Pylori Prevalence Research Articles

Management of patients with chronic gastritis after H. pylori eradication

Objective — to study the prevalence of H. pylori infection in patients with organic and functional dyspepsia in the central region of Ukraine and to perform clinical and morphological evaluation of the efficacy of “Gialera” preparation in the complex treatment of patients with chronic gastritis after H. pylori eradication.
 Materials and methods. To assess H. pylori prevalence, an analysis of endoscopic data and the frequency of contamination of the gastric mucosa with H. pylori was carried out in 5903 gastroenterological patients aged 18 to 94 years. The study was multicenter, multiplicative cross‑sectional and lasted from the year 2016 to 2022. The average age of patients was 50.5±15.6 years, there were 3188 (54.0%) women and 2715 (46.0%) men. The presence of H. pylori infection was assessed using a 13C‑urease breath test, performed according to the standard method before the start of the treatment. Sixty patients with chronic gastritis, who, after successful eradication of H. pylori, confirmed by a repeated 13C‑urease breath test, had dyspeptic symptoms after 1 month, were transferred to the second stage of the study. A multicenter, randomized, blinded, comparative study was conducted to evaluate the efficacy and safety of Giallera in the complex treatment of dyspepsia in patients with chronic gastritis after H. pylori eradication. The patients were divided into 2 groups: the first group — 30 patients received a proton pump inhibitor (PPI) in a dose of 40 mg/day and Gialera, the second group — 30 patients received only PPI in the same dose. In addition, in the presence of heaviness in the epigastrium, patients in both groups could take a prokinetic. All patients before and after treatment, in addition to clinical examination and assessment of the intensity of abdominal pain, underwent endoscopic examination of the esophagus, stomach and duodenum with a biopsy of the gastric mucosa. The biopsy was stained with hematoxylin and eosin, and PAS reaction and immunohistochemical study with tight junction sealing proteins claudins 1 and 7 were carried out.
 Results. Patients with functional dyspepsia predominate (51.1%) in the population of Ukrainian patients with lesions of the upper gastrointestinal tract, while patients with organic dyspepsia account for 46.1%, of which 52.8% have chronic gastritis with high H. pylori infection, which is the majority cases, eradication anti‑Helicobacter therapy is required. After eradication, some patients still have dyspeptic complaints in the presence of a morphological picture of chronic gastritis without signs of pronounced activity, with elements of gland atrophy with preserved mucus secretion, weak inflammatory cell infiltration and increased epithelial permeability with a decrease in the expression of sealing claudins.
 Conclusions. The use of combined therapy with Gialera resulted in a more rapid decrease in the intensity of abdominal pain and its stable absence after the end of treatment. Positive clinical symptoms in such patients are combined with improvement in morphological changes in the gastric mucosa (GM): minimization of histological signs of inflammation, improvement in mucosal formation and a tendency to stabilize the epithelial permeability of the GM, normalization of the expression of claudins 1 and 7.

Diagnostic Testing Accuracy for Helicobacter pylori Infection among Adult Patients with Dyspepsia in Cuba's Primary Care Setting.

Evidence of the effectiveness of the tests used to diagnose Helicobacter pylori (H. pylori) in primary healthcare is limited. This cross-sectional study aims to assess the accuracy of tests used for to diagnose H. pylori infection in primary care patients and its relationship with gastroduodenal pathologies. Over 12 months, 173 primary care patients with dyspeptic symptoms were referred for upper gastrointestinal endoscopy to obtain gastric biopsies, and venous blood was extracted from them. H. pylori infection was detected using a rapid urease test (RUT), real-time polymerase chain reaction (RT-PCR), H. pylori-IgG ELISA, and Western blot (WB). The culture and histological findings were used as the reference standard for H. pylori infection. H. pylori prevalence was 50%. There were no significant differences between men and women overall or by age group. The presence of H. pylori was associated with chronic moderate gastritis and its absence with chronic inactive gastritis, as well as the combination of gastritis and gastric lesions (p < 0.05). RUT and ELISA H. pylori -IgG tests showed the highest overall performance (accuracy 98.9% and 84.4%), followed by WB and RT-PCR (accuracy 79.3% and 73.9%). These findings support the notion that combined invasive and noninvasive methods, such as RUT and H. pylori-IgG ELISA, can be a primary diagnostic screening tool for detecting H. pylori among adult dyspeptic patients in Cuba's primary care setting.

