Changes in prevalence of Helicobacter pylori infection in two groups of patients undergoing endoscopy and living in the same region in the Netherlands.
BACKGROUND
There are few data on the prevalence of Helicobacter pylori in different populations and no data on changes in time. A cross-sectional study was done in a large population of patients undergoing endoscopy in order to relate the presence of H. pylori to ethnic background and to detect changes in time.


METHODS
All consecutive patients over a 10-year period were included and biopsy specimens from the gastric antrum were taken for detection of H. pylori. A large population of immigrants living in the Zaanstreek region was studied separately.


RESULTS
In the 10-year period, 14,909 consecutive diagnostic upper GI endoscopies were done in 11,691 consecutive patients. Only the first endoscopy done in a patient was included. Of 11,691 patients available for evaluation, there were 5669 men and 6022 women (mean age 55 years, range 4-99). Of these, 3201 (27.4%) were H. pylori-positive and 4988 (42.7%) were H. pylori-negative. No biopsy specimens were available for the remaining 3501 (29.9%) patients. In the group under study, 1309 (11%) patients were immigrants. H. pylori was present significantly more often in men and in immigrants, where prevalence was 75% versus 33% (P < 0.0001). The prevalence of H. pylori showed a marked decrease in both populations during the period of study. Extrapolating trend lines into the future indicates a prevalence of H. pylori below 10% by the year 2009. Among immigrants, this will be reached in approximately 2027.


CONCLUSIONS
This study shows differences in prevalence of H. pylori in different populations. We found a decreasing prevalence that can be explained by the lower acquisition rate of the infection. It is important to be aware of the differences in prevalence of H. pylori in a population composed of different ethnicities.
Loffeld
R J L F
RJ
Dept. of Internal Medicine, de Heel Zaans Medisch Centrum, Zaandam, The Netherlands. r.loffeld@chello.nl
van der Putten
A B M M
AB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000208:ethnology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence