Helicobacter pylori infection in Burkina Faso:: an enigma within an enigma

Background. In Burkina Faso, in contrast with high rates of Helicobacter pylori infection from an early age, the prevalence of H. pylori-associated diseases (ulcer and gastric cancer) is low. Aims. To look for the prevalence of H. pylori in healthy natives of Burkina Faso, both children and adults. Methods. We studied the prevalence of H. pylori infection in 258 healthy natives of Burkina Faso (70 children aged 6 months-15 years and 188 adults aged 16-65 years), using a serological screening (IgA and IgG H. pylori antibodies). All the studied subjects underwent a questionnaire regarding their life-style, socio-economic status, dietary habits and hygienic sanitary conditions. Data concerning the questionnaire were compared between H. pylori positive and negative subjects. Results. The rates of H. pylori positivity in children were significantly higher than in adults, and in adults the positivity for H. pylori infection decreased with increasing age. The comparison of the questionnaire's data between H. pylori seropositive and seronegative subjects showed that poor socio-economic status and hygienic sanitary conditions were similar in the two groups. Instead, a higher prevalence of H. pylori positivity was observed in subjects belonging to families living in close contact with sheep, because of their labour and agro-pastoral tradition (shepherds and sedentary farmers). Conclusion. H. pylori infection in Burkina Faso is acquired early in life and is related not only to some yet well-known risk factors (poor socio-economic and hygienic status), but also to a close contact with sheep. The gradually decreasing H. pylori seropositivity in adult population of Burkina Faso represents an unexplained enigma, which needs further studies. (C) 2004 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.