title: Epidemiology of Helicobacter pylori infection in six Latin American countries (SWOG Trial S0701).
abstract: OBJECTIVE
  To investigate the potential determinants of Helicobacter pylori infection between adults 21-65 years old.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Torre La Sabana, 300 mts. Oeste del ICE, planta baja frente al Lobby, Sabana Norte, San Jose, Costa Rica. cporras@proyectoguanacaste.org
authors.forename: Carolina
authors.initials: C
authors.lastname: Porras
authors.forename: Jesse
authors.initials: J
authors.lastname: Nodora
authors.forename: Rachael
authors.initials: R
authors.lastname: Sexton
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
authors.forename: Silvia
authors.initials: S
authors.lastname: Jimenez
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Dominguez
authors.forename: Paz
authors.initials: P
authors.lastname: Cook
authors.forename: Garnet
authors.initials: G
authors.lastname: Anderson
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Morgan
authors.forename: Laurence H
authors.initials: LH
authors.lastname: Baker
authors.forename: E Robert
authors.initials: ER
authors.lastname: Greenberg
authors.forename: Rolando
authors.initials: R
authors.lastname: Herrero
mesh_terms: D000328:Adult; D000368:Aged; D017326:Clinical Trials, Phase III as Topic; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D055815:Young Adult