Xie L, Liu GW, Liu YN, Li PY, Hu XN, He XY, Huan RB, Zhao TL, Guo HJ. Prevalence of Helicobacter pylori infection in China from 2014-2023: A systematic review and meta-analysis. World J Gastroenterol 2024; 30(43): 4636-4656 [DOI: 10.3748/wjg.v30.i43.4636]
Corresponding Author of This Article
Hui-Jun Guo, PhD, Professor, Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, No. 19 Renmin Road, Jinshui District, Zhengzhou 450000, Henan Province, China. guohuijun@hactcm.edu.cn
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Lu Xie, Ya-Nan Liu, Peng-Yu Li, Xin-Ning Hu, Xin-Yi He, Rui-Bo Huan, Tai-Long Zhao, Hui-Jun Guo, Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China
Lu Xie, Ya-Nan Liu, Xin-Ning Hu, Xin-Yi He, Rui-Bo Huan, Tai-Long Zhao, The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou 450046, Henan Province, China
Guang-Wei Liu, Department of Spleen, Stomach, Liver and Gallbladder, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China
Peng-Yu Li, Hui-Jun Guo, Henan Key Laboratory of Viral Diseases Prevention and Treatment of Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China
Author contributions: Xie L designed the study and edited the manuscript; Xie L and Liu GW reviewed papers and extracted relevant data; Li PY resolved disagreements; Hu XN and He XY conducted data cross checking; Xie L and Liu YN performed statistical analysis and wrote the manuscript; Li PY, Huan RB and Zhao TL provided comments or suggestions about the manuscript; Guo HJ guided the writing and editing of the article, had primary responsibility for final content; all of the authors read and approved the final version of the manuscript to be published.
Supported byThe Zhongyuan Famous Doctor, No. ZYYCYU202012119; Scientific Research Special Project of Traditional Chinese Medicine in Henan Province, No. 2024ZY2004; and Scientific Research Special Project of the National TCM Inheritance and Innovation Center of Henan Provincial Health Commission, No. 2023ZXZX1093.
Conflict-of-interest statement: The authors disclose that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Jun Guo, PhD, Professor, Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, No. 19 Renmin Road, Jinshui District, Zhengzhou 450000, Henan Province, China. guohuijun@hactcm.edu.cn
Received: July 3, 2024 Revised: September 19, 2024 Accepted: October 16, 2024 Published online: November 21, 2024 Processing time: 120 Days and 9.6 Hours
Abstract
BACKGROUND
Helicobacter pylori (H. pylori) stands as the predominant infectious agent linked to the onset of gastritis, peptic ulcer diseases, and gastric cancer (GC). Identified as the exclusive bacterial factor associated with the onset of GC, it is classified as a group 1 carcinogen by the World Health Organization. The elimination of H. pylori plays a crucial role in the primary prevention of GC. While the prevalence has declined in recent decades, H. pylori infection is still highly prevalent in China, accounting for a significant part of the disease burden of GC. Therefore, updated prevalence information for H. pylori infection, especially regional and demographic variations in China, is an important basis for the design of targeted strategies that will be effective for the prevention of GC and application of policies for H. pylori control.
AIM
To methodically evaluate the occurrence of H. pylori infection throughout China and establish a reference point for subsequent investigations.
METHODS
A systematic review and meta-analysis was conducted following established guidelines, as detailed in our methodology section.
RESULTS
Our review synthesized data from 152 studies, covering a sample of 763827 individuals, 314423 of whom were infected with H. pylori. We evaluated infection rates in mainland China and the combined prevalence of H. pylori was 42.8% (95%CI: 40.7-44.9). Subgroup analysis indicated the highest prevalence in Northwest China at 51.3% (95%CI: 45.6-56.9), and in Qinghai Province, the prevalence reached 60.2% (95%CI: 46.5-73.9). The urea breath test, which recorded the highest infection rate, showed a prevalence of 43.7% (95%CI: 41.4-46.0). No notable differences in infection rates were observed between genders. Notably, the prevalence among the elderly was significantly higher at 44.5% (95%CI: 41.9-47.1), compared to children, who showed a prevalence of 27.5% (95%CI: 19.58-34.7).
CONCLUSION
Between 2014 and 2023, the prevalence of H. pylori infection in China decreased to 42.8%, down from the previous decade. However, the infection rates vary considerably across different geographical areas, among various populations, and by detection methods employed.
Core Tip: Globally, Helicobacter pylori infection continues to be the most prevalent infectious disease, posing substantial public health challenges. Despite a reduction in overall prevalence to 42.8% over the past decade, high rates persist in specific areas and demographics within China, necessitating continued vigilance and targeted interventions.
