Helicobacter pylori infection in rural China: demographic, lifestyle and environmental factors.
BACKGROUND
Although Helicobacter pylori is one of the most common human bacterial infections worldwide, its mode of transmission is unclear.


METHODS
To investigate possible associations between H. pylori infection and demographic, lifestyle, and environmental factors in a rural Chinese population, a cross-sectional survey was administered to 3288 adults (1994 seropositive, 1019 seronegative, 275 indeterminate) from 13 villages in Linqu County, Shandong Province, China.


RESULTS
Helicobacter pylori prevalence was elevated for: infrequent handwashing before meals (OR = 1.7, 95% CI: 1.0-3.0), crowding (i.e. sharing a bed with >2 people [OR = 2.3, 95% CI: 1.3-4.2]), washing/bathing in a pond or ditch (OR = 1.5, 95% CI: 1.0-2.4), and medium (OR = 1.6, 95% CI: 1.3-2.0) and low (OR = 2.3, 95% CI: 1.9-2.9) compared to high village education level, and reduced for never being married or divorced (OR = 0.4, 95% CI: 0.2-1.0). There was also a suggestion that source of drinking water, especially water from a shallow village well might be related to H. pylori seropositivity. There was no evidence of an association between H. pylori prevalence and alcohol or tobacco use, raw fruit and vegetable intake, or individual social class measures.


CONCLUSIONS
The results of this study suggest that person-to-person transmission is the most plausible route of H. pylori infection in this rural Chinese population, but waterborne exposures deserve further investigation.
Brown
Linda Morris
LM
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. BrownL@mail.nih.gov
Thomas
Terry L
TL
Ma
Jun-Ling
JL
Chang
Yun-Sheng
YS
You
Wei-cheng
WC
Liu
Wei-dong
WD
Zhang
Lian
L
Pee
David
D
Gail
Mitchell H
MH
D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003441:Crowding; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000517:prevention & control; D016480:Helicobacter pylori; D006801:Humans; D008019:Life Style; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012306:Risk; D012959:Socioeconomic Factors; D014881:Water Supply