Epidemiology of Helicobacter pylori infection in six Latin American countries (SWOG Trial S0701)
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To investigate the potential determinants of Helicobacter pylori infection between adults 21–65 years old.
Data are from the initial screening visit of a randomized clinical trial of three antibiotic regimens to eradicate H. pylori, conducted in seven sites (Santiago–Chile, Túquerres–Colombia, Guanacaste–Costa Rica, Copán–Honduras, Obregón and Tapachula–México, León–Nicaragua). Thousand eight hundred and fifty-nine adults from the general population were screened for H. pylori infection using an urea breath test (UBT) and were interviewed to assess socioeconomic-, demographic-, and symptom-related characteristics. Logistic regression was used to assess the relationship between these characteristics and H. pylori positivity at enrollment.
Among the 1,852 eligible participants for whom a conclusive UBT result was obtained, H. pylori prevalence was 79.4 %, ranging from 70.1 to 84.7 % among the seven centers. Prevalence did not differ by sex (female: 78.4, male: 80.9; p = 0.20) or age (p = 0.08). H. pylori positivity increased with increasing number of siblings (p trend <0.0001). Participants with education beyond 12 years were less likely to be UBT-positive (OR 0.4: 0.3–0.6, compared to participants with 0–6 years of schooling) as were those employed outside the home (OR 0.7: 0.6–1.0). Odds of H. pylori infection increased with the presence of certain living conditions during childhood including having lived in a household with an earth floor (OR 1.8: 1.4–2.4), lack of indoor plumbing (OR 1.3: 1.0–1.8) and crowding (OR 1.4: 1.0–1.8, for having more than two persons per bedroom). Regarding current household conditions, living with more than 3 children in the household (OR 1.7: 1.2–2.5) and crowding (OR 1.8: 1.3–2.3) were associated with H. pylori infection.
The prevalence of H. pylori in adults was high and differed significantly among the six Latin American countries studied (p < 0.001). Our findings confirm the strong link between poor socioeconomic conditions and H. pylori infection.
KeywordsHelicobacter pylori Infection Prevalence Risk factors Determinants Epidemiology
The Bill & Melinda Gates Foundation provided financial support for the trial, and the National Institutes of Health (Grant number CA037429) supported the SWOG administrative and statistical infrastructure. The authors express special gratitude to the men and women of the six Latin American countries who took part of the screening visit of the clinical trial and recognize the many contributions of the investigative team members: SWOG Statistical Center, Seattle, WA, USA—Vanessa Bolejack, Susie Carlin, Dacia Christin, Evonne Lackey, and Rachael Sexton; Division of Gastroenterology, University of North Carolina, Chapel Hill, CA, USA— Paris Heidt; Universidad del Valle, Cali, Colombia—Luz Stella García, Yolanda Mora; Hospital Regional de Occidente, Santa Rosa de Copán, Honduras—Jean Paul Higuero, Glenda Jeanette Euceda Wood, Lesby Maritza Castellanos; Pontificia Universidad Católica de Chile, Santiago, Chile—María Paz Cook, Paul Harris, Antonio Rollán; Fundación INCIENSA, San José, Costa Rica—Silvia Jiménez, Paula González, Ana Cecilia Rodríguez, Lidiana Morera, Blanca Cruz Reyes; Instituto Nacional de Salud Pública, Cuernavaca, Mexico—Rogelio Danis, Erika Marlen Hurtado Salgado, María del Pilar Hernández Neváres; Instituto Tecnológico de Sonora, Ciudad Obregón, Mexico—Myriam Bringas, Araceli Molina, Claudia Osorio, María de Jesús López Valenzuela; Centro de Investigación en Demografía y Salud, León, Nicaragua— Yesenia Zapata; and also Charles A Coltman, David S Alberts, and Jesse Nodora for their help during the course of the study.
Conflict of interest
The authors declare that they have no conflict of interest.
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