H. pylori predictors and outcomes among adults undergoing upper endoscopy at a Jamaican teaching hospital: A cross-sectional study.

Recent data on the prevalence of H. pylori infection in Jamaica are lacking. It is postulated that there has been a decline in the prevalence of H. pylori infection and its associated complications. We determined sociodemographic characteristics, prevalence of H. pylori infection and clinical outcomes among adults undergoing esophagogastroduodenoscopy (EGD) and histology at the University Hospital of the West Indies (UHWI) between May 2018 and December 2020. A cross-sectional study of patients (≥18 years old), who underwent EGD and histological evaluation for H. pylori infection, was conducted. Associations of H. pylori positivity and gastric cancer with sociodemographic/clinical variables and endoscopic findings were determined by stepwise logistic regression using backward selection. Unadjusted and adjusted odds ratios with related 95% confidence intervals (Cis) were calculated for H. pylori positivity and gastric cancer status. There were 323 participants (mean age 58.6± 17.8 years, 54.2% females). H. pylori prevalence was 22.2% (n= 70 of 315), 5.6% had gastric neoplasia (GN), 15.5% gastric atrophy, 11.4% intestinal metaplasia and 3.7% dysplasia on histology. Mucositis (64.5%), gastric ulcer (14.9%), and duodenal ulcer (13.9%) were the most common endoscopic findings. Participants with peptic ulcer disease (PUD) (unOR=4.0; p= .017), gastric cancer (unOR=9.5; p= .003), gastric atrophy (unOR=12.8; p< .001), and intestinal metaplasia (unOR=5.0; p< .001) had a significantly higher odds of being H. pylori positive, but after multivariable analyses only gastric atrophy remained significant (aOR=27.3; p< .001). Participants with mucositis had a significantly lower odds of gastric cancer (unOR 0.1; p= .035) while participants with dysplasia had significantly higher odds (unOR 8.0; p= .042), but these were no longer significant after multivariable analyses (aOR=0.2; p= .156 and aOR=18.9; p= .070, respectively). Histology based prevalence of H. pylori infection is lower than previously reported in Jamaica. Gastric atrophy is a significant predictor of H. pylori positivity.

Serological Diagnosis and Epidemiological impact of Helicobacter pylori infection on human health in Diyala Governorate, Iraq

Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of stomach and duodenum ulcer as well as may be gastric cancer. The study showed that the incidence in diyala is nearly high comparing with the surrounding, little known about H. pylori prevalence in this population or other Native communities. In this cross-sectional study aimed to determine the prevalence of H. pylori among people subjects of different age groups ranged between 1 year to &gt;50 years old. Two hundred and fifty of blood samples were collected from patients admitted Teaching hospitals in Baqubaa city and subjected to serological screening test.&#x0D; The results revealed that the prevalence of H. pylori antibody in human blood samples were 75.2%. the results appeared that H. pylori in males were more infected than females as the rate78.1% among males compared with females’ infection rate was 70%. The study also showed that the high prevalence rate of H. pylori antibody in the blood of patient’s age group 31-40 years was (77.8%), followed by the age group of 41-50 years (76.2%). Regarding risk factors, smoker males were the most infected with H. pylori (78.4%) compared to smoker females (31.7%). The results concluded that, the seroprevalence of H. pylori among human in Diyala Governorate was very high, and the infection occurred at all ages, particularly the youth ages

Community prevalence of Helicobacter pylori and dyspepsia and efficacy of triple therapy in a rural district of eastern Uganda

BackgroundHelicobacter pylori (H. pylori) infection and chronic dyspepsia represent significant medical burdens in the developing world. An accurate assessment of the prevalence of chronic dyspepsia, as well as of the effectiveness of population-based screening and eradication of H. pylori are warranted. ObjectivesWe determined the prevalence of H. pylori and chronic dyspepsia within the general adult population in a region of eastern Uganda. Independent predictors of H. pylori infection were assessed. Finally, we evaluated the efficacy of standard triple therapy on H. pylori eradication. MethodsOf 400 randomly selected adult residents in eastern Uganda, 376 were administered a validated, chronic dyspepsia questionnaire and provided a stool sample for H. pylori testing. H. pylori-positive participants were given standard triple therapy and monitored for medication adherence. The efficacy of triple therapy on H. pylori eradication was determined by fecal antigen testing after treatment. Log-linear and logistic regression analyses identified predictors of H. pylori positivity and eradication failure. ResultsH. pylori prevalence within the study population was 48%. The prevalence of chronic dyspepsia was 87%. The presence or severity of dyspepsia did not predict H. pylori infection. However, a higher level of education was an independent predictor of H. pylori infection. Standard triple therapy resulted in ∼90% eradication. Missing at least four doses of any of the triple therapy medications over the 14-day course predicted eradication failure. ConclusionsIn our study population, chronic dyspepsia did not predict H. pylori infection, though clinical suspicion for this prevalent pathogen should nonetheless remain high. Population-based screening and adherence to triple therapy are effective at eradicating H. pylori within this region.

