Prevalence of Helicobacter pylori Infection evaluated by Stool antigen test in Khuzestan Province since September to October 2009, south-west of Iran: a population based study

Background: Although infection with Helicobacter pylori is a global health problem, its prevalence is different among countries. Serologic tests for the diagnosis of H. pylori infection are limited by low accuracy rates and lack of validation. Recent studies indicate that the stool antigen test has an acceptable level of accuracy. Objectives: Our objective was to investigate the prevalence of H. pylori infection in Khuzestan province, south-west of Iran by stool antigen test and to evaluate possible risk factors for the H. pylori infection. Patients and Methods: In this study, from September to October 2009, 861 healthy individuals aged 0-80 years were sampled by cluster sampling from 4.5 million inhabitants of the province. Infection with H. pylori was evaluated by detection of H. pylori antigens in stool (HpSA). Epidemiologic data of each subject were determined by filling up a questionnaire. Results: The overall HpSA positivity was (53.5%, CI 95% = 50.2-56.84%) and the mean age of infected cases was greater than that of non-infected ones (29.2 yrs vs. 24.5 yrs) (P < 0.001). HpSA positivity increased with age. The peak prevalence was reached in the 41-50 years age group (66%). No association was detected between H. pylori positivity and gender. Additionally, there was no significant relationship between H. pylori infection and previous hospital admission, gastrointestinal symptoms, and living area (P > 0.05). Conclusions: H. pylori infection is highly prevalent (57%) in Khuzestan province, south-west of Iran. Low educational levels, low socioeconomic jobs, and increasing age were related to high prevalence of H. pylori infection in this area.