Prevalence rate of Helicobacter pylori infection among population of Ryazan region

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Abstract


Aim. Determination of the prevalence of Helicobacter pylori (H. pylori) infection among the population of the Ryazan region.

Materials and Methods. 833 individuals (809 adults and 24 children) were examined for presence of IgG class antibodies using the enzyme immunoassay (2017-2018). The criteria for inclusion into the study were: a desire of a patient to undergo examination for the presence of antibodies to H. pylori in blood. Criteria for exclusion: past treatment for helicobacteriosis. The presence of helicobacteriosis was determined by enzyme immunoassay for quantitative detection of IgG class antibodies (anti-H. pylori IgG) using BCM Diagnostics Helicobacter pylori IgG (USA) test system and for qualitative determination of IgG antibodies to H. pylori in blood serum on IMMULITE 2000 (Germany; test IMMULITE® 2000 H. pylori IgG). Sensitivity of the used test systems was >95.0%, specificity >98.0%.

Results. High contamination of adult residents of Ryazan with H. pylori – 65.6% was found (70.6% of males, 64.4% of females). Prevalence of H. pylori infection among adults in 2017 was 64.4% and in 2018 – 70.2%, however, the observed increase in the number of infected individuals was not statistically significant (p<0.05). The highest prevalence of H. pylori infection was observed in individuals ≥40 years of age (67.2%). Gender-related differences in the prevalence of Helicobacter pylori infection were revealed in individuals of 40 years and older. H. pylori infection in males of ≥40 years was 75.2%, against 65.5% in females of the same age (p<0.05). In children of 4-16 years, the share of individuals with positive serological test with anti-H. pylori IgG reached 20.8%. All H. pylori infected children were above 9 years of age. Individuals with positive serological tests received consultation of a gastroenterologist, and on indications underwent additional examination with administration of eradication treatment. In patients with indefinite results the examination was repeated after a week and/or the presence of H. pylori antigen in feces was determined.

Conclusion. The data obtained indicate a high level of infection with H. pylori in the adult population in the Ryazan region – 65.6%. The incidence of detection of anti-H. pylori IgG in the population was maximal in individuals ≥40 years (67.2%).


In the records of the joint conference Maastricht V it is noted that eradication of Helicobacter pylori (H. pylori) provides clinical and economic benefits not only in terms of the prophylaxis of gastric cancer, but also in terms of prevention of bleedings and recurrences of gastric ulcer and gastropathy associated with intake of non-steroidal anti-inflammatory drugs, and of dyspepsia [1]. Unfortunately, epidemiological data indicate a high prevalence of helicobacteriosis among the Russian population with the share of infected individuals 78.5% [2].

Therefore, we consider it extremely important to find out the prevalence of H. pylori infection among the population of a particular region by comparing the epidemiological data with the data of incidence of helicobacteriosis-relatedconditions. The obtained information should be used for planning of the prophy-lactic work and for creation of the econo-mically efficient model of the morbidity, and will also stimulate healthcare managers and practitioners to strictly observe the existing Russian and international recommendations on diagnosis and treatment of H. pylori-related diseases.

The aim of the given work was to study infection of population of the Ryazan region with H. pylori.

Materials and Methods

The study was conducted in 2017-2018 at the premises of Center of Molecular Diagnostics of Central Research Institute of Epidemiology, Ryazan. Criteria of inclusion into the study: a desire of a patient to undergo examination for the presence of antibodies to H. pylori in blood. Criteria of exclusion: past treatment for helicobacteriosis.

In result, 833 residents of the Ryazan region underwent examination for infection with H. pylori including 809 adults at the age from 18 to 88 years (649 females and 160 males), and 24 children from 4 to 16 years. The incidence of helicobactriosis was studied by examination of patient’s blood serum for the presence of IgG antibodies to H. pylori using enzyme-immunoassay. Serological method of determination of H. pylori infection is used in Russia for primary diagnosis in 29.7% of cases, and in cases of low bacterial contamination of gastric mucosa it possesses the highest sensitivity in comparison with other methods of identification of helicobacteriosis [1,3]. The presence of IgG antibodies in the patient’s blood serum evidences the past infection.

The presence of helicobacteriosis was determined by enzyme immunoassay for quantitative determination of IgG class antibodies (anti-H. pylori IgG) using test system BCM Diagnostics Helicobacter pylori IgG (USA), and for qualitative determination of IgG antibodies to H. pylori in blood serum on analyzer IMMULITE 2000 (Germany; test IMMULITE® 2000 H. pylori IgG). The used systems possess sensitivity >95.0%, specificity>98.0%.

Individuals with a positive result of serological test were consulted by a gastroenterologist, and on indications eradication treatment was administered. Patients with the indefinite result had to repeat the examination and/or were determined the presence of H. pylori antigen in feces.

Statistical processing of the material was implemented using software package Microsoft Excel 2010, Statistica 13.0 (Stat Soft Inc., USA). The differences between frequency of variables in groups were analyzed by Pearson criterion χ2. The dif-ferences were considered statistically significant at p<0.05.

