Prevalence and risk factors of Helicobacter pylori infections in the patients suffering from acid-peptic disease at tertiary care center, Gujarat, India
Keywords:Helicobacter pylori, Prevalence, Peptic ulcer, Risk factors
Background: Helicobacter pylori (H. pylori) infection is a medical encumber especially in the developing countries, ranging from acute inflammation to malignancy. The study is intended to explore the prevalence of H. pylori infection and also to compute its associated risk factors.
Methods: Sixty two (n=62) symptomatic patients attending the tertiary care hospital, were included in the study. Two antral biopsies collected from each patient were subjected to rapid urease test and Gram staining. IgG antibodies were detected by rapid test based on the principle of Immunochromatography. To evaluate the risk factors, various determinants were asked to each patient in the form of questionnaire. Statistical analysis was done using Fisher exact test. P value < 0.05 was considered significant.
Results: Prevalence rate of H. pylori infection was 24.19 % (15/62). More than half (53%) of the infected patients had complained of persistent burning abdominal pain. Prevalence rate was found highest in the patients suffering from peptic ulcer disease (66.6%, P=0.0237). Consumption of unfiltered water (P=0.007, Odd Ratio (OR)-1.06), eating spicy food, meat, fish and chili pepper (P=0.052, OR-1.01) was found the major risk factors. Addictive habits of either smoking/alcohol/tobacco (P=0.904) were not associated with infection.
Conclusions: Prevalence of H. pylori infection was found low comparatively and was mainly associated with symptom of persistent burning abdominal pain and peptic ulcer. Use of unfiltered water, spicy food, chili pepper and meat undoubtedly increase the risk of acquiring H. pylori infection. Addictive habits were not significantly associated with infection.
Marshall, B. J., and J. R. Warren. Unidentified curved bacilli in the stomach of Patients with gastritis and peptic ulceration. Lancet 1984; 1311–15.
Sipponen P, Hyvarinen H. Role of Helicobacter pylori in the pathogenesis of gastritis, peptic Ulcer and gastric cancer. Scand J Gastroenterol 1993; 28 (Suppl 196): 3-6.
Mhaskar RS, Ricardo I, Azliyati A, Laxminarayan R, Amol B, Santosh W, Boo K. Assessment of risk factors of Helicobacter pylori infection and peptic ulcer disease. J Global Infect Dis. 2013; 5:60-7.
Choudhury G, Mohindra S: Epidemiology of Helicobacter pylori in India. Indian J Gastroenterol, 2000; 19 (Suppl1): S3- S6.
Thirumurthi S, Graham DY: Helicobacter pylori infection in India from a western perspective. Indian J Med Res 2012; 136 (4): 549-62.
Ramakrishna BS: Helicobacter pylori infection in India: the case against eradication. Indian Journal of Gastroenterology 2006; 25: 25-28.
Brown LM. Helicobacter pylori: epidemiology and routes of transmission. Epidemiol Rev. 2000; 22:283–97.
Kanbay M, Gur G, Arslan H, Yilmaz U, Boyacioglu S. The relationship of ABO blood group, age, gender, smoking, and Helicobacter pylori infection. Digestive Diseases and Sciences 2005; 50(7): 1214-17.
Yousuf M, Rao UA, Thyagarajan SP. A comparative study between rapid urease [Modified], CLO-test, culture & histopathological examination for Helicobacter pylori in-patients with acid peptic disease. Indian J Pathol Microbiol. 1995; 38(4):349-54.
Vijaya D, Chandrashekhar N, Nagarantnamma T, Shivarudrappa AS. Simple stain for Helicobacter pylori. Journal of Clinical and Diagnostic Research 2012; 6: 664-66.
Himani B. Pandya, Jagdish S. Patel, Harihar H. Agravat, Sahil B. Patel, Minal C. Thakkar. Identification of Helicobacter pylori by different conventional staining techniques and its comparison with polymerase chain reaction. Saudi Med J 2013; 34 (9):942-48.
Sreenivasan Sasidharan, Batumanathan Ghayethry, Manickam Ravichandran, Lachimanan Yoga Latha, Subaramanion Jothy Lachumy, Khoo Miew Leng et al. Prevalence of Helicobacter pylori infection among patients referred for endoscopy: Gender and ethnic differences in Kedah, Malaysia. Asian Pacific Journal of Tropical Disease 2012; 55-9.
Sara Ashtari, Mohamad Amin Pourhoseingholi, Mahsa Molaei, Hajar Taslimi, and Mohammad Reza Zali. The prevalence of Helicobacter pylori is decreasing in Iranian patients. Gastroenterol Hepatol Bed Bench 2015 spring; 8(Suppl1): S23–S29.
