Traditional risk factors for Helicobacter pylori infection not found among patients undergoing diagnostic upper endoscopy—Republic of Georgia, 2007–2008

• Published in: International journal of infectious diseases Vol. 16; no. 9; pp. e697 - e702
• Main Authors: Tarkhashvili, Nato, Chakvetadze, Neli, Mebonia, Nana, Chubinidze, Marina, Bakanidze, Lela, Shengelidze, Vladimer, Mirtskhulava, Merab, Chachava, Tamar, Katsitadze, Guram, Gabunia, Ucha, Kordzaia, Dimitri, Imnadze, Paata, Guarner, Jeannette, Sobel, Jeremy
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.09.2012
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Bacterial - blood; Biopsy; blood serum; case studies; Child; Child, Preschool; Cohort Studies; confidence interval; duodenal ulcers; education; endoscopy; Endoscopy, Digestive System; enzyme-linked immunosorbent assay; Female; gastritis; gastrointestinal system; Georgia; Georgia (Republic) - epidemiology; Helicobacter Infections - blood; Helicobacter Infections - epidemiology; Helicobacter Infections - microbiology; Helicobacter pylori; Helicobacter pylori - isolation & purification; Histocytochemistry; Humans; immunoglobulin G; Infectious Disease; Logistic Models; Male; Middle Aged; Multivariate Analysis; odds ratio; patients; Prevalence; Prospective Studies; Pulmonary/Respiratory; questionnaires; regression analysis; Republic of Georgia; Risk Factors; Rural Population; sanitation; socioeconomic status; Stomach Diseases - blood; Stomach Diseases - epidemiology; Stomach Diseases - immunology; Stomach Diseases - microbiology; stomach neoplasms; Urban Population; urease; Urease - analysis; Young Adult; Georgia (Republic); Republic of Georgia; Georgia; Helicobacter pylori; Risk factors; Prevalence
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2012.05.1031

Helicobacter pylori causes gastritis, duodenal ulcers, and gastric cancer. Although household crowding, low socioeconomic status (SES), and poor sanitation are associated with infection elsewhere, risk factors of infection in the Republic of Georgia (ROG), a country with a high prevalence rate (>70%), remain unknown. In this study we explored potential risk factors of infection among symptomatic patients in ROG. During 2007–2008, we prospectively recruited 390 subjects with gastrointestinal symptoms referred to five tertiary care centers for diagnostic upper endoscopy. We administered a questionnaire on potential risk factors and tested patients using three diagnostic tests: gastric biopsies underwent histological evaluation and rapid urease test (CLO test), and an ELISA was used to detect IgG against H. pylori in serum. We defined a case as having two or more positive results from the three available tests. Univariate and multivariate logistic regression analyses were performed. Overall, 217 (56%) patients met the study case definition. Subjects diagnosed with cancer had the highest rate of H. pylori infection (62%), followed by those with gastritis (55%), and ulcer (54%). Age >30 years (adjusted odds ratio (aOR 2.6, 95% confidence interval (CI) 1.6–4.3) and residing in the capital city (aOR 0.6, 95% CI 0.4–0.9) were significantly associated with infection. In this large cohort with gastrointestinal symptoms, only age >30 years and living in the capital were significant factors associated with infection. Lower SES, less education, and crowding did not confer an increased risk, in contrast to the findings of previous studies. Population-based studies are needed to identify potential routes and risk factors of H. pylori infection in ROG.