodies to H. pylori in blood. Criteria for exclusion: past treatment for helicobacteriosis. The presence of helicobacteriosis was determined by enzyme immunoassay for quantitative detection of IgG class antibodies (anti-H. pylori IgG) using BCM Diagnostics Helicobacter pylori IgG (USA) test system and for qualitative determination of IgG antibodies to H. pylori in blood serum on IMMULITE 2000 (Germany; test IMMULITE 2000 H. pylori IgG). Sensitivity of the used test systems was 95.0%, specificity 98.0%.&#x0D; Results. High contamination of adult residents of Ryazan with H. pylori 65.6% was found (70.6% of males, 64.4% of females). Prevalence of H. pylori infection among adults in 2017 was 64.4% and in 2018 70.2%, however, the observed increase in the number of infected individuals was not statistically significant (p0.05). The highest prevalence of H. pylori infection was observed in individuals 40 years of age (67.2%). Gender-related differences in the prevalence of Helicobacter pylori infection were revealed in individuals of 40 years and older. H. pylori infection in males of 40 years was 75.2%, against 65.5% in females of the same age (p0.05). In children of 4-16 years, the share of individuals with positive serological test with anti-H. pylori IgG reached 20.8%. All H. pylori infected children were above 9 years of age. Individuals with positive serological tests received consultation of a gastroenterologist, and on indications underwent additional examination with administration of eradication treatment. In patients with indefinite results the examination was repeated after a week and/or the presence of H. pylori antigen in feces was determined.&#x0D; Conclusion. The data obtained indicate a high level of infection with H. pylori in the adult population in the Ryazan region 65.6%. The incidence of detection of anti-H. pylori IgG in the population was maximal in individuals 40 years (67.2%).

Time trends in the incidence of esophageal adenocarcinoma, gastric adenocarcinoma, and superficial esophagogastric junction adenocarcinoma.

In Japan, the incidence of esophageal adenocarcinoma (EAC) and esophagogastric junction (EGJ) adenocarcinoma is expected to increase and that of gastric adenocarcinoma (GAC) is expected to decrease due to Westernization of the diet and the decreasing prevalence of Helicobacter pylori infection. However, few reports about these trends have included the latest data, and no reports about the time trend in the incidence of EGJ adenocarcinoma have focused on the etiologies (gastric cardia adenocarcinoma or EAC, including Barrett's adenocarcinoma). We therefore investigated the time trends in the incidence of these cancers by including the latest data. First, we investigated the time trends in EAC and GAC using population-based cancer registry data in Osaka Prefecture (1985-2014). We then investigated the time trend in superficial EGJ adenocarcinoma with clinicopathological features at Osaka International Cancer Institute (2006-2017). From 1985 to 2014 in Osaka Prefecture, the incidence of EAC gradually increased in both sexes, while that of GAC in men did not significantly change and that in women decreased. The ratio of the EAC/GAC incidence increased 3.5 times in men and 1.8 times in women. In the secondary time trend survey for EGJ adenocarcinoma, the numbers of patients with endoscopic Barrett's esophagus and those without gastric mucosal atrophy increased, and the number of patients with lesions located above the EGJ line and histologically diagnosed as Barrett's adenocarcinoma increased. The incidence of EAC and superficial EGJ adenocarcinoma with characteristics similar to those of EAC, including Barrett's adenocarcinoma, might be increasing.

THE EXPERIENCE OF THE USE DATA OF PROPHYLACTIC EXAMINATION FOR EPIDEMIOLOGICAL STUDIES

The experience of the use data of prophylactic examination in working groups for epidemiological studies is presented. A prevalence of chronic and background diseases in different age and gender groups is demonstrated as well as a prevalence of Helicobacter pylori infection among the population and the shift in the work impact on the risk of health impairment in female workers. Data obtained can be used for the clinical and epidemiological analysis of the relationships between diverse pathologies and environmental and occupational factors with the view of optimization of financial expenditures. Data on prophylactic examinations are particularly valuable for the estimation the recent population health and environment to make decisions for prevention of widespread diseases.

TIME TRENDS OF HELICOBACTER PYLORI PREVALENCE IN ITAJAÍ - SC: A RETROSPECTIVE STUDY OF 25 YEARS BASED ON ENDOSCOPIC DATABASE.

