Jiang Q, Liu WD, Hui WJ, Kong WJ, Feng Y, Kuerbanjiang A, Huang XL, Gao F. Prevalence and risk factors of Helicobacter pylori infection in Xinjiang Uygur Autonomous Region: A cross-sectional study of all age groups. World J Gastroenterol 2025; 31(21): 106033 [DOI: 10.3748/wjg.v31.i21.106033]
Corresponding Author of This Article
Feng Gao, PhD, Professor, Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Tianshan District, Urumqi 830001, Xinjiang Uygur Autonomous Region, China. xjgf@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
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/
Author contributions: Jiang Q, Liu WD, Hui WJ, Kong WJ, and Gao F conceived the experiment; Huang XL, Feng Y, and Kuerbanjiang A conducted the experiment and analyzed the results; Jiang Q, Liu WD, and Hui WJ wrote the manuscript; Gao F supervised the project, administered it, and acquired funding; All authors have read and agreed to the published version of the manuscript.
Supported by Central Government Guide Local Science and Technology Development Special Fund Project, No. ZYYD2024JD11 and No. ZYYD2022A06; and Natural Science Foundation of Xinjiang Uygur Autonomous Region, No. 2024D01C76.
Institutional review board statement: This study was conducted in accordance with the principles of the Declaration of Helsinki, and was approved by the Ethics Committee of People’s Hospital of Xinjiang Uygur Autonomous Region, No. KY2022060173.
Informed consent statement: Written informed consent was obtained from each participant.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request at xjgf@sina.com.
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: Feng Gao, PhD, Professor, Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Tianshan District, Urumqi 830001, Xinjiang Uygur Autonomous Region, China. xjgf@sina.com
Received: February 17, 2025 Revised: April 14, 2025 Accepted: May 23, 2025 Published online: June 7, 2025 Processing time: 112 Days and 17.8 Hours
Abstract
BACKGROUND
Helicobacter pylori (H. pylori) infection rates have been changing with different populations and geographic areas. Currently, there is still a lack of comprehensive survey data on the H. pylori infection rate and its risk factors in the natural population of Xinjiang Uygur Autonomous Region.
AIM
To understand the H. pylori infection and risk factors in Xinjiang Uygur Autonomous Region for the prevention and control strategies.
METHODS
This study comprehensively collected the survey data on H. pylori infection in 15 regions of Xinjiang Uygur Autonomous Region by using the method of stratified random cluster sampling. A total of 4361 individuals from the general population were selected as research subjects, and questionnaire surveys and blood tests for H. pylori antibodies were conducted.
RESULTS
The overall H. pylori infection rate in Xinjiang Uygur Autonomous Region was 70.79% (3087/4361). The H. pylori infection rate showed a trend of first increasing and then decreasing with the increase of age, and the difference was statistically significant (P < 0.05). The analysis of the H. pylori infection rates among different ethnic groups showed that the infection rates of ethnic minorities such as Uyghur, Kirgiz, and Tajik were significantly higher than those of Han and Hui ethnic groups, and the difference was statistically significant (P < 0.01). Multivariate analysis showed that altitude, regular consumption of beef, mutton, dried nuts, barbecue foods, and drinking river water were positively correlated with the H. pylori infection rate.
CONCLUSION
This study indicates that the overall H. pylori infection rate in Xinjiang Uygur Autonomous Region is relatively high, with obvious regional and ethnic differences, which are closely related to the sanitation conditions and eating habits.
Core Tip: The infection rate of Helicobacter pylori (H. pylori) in China is approximately 49.6%, and there are significant differences in the infection rates among different regions. In-depth exploration of the infection rate of H. pylori and its potential risk factors in Xinjiang Uygur Autonomous Region is of crucial reference value for formulating scientific and effective prevention and control strategies against H. pylori infection. Studies have shown that the infection rate of H. pylori in Xinjiang Uygur Autonomous Region is at a high level, with obvious regional and ethnic differences, and it is closely related to the local sanitation conditions and residents' eating habits.
