Farag Tamer H, Stoltzfus Rebecca J, Khalfan Sabra S, Tielsch James M
Department of International Health, Bloomberg School of Public Health, Johns Hopkins, University, Baltimore, MD, USA.
Trans R Soc Trop Med Hyg. 2007 Sep;101(9):915-22. doi: 10.1016/j.trstmh.2007.05.003. Epub 2007 Jul 6.
Helicobacter pylori is strongly associated with peptic ulcer and gastric cancer and may be the most common human bacterial infection. The epidemiology of H. pylori has been poorly studied in Africa, where its relevance to disease has not been fully appreciated. Following a cross-sectional study design, H. pylori infection was measured by (13)C-urea breath test among 857 pregnant women attending antenatal care clinics. Location, water use practices, anthropometry, and social and demographic variables were assessed as covariates. The prevalence of H. pylori infection was 17.5%. Multiple logistic regression showed that H. pylori was positively associated with location of enrollment clinic along the main road leading from the southern seaport (odds ratio (OR)=2.5), presence of costlier household lighting in the home (OR=1.6) and height (10 cm) (OR=1.5). The prevalence of H. pylori infection was unexpectedly low for a developing country population, where prevalence is typically very high. Higher prevalence along the road from the southern seaport suggests that infection was imported from the mainland. The reason for very low prevalence should be investigated further because the discovery of bacterial or dietary factors that limit infection in this population could have useful public health applications.
幽门螺杆菌与消化性溃疡和胃癌密切相关，可能是人类最常见的细菌感染。在非洲，幽门螺杆菌的流行病学研究较少，其与疾病的相关性尚未得到充分认识。采用横断面研究设计，对857名到产前保健诊所就诊的孕妇进行了碳-13尿素呼气试验，以检测幽门螺杆菌感染情况。将地点、用水习惯、人体测量数据以及社会和人口统计学变量作为协变量进行评估。幽门螺杆菌感染率为17.5%。多因素logistic回归分析显示，幽门螺杆菌感染与从南部海港延伸的主干道沿线的就诊诊所位置（比值比（OR）=2.5）、家中使用更昂贵的家庭照明（OR=1.6）以及身高每增加10厘米（OR=1.5）呈正相关。对于一个发展中国家的人群来说，幽门螺杆菌感染率意外地低，因为在发展中国家感染率通常非常高。从南部海港延伸的道路沿线感染率较高，这表明感染是从大陆传入的。应进一步调查感染率极低的原因，因为发现限制该人群感染的细菌或饮食因素可能具有有益的公共卫生应用价值。