Serological Diagnosis and Epidemiological impact of Helicobacter pylori infection on human health in Diyala Governorate, Iraq

Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of stomach and duodenum ulcer as well as gastric cancer. The study showed that the incidence in Diyala is nearly high comparing with the surrounding, little known about H. pylori prevalence in this population or other Native communities. In this cross-sectional study aimed to determine the prevalence of H. pylori among people subjects of different age groups ranged between 1 year to &gt;50 years old. Two hundred and fifty of blood samples were collected from patients admitted Teaching hospitals in Baqubah city and subjected to serological screening test.&#x0D; The results revealed that the prevalence of H. pylori antibody in human blood samples were 75.2%. The results appeared that H. pylori in males were more than females as rate was 78% among males compared to females’ infection rate was 70%. The study also showed that the high prevalence rate of H. pylori antibody in the blood of patient’s age group 31-40 years was (77.8%), followed by the age group of 41-50 years (76.2%). Regarding risk factors, smoker males were the most infected with H. pylori (78.4%) compared to smoker females (31.7%). The results concluded that, the seroprevalence of H. pylori among human in Diyala Governorate was very high, and the infection occurred at all ages, particularly in the young people ages.

S641 Spectrum of Endoscopic Findings in Patients With Helicobacter pylori Infection in a Nigerian Tertiary Institution

Introduction: Helicobacter pylori (H. pylori) is a widely prevalent infection considered a significant public health challenge. It is a major cause of gastroduodenal disorders, including gastric cancer. Thus prompt diagnosis and treatment are required for eradication. Nigeria has the highest worldwide H. pylori prevalence. Aims: To determine the spectrum of endoscopic findings in patients with H.pylori infectionat a tertiary care academic medical center. Methods: This retrospective hospital-based study was conducted between April 2018 and April 2022 among patients aged ≥18 years with dyspepsia. H. pylori was evaluated using non-invasive tests (urea breath test and fecal antigen test). Patients who tested positive for H. pylori and were further assessed with upper gastrointestinal endoscopy were included in the study. Demographics, clinical data, and endoscopic findings were extracted for analysis. A descriptive analysis of data obtained was carried out using SPSS version 20. Results: One hundred and twenty-nine (129) patients tested positive for H. pylori infection out of the two hundred and eighty dyspeptic patients evaluated during the period under study. However, only fifty-two (52) out of 129 dyspepticpatients who tested positive for H.pylori were evaluated with upper gastrointestinal endoscopy and thus met the inclusion criteria. Thirty-one (59.62%) were males, and 21 (40.38%) were females. The mean age was 45.65 years, with a range of 21-76 years. (Figure) Upper gastrointestinal endoscopy among the patients revealed predominantly gastritis 37 (71.15%), with gastritis involving the corpus and antral area being the most typical form. Others were gastro-duodenitis in 4 (7.7%), esophagitis in 4 (7.7%), gastric ulcer in 3 (5.8%), and duodenal ulcer in 2 (3.8%), and gastric tumor in 2 (3.8%). Conclusion: Our study revealed that gastritis was the predominant endoscopic finding in patients with H. pylori infection. This finding is particularly significant because of the risk of progression of chronic gastritis in some of these patients to intestinal metaplasia, dysplasia, and gastric cancer. Hence, endoscopy with gastric biopsy should be obtained in patients with gastric erythema for early diagnosis and treatment.Figure 1.: Socio demographics and spectrum of the endoscopic images A- Sex distribution of the study population. B- Age distribution of the study population. C- Endoscopic findings of the study population. D- Endoscopic image showing a widespread patchy redness involving the corpus and the antrum. E- Endoscopic image of fungating gastric mass involving the body and the antrum. F- Endoscopic image of a Forrest III gastric ulcer located on the lesser curvature.