Sabina Khan, P.N. Fathima Beevi, Musharraf Husain, Mohd. Jaseem Hassan, Sujata Jetley. Helicobacter pylori Infection and Associated Risk Factors in Patients with Upper Gastrointestinal Symptoms. International Archives of Bio Medical and Clinical Research 2017; 3(1): 38-43.
Paul N, Rajahamsan J. Theodore RB. Prevalence of Helicobacter pylori among dyspeptic patients in a tertiary care centre in South Kerala, India. J.Acad. Clin. Microbiol 2016; 18:105-9.
A. Al-Sulami, H.S. Al-Kiat, L.K. Bakker and H. Hunoon. Primary isolation and detection of Helicobacter pylori from dyspeptic patients: a simple, rapid method. East Mediterr. Health J. 2008 Mar-Apr;14(2):268-76.
Valliani A, Khan F, Ahmed B, Khuwaja A K, Majid S, Hashimi S, Nanji K, Valliani S: Factors associated with Helicobacter pylori infections, Results from a developing country- Pakistan. Asian Pac J Cancer Prev 2013; 14: 53-6.
Sharma B, Sharma N, Chauhan V, Thakur S, Kaushal SS: Relationship of Smoking with H. pylori Incidence in Non-ulcer Dyspepsia Patients. Indian Academy of Clinical Medicine 2006; 7(1): 22-4.
Alsaimary IE, Mezal TJ, Jassim HA, Alwajeeh YAY, Talib RA, Abdul-Samad HQ, et al Seroprevalence of Helicobacter pylori among Healthy Medical Students in Al- Basrah Province. Donnish Journal of Microbiology and Biotechnology Research 2014; 1(2): 012-017.
Ghosh P, Kandhare AD, Raygude KS, Gauba D, Gosavi TP, Bodhankar SL: Cigarette smoking and H. pylori infection: A meta-analysis of literature, Der Pharmacia Lettre 2012; 4 (1): 128-34.
Rodrigues MN, Queiroz DM, Bezerra Filho JG, Pontes LK, Rodrigues RT, Braga LL. Prevalence of Helicobacter pylori infection in children from an urban community in north-east Brazil and risk factors for infection. Eur J Gastroenterol Hepatol. 2004;16: 201–5.
Epplein M, Zheng W, Honglan L, Peek RM. Jr, Correa P, Gao J, Michel A, Pawlita M, Cai Q, Xiang YB, Shu XO: Diet, Helicobacter pylori strain-specific infection, and Gastric cancer risk on Chinese men. Nutr Cancer 2014;66(4):550-57.
Rastogi M, Rastogi D, Singh S, Agarwal A, Priyadarshi BP, Middh T: Prevalence of Helicobacter pylori in asymptomatic adult patients in a tertiary care hospital: A cross sectional study. Biomedical Research 2014; 25 (4): 117-22 .
Lee IO, Lee KH, Pyo JH, Kim JH, Choi YJ, Lee YC. Anti-inflammatory effect of capsaicin in Helicobacter pylori-infected gastric epithelial cells. Helicobacter 2007; 12:(5)10-7.
Vandana berry, Vidya sagar. Rapid urease test to diagnose Helicobacter pylori infection. JK Science 2006; 8: 86-8.
Jayesh R. Ruparelia, Nilofar R. Sodagar, Jagdish S. Patel, Himani B. Pandya, Navneetkumar R. Singh, Karishma B. Naik et al. Comparison of Conventional Diagnostic Modalities with PCR for Detection of Helicobacter Pylori Infection in Symptomatic Patients. Asian J. Med. Pharm. Res 2013 3(4): 105-10.
Mojgan Foroutan, Behnam Loloei, Shahrokh Irvani. Accuracy of RUT in diagnosing h.pylori infection in patients using NSAID’s, Saudi journal of gastroenterology 2010; 16(2): 110-2.
Sufi HZ Rahman, M Golam Azam, M Anisur Rahman, MS Arfin, M Mahbub Alam, Tareq M Bhuiyan, Nasim Ahmed, Motiur Rahman, Shamsun Nahar, MS Hassan. Non-invasive diagnosis of H pylori infection: Evaluation of serological tests with and without current infection marker CIM. World J Gastroenterol 2008 February 28; 14(8): 1231-36.
Ujjal Poddar, Surender Kumar Yachha. Helicobacter pylori in Children: An Indian Perspective. Indian Pediatrics 2007;44: 761-70