International Journal of Epidemiology 2002;31:638-645
© International Epidemiological Association 2002
Infectious Diseases |
Helicobacter pylori infection in rural China: demographic, lifestyle and environmental factors
a Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
b Beijing Institute for Cancer Research and School of Oncology, Beijing University, Beijing, China 100034.
c Linqu Public Health Bureau, Linqu, Shandong Province, China 262600.
d IMS, Inc., Rockville, MD 20852, USA.
Linda Morris Brown, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Executive Plaza South, Room 8026, 6120 Executive Blvd. MSC 7244, Bethesda, MD 20892–7244, USA. E-mail: BrownL{at}mail.nih.gov
Background Although Helicobacter pylori is one of the most common human bacterial infections worldwide, its mode of transmission is unclear.
Methods To investigate possible associations between H. pylori infection and demographic, lifestyle, and environmental factors in a rural Chinese population, a cross-sectional survey was administered to 3288 adults (1994 seropositive, 1019 seronegative, 275 indeterminate) from 13 villages in Linqu County, Shandong Province, China.
Results Helicobacter pylori prevalence was elevated for: infrequent handwashing before meals (OR = 1.7, 95% CI: 1.0–3.0), crowding (i.e. sharing a bed with >2 people [OR = 2.3, 95% CI: 1.3–4.2]), washing/bathing in a pond or ditch (OR = 1.5, 95% CI: 1.0–2.4), and medium (OR = 1.6, 95% CI: 1.3–2.0) and low (OR = 2.3, 95% CI: 1.9–2.9) compared to high village education level, and reduced for never being married or divorced (OR = 0.4, 95% CI: 0.2–1.0). There was also a suggestion that source of drinking water, especially water from a shallow village well might be related to H. pylori seropositivity. There was no evidence of an association between H. pylori prevalence and alcohol or tobacco use, raw fruit and vegetable intake, or individual social class measures.
Conclusions The results of this study suggest that person-to-person transmission is the most plausible route of H. pylori infection in this rural Chinese population, but waterborne exposures deserve further investigation.
Keywords Helicobacter pylori, risk factors, aetiology, transmission
Accepted 22 October 2001
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