New insights regarding Helicobacter pylori infection in children

Helicobacter pylori (H. pylori) are one of the most common infections during childhood, and if left untreated it might persist lifelong resulting in severe complications such as gastric malignancies. The epidemiology of this infection has wide variations along the continents, countries and sub-regions being related mainly to the socio-economic status, hygiene and sanitary conditions. Nevertheless, a descending trend of H. pylori prevalence was noticed worldwide during the last decades, fact that might decrease in time the incidence of gastric cancer in adults. The diagnosis of this infection remains tricky in children and the selection of the most effective diagnostic tool is essential in order to early diagnose H. pylori associated gastropathies and extraintestinal manifestations. In spite of the lack of symptoms which occurs especially in pediatric subjects, H. pylori infection might result in severe damage to the gastric mucosa and further complications requiring close monitoring after the eradication regimen. Therefore, multiple non-invasive and invasive methods were designed to identify properly the presence of this bacterium within the individual’s stomach and for enabling the clinician to use to most adequate method based on its sensitivity and specificity, but also based on the specific clinical situations. Aside from the well-known standard triple therapy used for the eradication of this infection, multiple other regimens were lately proposed in order to prevent failure of eradication. Moreover, probiotics were recently proved to improve the eradication rate, and at the same time to decrease the side effects of the antibiotics therapy. The proper eradication of H. pylori infection during childhood remains the cornerstone in preventing gastric cancer during adulthood.

Worldwide Prevalence and Risk Factors of Helicobacter pylori Infection in Children.

Helicobacter pylori is usually acquired during childhood. The reports from the last two decades pointed out a decrease in H. pylori prevalence across geographical areas worldwide compared to previously reported data. Most of the studies performed in America found an overall H. pylori infection prevalence of approximately 50%. The most important risk factors in America include being male, poor adherence or difficult access to treatment, and the lack of in-home water service. Despite the descending trend in prevalence worldwide, the overall prevalence in Africa remains very high (70%). Nevertheless, the prevalence of H. pylori in children without gastrointestinal who underwent screening was reported to be only 14.2%. The main risk factors in Africa are having a traditional pit or no toilet, poverty, birth order, source of drinking water, or being a farmer. Asia seems to have the widest variations in terms of H. pylori prevalence. Several risk factors were reported in Asia to be associated with this infection, such as lower income and educational level, house crowding, rural residence, ethnicity, the use of tanks as water supplies, alcohol drinking, active smoking, eating spicy food or raw uncooked vegetables, poor living conditions and sanitation. The overall prevalence of H. pylori infection in European children is almost 25%. Portugal has the highest prevalence of all European countries at 66.2% in children 13 years of age. The risk factors in European individuals consist of living in rural areas, eating unwashed fruits and vegetables, not washing hands after school, low parental education and unemployment, and short education duration. Further studies are required to identify the precise mechanisms involved in the discrepancies of H. pylori prevalence worldwide.

Association of serum pepsinogens and gastrin-17 with Helicobacter pylori infection assessed by urea breath test.