Results and Discussion

Analysis of the examined males showed predomination of individuals of 40-79 years of age in the group (75.0%). The number of females desiring to take part in the examination increased with age reaching maximum at 60-69 years. 74.9% of the examined females were 50-79 years old.

Thus, the highest interest in the examination for helicobacteriosis was seen in the population of 40-79 years old. A high quantity of individuals of the advanced age among the examined population correlated with the data of Federal State Statistics Service according to which in 2018 individuals of ≥40 years of age made 66.7% of adult population, and individuals ≥20 years of age made 33.3% [4].

It was found out in the study that 531 (65.6%) of 809 examined adult individuals showed a positive anti-H. pylori IgG test. The obtained information evidenced a high contagion of population of the Ryazan region with H. pylori and agrees with the existing data for other regions of RF with the prevalence of helicobacteriosis 61-90% [5-7].

The analysis of the results of a 2-year examination of the population of the Ryazan region showed that in 2017 the prevalence of helicobacteriosis among adults was 64.4%, and in 2018 – 70.2%. However, the observed increase in the amount of infected individuals was not statistically reliable (p>0.05).

The prevalence of helicobacteriosis in adults under 40 years was 54.5% that was reliably lower than in the examined population of older age – 67.2% (p<0.05).

Of 24 examined children and teenagers of the Ryazan region, 5 (20.8%) exhibited a positive test for IgG antibodies to H. pylori, all infected individuals were above 9 years of age. The prevalence of H. pylori infection among teenagers of 14-16 years old was 33.3%. The literature data about contagion of teenagers in other regions vary from 33-45 to 94.0% [5,8,9]. Thus, the rate of infection with H. pylori increases with the age of the population, however, this requires active prophylactic measures among children also, beginning from preschool and school age.

As to gender-related parameters of the prevalence of infection with H. pylori, it was found in 70.6% of males and 64.4% of females. Here, no reliable difference was revealed between contamination in males and females (p>0.05).

In individuals above 40 the incidence rate of helicobacteriosis was higher in males – 75.2%, and 65.5% in females (p<0.05). In young males and females under 40 years the incidence of infection did not show any reliable difference and was 54.3 and 54.5%, respectively (p>0.05).

In Figure 1 the gender-related and age-related differences in the incidence rate of helicobacteriosis in the examined individuals are given. In some publications there is an indication of different incidence of helicobacteriosis in males and females in different ethnic groups which requires further correlation with epidemiology of H. pylori-associated diseases [10,11].

 

Fig. 1. Prevalence of H. pylori infection in males and females of the Ryazan region who passed examination in 2017-2018 (n=833)

Note: * – p<0.5 in comparison with males inside the age group
** – p<0.05 in comparison with males of 18-39 year group

Conclusion

Thus, prevalence of H. pylori infection among the adult population in the Ryazan region is high and makes 65.6% (70.6% in males and 64.4% in females). Contamination with H. pylori starts in childhood and adolescence reaching 20.8%, and further increases with age. The maximal incidence rate of helicobacteriosis was found in individuals of 40 years and above – 67.2%. The ascertained differences in the rate of contamination with H. pylori in males andfemales ≥40 years require further study for development of measures for prophylaxis of helicobacteriosis and of the related diseases.

Tatyana V. Zhestkova

Ryazan State Medical University

Author for correspondence.
Email: t-zhestkova@bk.ru
ORCID iD: 0000-0002-6505-1031
SPIN-code: 7403-9954
ResearcherId: A-4929-2019

Russian Federation, 9, Vysokovoltnaja, Ryazan, 390026

MD, PhD, Assistant of the Department of Propaedeutic Internal Diseases

Mikhail A. Butov

Ryazan State Medical University

Email: t-zhestkova@bk.ru
ORCID iD: 0000-0003-3402-1128
SPIN-code: 7999-8925
ResearcherId: A-6144-2019

Russian Federation, 9, Vysokovoltnaja, Ryazan, 390026

MD, PhD, Professor, Head of the Department of Propaedeutic Internal Diseases

Yulian Yu. Lymar

Center of Molecular Diagnostics of Central Research Institute of Epidemiology

Email: t-zhestkova@bk.ru
ORCID iD: 0000-0001-9689-830X
SPIN-code: 6721-3370
ResearcherId: A-9647-2019

Russian Federation, Ryazan

Medical director, Advisor of Clinical and Laboratory Diagnostics

Sergey V. Papkov

Ryazan State Medical University

Email: t-zhestkova@bk.ru
ORCID iD: 0000-0002-1989-9939
SPIN-code: 3521-7226
ResearcherId: A-7645-2019

Russian Federation, 9, Vysokovoltnaja, Ryazan, 390026

MD, PhD, Associate Professor of the Department of Propaedeutic Internal Diseases

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Supplementary files

Supplementary Files Action
1. Fig. 1. Prevalence of H. pylori infection in males and females of the Ryazan region who passed examination in 2017-2018 (n=833) View (63KB) Indexing metadata

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Copyright (c) 2019 Zhestkova T.V., Butov M.A., Lymar Y.Y., Papkov S.V.

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