title: Helicobacter Pylori Infection in Waste Pickers: A Case Control Seroprevalence Study.
abstract: BACKGROUND
  The epidemiology ofHelicobacter pylori(H. pylori) infection in waste pickers had not been previously studied. This study aims to determine the association ofH. pyloriseropositivity and waste picking activity; and to determine socio-demographic, clinical, work, and behavioral characteristics associated withH. pyloriseropositivity in waste pickers.
  
  
  METHODS
  Through a case-control study design, we examined 90 waste pickers and 90 age- and gender-matched control subjects for the presence of anti-H. pyloriIgG antibodies using enzyme-linked immunoassays. Seroprevalence association with socio-demographic, clinical, work and behavioral characteristics of the waste pickers were also investigated.
  
  
  RESULTS
  Antibodies toH. pyloriwere found in 60 (66.7%) of the 90 waste pickers and in 51 (56.7%) of the 90 controls (P = 0.16). Stratification by age showed that waste pickers aged 14 -30 years old had significantly higher frequency ofH. pyloriinfection than controls of the same age group (56.5% versus 35.6%, respectively; P = 0.04). The seroprevalence ofH. pyloriinfection was not influenced by gender, age, educational level, socioeconomic status, residence, or housing conditions of waste pickers. The presence of underlying diseases and the frequency of gastritis were similar amongH. pyloripositive andH. pylorinegative waste pickers. Logistic regression analysis showed that the duration (years) in the waste picking activity was positively associated withH. pyloriexposure (OR = 2.76; 95% CI: 1.22 - 6.25; P = 0.01). In contrast, consumption of alcohol was negatively associated withH. pyloriexposure (OR = 0.27; 95% CI: 0.09 - 0.78; P = 0.01). Other work or behavioral characteristics of waste pickers including washing hands before eating, eating from the garbage, animal contacts, consumption of unpasteurized milk, unwashed raw vegetables, fruits, or untreated water, and contact with soil were not associated withH. pyloriexposure.
  
  
  CONCLUSIONS
  This is the first report on the seroprevalence ofH. pyloriinfection among waste pickers and the factors contributing to such exposure. Results warrant for further research on the potential role of contact with garbage forH. pyloriinfection.
authors: Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Dgo, Mexico.
authors: Cosme
authors: C
authors: Alvarado-Esquivel
keywords: Epidemiology; Helicobacter pylori; Mexico; Seroprevalence; Waste pickers