BackgroundAssociation of gastric atrophy or cancer with levels of serum pepsinogens, gastrin-17 and anti-Helicobacter pylori IgG antibody have been extensively studied. However, the association of serum pepsinogen and gastrin-17 with H. pylori infection has not been studied in a large population.AimTo investigate the impact of H. pylori infection on serum levels of pepsinogens and gastrin-17.MethodsA total of 354, 972 subjects who underwent health check-ups were included. Serum levels of pepsinogens and gastrin-17 were measured using the enzyme-linked immunosorbent assay. H. pylori infection was detected using 14C-urea breath test (UBT). Multivariable logistic regression analysis was used to investigate the association of serum pepsinogen and gastrin-17 with H. pylori infection.ResultsH. pylori prevalence was 33.18% in this study. The mean levels of pepsinogens and gastrin-17 were higher, while the mean pepsinogen-I/II ratio were lower among H. pylori-positive than -negative subjects. In H. pylori-positive subjects, pepsinogen and gastrin-17 levels correlated positively, whereas the pepsinogen-I/II ratio correlated negatively with UBT values (e.g., the mean serum level of pepsinogen-I in subjects with UBT values in the range of 100-499dpm, 500-1499dpm, and ≥1500dpm was 94.77 ± 38.99, 102.77 ± 43.59, and 111.53 ± 47.47 ng/mL, respectively). Compared with H. pylori-negative subjects, the adjusted odds ratio (aOR) of having pepsinogen-I ≤ 70 ng/mL in the three H. pylori-positive but with different UBT value groups was 0.31 (p<0.001), 0.16 (p<0.001), and 0.08 (p<0.001), respectively; while the aOR of having G-17>5.70 pmol/L was 4.56 (p<0.001), 7.43 (p<0.001), and 7.12 (p<0.001). This suggested that H. pylori-positive subjects with higher UBT values were less likely to have pepsinogen-I ≤70 ng/mL (a serum marker for gastric atrophy), but more likely to have gastrin-17 >5.70 pmol/L (a marker for peptic ulcer).ConclusionsH. pylori-positive subjects with higher UBT values are unlikely to have gastric atrophy, but may have greater risk of severe gastritis or peptic ulcers. Our study suggests that H. pylori-positive patients with high UBT values may benefit the most from H. pylori eradication.

Helicobacter pylori infection prevalence in ambulatory settings in 2017-2019 in RUSSIA: The data of real-world national multicenter trial.

The recent data on the prevalence of Helicobacter pylori (H. pylori) infection in Russia are limited. The aim of the study was to compare Helicobacter pylori infection prevalence in ambulatory settings in Russia in 2017 and 2019 years. Subjects visiting primary care centers were invited to take part in the study. H. pylori status was assessed by 13 C-urea breath test (UBT). Data on subjects' demography, previous treatment exposure, and place of residence were collected in all federal districts of Russia in 2017 and in 2019 calendar years and processed centrally. The data of 19,875 subjects were available for analysis. The prevalence of H. pylori infection assessed by positive UBT in treatment-naive subjects was highest in the Southern (54.9%) and the North Caucasian (45.1%) federal districts. A significant difference (p < 0.05) in H. pylori prevalence between two testing periods was found only in a half of federal districts: the Central (46.2% in 2017 vs. 36.2% in 2019), the Northwestern (38.6% vs. 35.5% accordingly), the Volga (40.6% vs. 33.0%, accordingly), and the Ural (40.4% vs. 32.7%, accordingly). The lowest prevalence of H. pylori infection was revealed in the age group <18 years old (20.2%), while the highest in the age group of 41-50 years old (43.9%). In 2017, the prevalence of H. pylori was significantly (p < 0.05) higher than in 2019 in all age groups but younger than 18 and older than 70 y.o., where similar rates were found during both study periods. The prevalence of H. pylori according to 13 C-UBT testing of primary care visitors in Russia is lower than expected (38.8%). The highest prevalence of H. pylori infection found in the Southern and the North Caucasian federal districts of Russia and in the age group of 41-50 years old. This study was registered at clinicaltrials.gov (NCT04892238).

Prevalence and factors associated with Helicobacter Pylori infection among children with sickle cell anemia attending Mulago hospital, in Uganda.

Children with sickle cell anemia (SCA) have a high predisposition to a range of infections and gastrointestinal disorders. Studies of children living in low income countries have shown high levels of infection with Helicobacter Pylori (H. pylori), however, there are no reports in Ugandan children with SCA. We aimed to describe the prevalence and factors associated with H. pylori infection among children with SCA at Mulago Hospital. A cross-sectional study was conducted on 340 children with SCA aged 5-18 years. Assessments included recurrent abdominal pain(RAP), dyspeptic symptoms, relevant medical and social histories. Stool samples were collected and an antigen test carried out to determine H. pylori infection. H. pylori prevalence and its associated factors were determined. Helicobacter pylori infection was detected in 49%(168/340); (95%Confidence interval (CI): 44.1, 54.7) of the study subjects. Having epigastric pain was independently associated with H. pylori infection; (Adjusted odds ratio [aOR] = 1.89; 95%CI: 1.1, 3.6; p= 0.048). Pneumococcal vaccination; (aOR=0.425; 95%CI: 0.2, 0.9; p=0.019) and appetite loss; (aOR=0.588; 95%CI: 0.3, 0.9; p=0.046) were negatively associated with H. pylori infection. RAP was not associated with H. pylori infection. H. pylori infection was common among children with SCA and independently associated with epigastric pain but not recurrent abdominal pain. Pneumococcal vaccination and appetite loss were protective against the infection. Screening for H. pylori should be carried out in SCA children with epigastric pain.

