title: Epidemiology of Helicobacter pylori infection among the healthy population in Iran and countries of the Eastern Mediterranean Region: a systematic review of prevalence and risk factors.
abstract: OBJECTIVE
  To investigate the epidemiology of Helicobacter pylori (H. pylori) infection among the healthy asymptomatic population in Iran and countries of the Eastern Mediterranean Region.
  
  
  METHODS
  A computerized English language literature search of PubMed, ISI Web of Science, Scopus, and Google Scholar was performed in September 2013. The terms, "Eastern Mediterranean Regional Office (EMRO)" and "Helicobacter pylori", "H. pylori" and "prevalence" were used as key words in titles and/or abstracts. A complementary literature search was also performed in the following countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, The United Arab Emirates, and Yemen.
  
  
  RESULTS
  In the electronic search, a total of 308 articles were initially identified. Of these articles, 26 relevant articles were identified and included in the study. There were 10 studies from Iran, 5 studies from the Kingdom of Saudi Arabia, 4 studies from Egypt, 2 from the United Arab Emirates, and one study from Libya, Oman, Tunisia, and Lebanon, respectively. The overall prevalence of H. pylori infection in Iran, irrespective of time and age group, ranged from 30.6% to 82%. The overall prevalence of H. pylori infection, irrespective of time and age group, in other EMRO countries ranged from 22% to 87.6%.
  
  
  CONCLUSIONS
  The prevalence of H. pylori in EMRO countries is still high in the healthy asymptomatic population. Strategies to improve sanitary facilities, educational status, and socioeconomic status should be implemented to minimize H. pylori infection.
authors.affiliation: Ahad Eshraghian, Department of Internal Medicine, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz 71345-1744, Iran.
authors.forename: Ahad
authors.initials: A
authors.lastname: Eshraghian
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D055815:Young Adult
keywords: Eastern Mediterranean Region Office; Epidemiology; Helicobacter pylori; Iran; Prevalence