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Sociodemographic Determinants of Prevalence and Incidence of Helicobacter pylori Infection in Portuguese Adults
Author(s) -
Bastos Joana,
Peleteiro Bárbara,
Barros Rita,
Alves Luís,
Severo Milton,
Fátima Pina Maria,
Pinto Hugo,
Carvalho Sandra,
Marinho Ana,
Guimarães João T.,
Azevedo Ana,
Vecchia Carlo,
Barros Henrique,
Lunet Nuno
Publication year - 2013
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12061
Subject(s) - poisson regression , medicine , incidence (geometry) , confidence interval , demography , helicobacter pylori infection , helicobacter pylori , rate ratio , population , portuguese , environmental health , sociology , optics , physics , linguistics , philosophy
Background Understanding the determinants of H elicobacter pylori infection in adults is essential to predict the burden of H . pylori ‐related diseases. We aimed to estimate the prevalence and incidence of H . pylori infection and to identify its major sociodemographic correlates in an urban population from the North of Portugal. Material and Methods A representative sample of noninstitutionalized adult inhabitants of Porto (n = 2067) was evaluated by ELISA ( I g G ) and a subsample (n = 412) was tested by W estern B lot to assess infection with C ag A ‐positive strains. Modified Poisson and Poisson regression models were used to estimate crude and sex‐, age‐, and education‐adjusted prevalence ratios ( PR ) and incidence rate ratios ( RR ), respectively. Results The prevalence of H. pylori infection was 84.2% [95% confidence interval (95% CI ): 82.4–86.1]. It increased across age‐groups in the more educated subjects, (18–30 years: 72.6%; ≥71 years: 88.1%; p for trend <0.001) and decreased with education in the younger (≤4 schooling years: 100.0%; ≥10 schooling years: 72.6%; p for trend <0.001). Living in a more deprived neighborhood was associated with a higher prevalence of infection, only in the younger ( PR = 1.20, 95% CI : 1.03–1.38) and more educated participants ( PR = 1.15, 95% CI : 1.03–1.29). Among the infected, the proportion with C ag A ‐positive strains was 61.7% (95% CI : 56.6–66.9). The incidence rate was 3.6/100 person‐years (median follow‐up: 3 years; 95% CI : 2.1–6.2), lower among the more educated (≥10 vs ≤9: RR = 0.25, 95% CI : 0.06–0.96). The seroreversion rate was 1.0/100 person‐years (95% CI : 0.6–1.7). Conclusions The prevalence of infection among adults is still very high in P ortugal, suggesting that stomach cancer rates will remain high over the next few decades.