Abstract 5863: The ABID (Assessing the gut microbiota and Individual Diet) Study in the Navajo Nation

Abstract A substantial burden of stomach cancer continues to be observed in American Indians (AI) in the Southwestern United States. The Navajo Nation, the largest tribe in the Southwest, is experiencing higher incidence of stomach cancer compared to the general population in the region, possibly due to high prevalence of Helicobacter pylori (H. pylori) infection and other contributing factors, like diet. To learn about factors linked to stomach cancer, we initiated a cross-sectional study to determine the prevalence, virulence, and dietary correlates of H. pylori infection among Navajo adults. We hypothesized that H. pylori infections, particularly with the virulent cagA gene, would be highly prevalent in Navajo adults compared to other non-AI populations, and that diets high in salt, processed meats, and low in vegetables would be associated with prevalent H. pylori infection. Study recruitment occurred from January to October 2021 in two geographic areas of the Navajo Nation. Participants were recruited using online and offline platforms, including social media (Facebook, Instagram), study website (www.theabidstudy.com), newspapers, flyers, word of mouth, and community outreach events. Eligible, consenting study participants provided a stool sample, which was analyzed by droplet digital PCR assays for H. pylori 16S gene detection and cagA virulence gene typing. Participants also provided health and food information through two questionnaires.Preliminary data indicate that prevalence of H. pylori is high in the included regions of the Navajo Nation. The H. pylori prevalence (51.5%, 95% CI: 38.9-64.0) in this study is higher than the prevalence in the US population (35%). Moreover, the cagA virulence gene prevalence in the Navajo with H. pylori was 55.9% (95% CI: 37.9-72.8), which is comparable to the US prevalence of 50%. These early results point to a need of developing prevention strategies to reduce H. pylori infection in the Navajo Nation. Citation Format: Dornell Pete, Amanda I. Phipps, Nina R. Salama, Johanna W. Lampe, Michael C. Wu. The ABID (Assessing the gut microbiota and Individual Diet) Study in the Navajo Nation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5863.

Asymptomatic Helicobacter pylori infection among rural children and adolescents in Bangladesh

Background and objectives: The Helicobacter pylori infection rate varies according to the age, location of the residence and socioeconomic status. The aim of the present study was to investigate the status of H. pylori infection among the asymptomatic Bangladeshi rural children and adolescents. Material and methods: This cross-sectional study was carried out in a rural area under Pabna district about 150 km north-west of capital Dhaka. Asymptomatic and apparently healthy rural children and adolescents aged 6 to 18 years were enrolled in the study. A structured questionnaire was used to record the socio-demographic and clinical information. The rate of H. pylori infection was determined by the presence of H. pylori antigen in faeces and/or anti-H. pylori IgG and/or IgA antibodies in blood. H. pylori stool antigen was detected by lateral flow chromatographic immunoassay and serum anti-H. pylori IgG and IgA antibodies were estimated by ELISA method. Results: A total number of 185 asymptomatic and apparently healthy children and adolescents were enrolled of which 34, 131 and 20 were in 6-10, 11-15 and 16-18 years age groups respectively. The overall H. pylori infection rate was 79.5% (95% CI: 0.729, 0.85) by positive stool antigen or by the presence of serum anti-H. pylori IgG/IgA antibodies. The rate of H. pylori infection significantly (p=0.05) increased with progress of age. H. pylori infection rate was 67.6%, 80.2% and 95% in 6-10, 11-15 and 16-18 years age groups respectively. The concentration of serum anti-H. pylori IgG/IgA antibodies did not differ across the age groups. The infection rate was significantly (p&lt;0.05) higher among the children of illiterate parents compared to the children of literate parents. Conclusion: The study demonstrated a high prevalence of H. pylori infection among children and adolescents in a rural setting. Gender and family history did not affect H. pylori prevalence but increasing age and poor educational status of parents were associated with a higher H. pylori prevalence. IMC J Med Sci 2022; 16(2): 007. DOI: https://doi.org/10.55010/imcjms.16.017 *Correspondence: J. Ashraful Haq, Department of Microbiology, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh. Email: jahaq54@yahoo.com

Persistent advanced periductal fibrosis is associated with cagA-positive Helicobacter pylori infection in post-praziquantel treatment of opisthorchiasis.

Liver fluke infection caused by Opisthorchis viverrini is associated with several hepatobiliary diseases including advanced periductal fibrosis (APF) and cholangiocarcinoma. Recently, we demonstrated a persistent APF in over one-third of opisthorchiasis patients after worm removal by praziquantel (PZQ) treatment. However, the underlying mechanism(s) of this phenomena is unclear. Given a co-infection with Helicobacter pylori (H. pylori) especially cagA-positive strain enhances APF, we hypothesized that H. pylori with CagA virulent factor contributes to persistent APF. Seventy-five opisthorchiasis patients who underwent ultrasonography and treatment with PZQ were recruited in the 2-year follow-up study. Helicobacter and its cagA in the feces were examined by conventional and qPCR. Correlations between prevalence or bacterial loads of Helicobacter spp., H. pylori, and cagA-positive H. pylori before and after PZQ treatment were analyzed among resolved, slowly resolved, relapsed, and persistent APF groups. Overall, prevalence of Helicobacter spp., H. pylori, and cagA-positive H. pylori declined after PZQ treatment. However, only the prevalence and bacterial loads of cagA-positive H. pylori detected at 2-year post-treatment were significantly lower than those before treatment (p < .05). In addition, both prevalence and bacterial loads of cagA-positive H. pylori were significantly lower in the resolved APF group after PZQ treatment, while there were no significant changes in the slowly resolved, relapsed, and persistent APF groups. Among the APF subgroups, cagA-positive H. pylori prevalence in both relapsed and persistent APF groups were significantly higher than the resolved APF group. The results support our hypothesis that H. pylori, especially cagA-positive strain, contributes to the relapsed and persistent APF. A supplementary antibiotic treatment for H. pylori to reduce persistent APF and eventually CCA is warranted.

Prevalence of Helicobacter pylori infection among resettled refugees presenting to a family medicine clinic in the United States.

BackgroundAlthough endemic to much of the global population, few studies have examined Helicobacter pylori (H. pylori) in US refugee populations. This study investigates the prevalence of H. pylori infection and barriers to treatment in the International Family Medicine Clinic (IFMC), a primary care refugee clinic, in central Virginia.Materials and MethodsWe conducted a chart review of 188 refugee patients of the IFMC who were referred for an H. pylori test between January 1, 2019, and December 31, 2020. Recorded measures included patient demographics, H. pylori test result, treatment of initial infection, completion of test of cure (TOC), TOC results, salvage therapy, and barriers to treatment. Binary logistic regression was performed to examine the association between demographic factors and H. pylori test results.ResultsOf the 171 patients who completed an H. pylori test, 94 tested positive (54.9%). Of the 93 patients that were subsequently treated, 76 were treated with clarithromycin triple therapy (82%). Forty‐eight patients (52%) completed a TOC after completing treatment, and 21 (43%) of these patients remained positive, indicating persistent infection. Eighteen patients (90%) who remained positive for H. pylori were subsequently treated with quadruple therapy. Patients under 18 (OR = 0.25, p < 0.01) and patients with a history of previous H. pylori (OR = 0.44, p < 0.05) were less likely to have positive results on initial H. pylori testing. Common barriers to treatment included pregnancy, religious observance (e.g., fasting), and health system complications (e.g., prior authorization for medications, cost of treatment).ConclusionsThe prevalence of H. pylori among refugees at the IFMC was higher than the overall prevalence estimate for the United States, which is consistent with previous studies. This work represents an updated picture of H. pylori prevalence among refugees in the United States and contributes to the identification of treatment barriers.

Is Helicobacter pylori prevalence associated with the family population

Is Helicobacter pylori prevalence associated with the family population

Breastfeeding Is Associated with Lower Likelihood of Helicobacter Pylori Colonization in Babies, Based on a Prospective USA Maternal-Infant Cohort.