The bacterium Helicobacter pylori is strongly associated with the development of gastric adenocarcinoma. Currently, the prevalence in developed countries is 40%, but this value increases considerably in developing countries, which can reach rates bigger than 90%. The objective of this study was to determine the mean and annual prevalence of Helicobacter pylori infection in patients from Itajaí during the period from July 1992 to April 2016, as well as the gender and age groups most affected. After consent of the clinical director of the Gastroclinica Itajaí and confidentiality commitment about the research, the database of the Endoscopy Service of the clinic was evaluated. All the patients who underwent their first upper digestive endoscopy with urease test and/or histological analysis were included. The data were submitted to statistical analysis of prevalence by gender, age group and years of study, with subsequent correction through the confidence interval. The mean prevalence of Helicobacter pylori infection thru all years of study was 50.07%. With the calculation of the annual prevalences, it was evident the gradual reduction of infection in the population of Itajaí, that was 81.3% in 1992, declining to 33% in the year of 2016. When classifying the prevalence of infection by gender, it was higher in males (53.59%), and gender distribution by age group showed no statistically significant difference among genders between the ages of 40 and 80 years. In relation to the age group, the highest prevalence was in the group between 40 and 49 years. Although this study is retrospective and based on endoscopic database analysis, without access to clinical data of patients such as prior use of proton pump inhibitor and antibiotics to endoscopy, its results are important because they may reflect the current panorama of Helicobacter pylori infection in the city under study, where it has been presenting a gradual reduction of prevalence over the years, with current rates similar to that of developed countries (33%). Future studies are needed to confirm our data.

Helicobacter pylori: qué debemos saber en el año 2018. Revisión de la evidencia y nuevas recomendaciones de tratamiento

Helicobacter pylori (HP) is the most widely chronic human infection around the world, and&#x0D; the main risk factor for the development of gastric cancer. Our country has high rates of&#x0D; this neoplasia and a high prevalence of HP infection. Even both have fallen in the last year,&#x0D; is a major concern to diagnose the population infected with HP in early stages, before the&#x0D; development of premalignant lesions and properly eradicate this infection. In this review, we&#x0D; discussed the different methods for the diagnosis of HP and factors that change positivity&#x0D; as the use of proton pump inhibitors. Also, we discussed the factors to be considered in the&#x0D; choice of the treatment, like local resistance to antibiotics, specially clarithromycin. In the last&#x0D; years has been documented in Chile a significant increase in resistance to clarithromycin, from&#x0D; 20 to 46%, which predicts inadequate effectiveness for the classic triple therapy. As the result&#x0D; of the previous analysis we discussed new possible therapies, including bismuth quadruple&#x0D; therapy and concomitant therapy.

Prevalence of Helicobacter pylori infection in patients with gastric ulcer perforation admitted in a tertiary care centre

Background: Gastric ulcers are one of the most prevalent gastro intestinal diseases. Perforation of gastric ulcer is most common and dreaded complication of a gastric ulcer. Causes of gastric ulcer include Helicobacter Pylori, the NSAID, smoking and alcohol. Helicobacter Pylori infection is a curable cause of gastric ulcer. As prevalence of H. pylori differ in populations, prevalence of H. pylori in our population need to be assessed for determining treatment strategy for gastric ulcer.Methods: Cross sectional study conducted in patients operated for perforation peritonitis and diagnosed to have gastric ulcer perforation in a tertiary care centre. Full thickness biopsy was taken from gastric ulcer perforation edge during the surgery for perforation peritonitis. The biopsy was stained with Giemsa stain and looked for the presence of H. pylori.Results: Helicobacter pylori prevalence was 48.8% in our study. 8 females (out of 16) and 51 males (out of 105) had H. pylori positivity. 43 had history of smoking. Among them 20 were diagnosed to be having H. pylori positive. 26 persons had history of pan chewing. Among pan chewers 17 were H. pylori positive. Among 50 patients with history of alcoholism, 24 got H. pylori positivity. Among 40 patients with history of NSAIDs, 14 were positive for H. pylori.Conclusions: Prevalence of Helicobacter pylori in gastric ulcer perforation in present study is 48.8%. Helicobacter Pylori eradication should be added in treatment protocols for perforated gastric ulcers.

Prevalence of Helicobacter pylori infection in Sari Northern Iran; a population based study.

In this study prevalence rate of Helicobacter pylori and its associated factors have been investigated in urban and rural areas of Sari. Helicobacter pylori has an important role in gastrointestinal diseases including peptic ulcer and gastric cancer. It is the most common infection in human population worldwide. Hence, the epidemiology of this infection in all parts of the world is of utmost importance. We conducted a cross-sectional study on 497 individuals ranging 15-65 years of age in Sari city and its surrounding rural residents. The sampling method was a cluster random sampling multi staged in stratified population by urban and rural areas. Questionnaires for personal and socio-economic data were filled. Blood samples were drawn and kept for analysis (IgG antibody ELISA for Helicobacter pylori). The data was analyzed by SPSS statistical software and Chi-square test and logistic regression were used. The prevalence of helicobacter infection was 44.5% in the studied population. This prevalence was 41.3% and 47.8% in urban and rural areas, respectively. Just a significant association between the infection and the age of subjects was observed in multiple regression analysis (p=0.001). However, in univariate analysis the level of education was also significantly associated with Helicobacter pylori infection (p=0.015). No other variable was associated with the infection. The prevalence of helicobacter infection has dropped significantly in the region in comparison with the previous studies during the last 15 years.