title: Traditional risk factors for Helicobacter pylori infection not found among patients undergoing diagnostic upper endoscopy-Republic of Georgia, 2007-2008.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, 615 East 4th Street, Pierre, SD 57501, USA. bwi2@cdc.gov, nato.tarkhashvili@state.sd.us
authors.forename: Nato
authors.initials: N
authors.lastname: Tarkhashvili
authors.forename: Neli
authors.initials: N
authors.lastname: Chakvetadze
authors.forename: Nana
authors.initials: N
authors.lastname: Mebonia
authors.forename: Marina
authors.initials: M
authors.lastname: Chubinidze
authors.forename: Lela
authors.initials: L
authors.lastname: Bakanidze
authors.forename: Vladimer
authors.initials: V
authors.lastname: Shengelidze
authors.forename: Merab
authors.initials: M
authors.lastname: Mirtskhulava
authors.forename: Tamar
authors.initials: T
authors.lastname: Chachava
authors.forename: Guram
authors.initials: G
authors.lastname: Katsitadze
authors.forename: Ucha
authors.initials: U
authors.lastname: Gabunia
authors.forename: Dimitri
authors.initials: D
authors.lastname: Kordzaia
authors.forename: Paata
authors.initials: P
authors.lastname: Imnadze
authors.forename: Jeannette
authors.initials: J
authors.lastname: Guarner
authors.forename: Jeremy
authors.initials: J
authors.lastname: Sobel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016145:Endoscopy, Digestive System; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D016481:Helicobacter Infections / Q000097:blood / Q000453:epidemiology / Q000382:microbiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006651:Histocytochemistry; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population; D013272:Stomach Diseases / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology*; D014505:Urban Population; D014510:Urease / Q000032:analysis; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D014510:Urease