Mother-to-child transmission of Helicobacter pylori (H. pylori) is the primary source of intrafamilial spread in early childhood in regions of high H. pylori prevalence. However, early-in-life H. pylori colonization and associated protective or risk factors have not been fully evaluated in lower prevalence regions, such as the USA. Therefore, from a well-characterized prospective US cohort, we selected women who provided fecal samples during pregnancy and had paired fecal samples from their babies up to 24months postpartum. We evaluated maternal and baby factors associated with likelihood of H. pylori colonization in the babies. Fecal antigen testing was used to determine H. pylori status. We also evaluated the association between maternal breastmilk cytokines and H. pylori colonization in breastfed babies. Among included mother-baby pairs (n = 66), H. pylori prevalence was 31.8% in mothers and 19.7% in their babies. Dominant breastfeeding (adjusted odds ratio [aOR] 0.17, 95% CI 0.03-0.98) and maternal IBD (aOR 0.05, 95% CI 0.01-0.27) were associated with significantly lower likelihood of H. pylori colonization among babies; no other clinical factors were associated with H. pylori colonization in the babies. Matrix metalloproteinase-10 (MMP-10) and tumor necrosis factor-related activation-induced cytokine expression were significantly higher in breastmilk of mothers with H. pylori positive vs negative babies. Consistent with data from high H. pylori prevalence regions, our findings suggest dominant breastfeeding may protect against early H. pylori colonization. Downregulation of pro-inflammatory cytokines such as MMP-10 may be relevant in mediating this protection among breastfed babies, but more data are needed.

Is young-onset esophageal adenocarcinoma increasing in Japan? An analysis of population-based cancer registries.

BackgroundWhile esophageal squamous cell carcinoma (ESCC) is the predominant histological type in Japan, concern has been expressed over an increase in the proportion of esophageal adenocarcinoma (EAC), especially in middle‐aged populations. This study aimed to assess long‐term trends in esophageal cancer incidence by histological type.MethodsWe used data from three population‐based cancer registries in Japan with 10,642 esophageal cancer cases diagnosed between 1993 and 2014. The multiple imputation approach was used to impute a specific histological type (ESCC, EAC, and others) for cases with “Unknown” or missing status. We calculated the age‐standardized incidence rates by histological type from 1993 to 2014 and fitted age‐period‐cohort models to estimate the annual percent changes (APCs) and adjusted incidence rate ratios (IRRs).ResultsAfter imputation of missing data, the largest mean APC increase was seen in the incidence of EAC in men aged 40–49 years (7.1%) followed by those aged 50–59 years (5.5%). The age‐period‐cohort analysis showed that men who were born in the 1960s and later were more likely to develop EAC relative to men who were born in 1950–1959 (1960–1969 cohort, IRR: 1.42; 1970–1974 cohort, IRR: 2.23), with a period effect indicating a constant increase after 2003. For women, no significant trend in EAC incidence was observed.ConclusionsThe incidence of EAC has increased more prominently compared with that of ESCC, especially in men aged 40–59 years, suggesting the impact of increasing obesity in men and a reduction in H. pylori prevalence in Japan.

Prevalence of H. pylori among asymptomatic HIV-positive and negative individuals in Central Ethiopia and efficacy of eradication therapy

ObjectivesHelicobacter pylori is a widespread pathogen and major contributor to dyspeptic disease and gastric cancer. Although the interaction between HIV and H. pylori infection is not well investigated, previous studies have suggested a decreased prevalence of H. pylori and limited efficacy of eradication therapy in HIV-positive individuals. Therefore, the objectives of this study were to describe the prevalence of H. pylori infection according to HIV status and analyze the efficacy of eradication therapy in Ethiopia. MethodsA prospective, randomized, interventional study was performed involving HIV-positive and negative participants presenting to the Asella Referral and Teaching Hospital in Central Ethiopia between March and June 2017. A stool antigen test was used as a screening tool for H. pylori infection. Randomly selected patients received triple eradication therapy. ResultsThe cumulative H. pylori prevalence was 77.3% (392/507): 78.8% (241/306) among HIV-positive individuals versus 75.1% (151/201) among HIV-negative individuals (P = 0.386). Twenty-five HIV-positive and 26 HIV-negative H. pylori-infected participants were randomized to receive standard triple therapy; three of them were lost to follow-up (one HIV-positive, two HIV-negative). The total eradication rate was 50.0%: 62.5% (15/24) among those HIV-negative versus 37.5% (9/24) among those HIV-positive [Au?1]. ConclusionsA high prevalence of H. pylori was observed among HIV-positive and negative individuals in Central Ethiopia. The efficacy of eradication therapy was low, with a trend towards lower efficacy in HIV-infected individuals.