Citation: Jiang Q, Liu WD, Hui WJ, Kong WJ, Feng Y, Kuerbanjiang A, Huang XL, Gao F. Prevalence and risk factors of Helicobacter pylori infection in Xinjiang Uygur Autonomous Region: A cross-sectional study of all age groups. World J Gastroenterol 2025; 31(21): 106033
Helicobacter pylori (H. pylori) infection, a chronic infectious disease with a high infection rate, has been classified as a definite Class I carcinogen by the World Health Organization[1-3]. Studies show that the H. pylori infection rate has been on a downward trend globally from 1980 to 2022. However, more than 40% of the world’s population is still infected with H. pylori[4]. Due to differences in socioeconomic development, population density and composition, income levels, and healthcare standards, the prevalence of H. pylori exhibits significant regional variations. The prevalence is the lowest in developed countries such as North America and Western Europe, while it remains high in most developing countries[5,6]. As a developing country, China has regional differences in economic and sanitation levels. The overall H. pylori infection rate in China is approximately 49.6%, and there are extensive regional disparities in the infection rate (20.6% to 81.8%)[7]. The H. pylori infection rates are relatively higher in the eastern and western regions than in the central region. There are even differences within some provinces[8,9]. Many studies have shown that various factors[9-11], including geographical location, living environment, socioeconomic status, personal habits, and socio-demographic characteristics, may be responsible for the wide variation in H. pylori infection rates among regions. Therefore, a comprehensive analysis of the prevalence of H. pylori infection and an assessment of regional risk factors are crucial for formulating targeted prevention and treatment strategies. Xinjiang Uygur Autonomous Region is located in the northwest of China, characterized by multi-ethnic aggregation, a vast area, and a scattered population. Currently, there is still a lack of comprehensive survey data on the H. pylori infection rate and its risk factors in the natural population of Xinjiang Uygur Autonomous Region. This paper aims to analyze the data from 15 regions in Xinjiang Uygur Autonomous Region, analyze the H. pylori infection rate in this region and evaluate the related risk factors, providing evidence - based support for the prevention and treatment of H. pylori infection in the population of Xinjiang Uygur Autonomous Region.
MATERIALS AND METHODS
Study subjects
This study was conducted in Xinjiang Uygur Autonomous Region from May 2022 to November 2023. Using the method of stratified random cluster sampling, random cluster sampling was carried out in 15 regions in Xinjiang Uygur Autonomous Region: Altay, Aksu, Börtala Mongol Autonomous Prefecture (Bole), Bayingolin Mongol Autonomous Prefecture (Korla, Yanqi), Changji Hui Autonomous Prefecture (Changji), Hami (Yiwu), Hetian (Hotan), Kashgar (Shule, Tashkurgan Tajike), Kizilsu Kirgiz Autonomous Prefecture (Artouche), Turpan, Tacheng, Ili Kazakh Autonomous Prefecture (Yining). According to "The Announcement of the Seventh National Population Census of Xinjiang Uygur Autonomous Region in 2021" (No. 2), the total population of the above - mentioned regions is 18951708, accounting for 73.31% of the total population of Xinjiang Uygur Autonomous Region. By simple random sampling, one area was randomly selected within each administrative region, and it was further divided into different standardized census areas according to natural villages or communities. The population of each census area was 200-400 people, and one standardized census area was randomly selected for the survey (the distribution of the survey locations and the number of participants in Xinjiang Uygur Autonomous Region are shown in Figure 1). A total of 4665 people were surveyed, with questionnaire surveys and H. pylori antibody blood tests conducted. Of 55 participants with missing basic information and 249 participants with missing blood samples were excluded. Finally, 4361 participants were included (flowchart of participant selection is shown in Figure 2).
The content of the questionnaire covers demographic and socioeconomic factors [including gender, age, ethnicity, marital status, occupation, family income (China Yuan), educational level, body mass index (BMI, kg/m2) and the altitude of the place of residence (m)], as well as dietary and lifestyle factors (including eating habits, smoking and drinking situations). The height and weight were measured by trained staff members, and the BMI was defined as the weight (kg) divided by the square of the height (m). According to the altitude standards, the surveyed areas were classified into low - altitude regions (< 1000 m), which included Altay, Bole, Jeminay, Korla, Turpan, Tacheng, and Yining; medium - altitude regions (1000-2000 m), which include Artux, Aksu, Changji, Hotan, Shule, Yiwu, and Yanqi; and medium to high altitude regions (3000-4000 m), with Tashkurgan Tajike being the representative area[12]. Smoking is defined as smoking at least one cigarette per day within the past year or having smoked in the past. Drinking alcohol is defined as consuming at least 1000 g of beer, 150 g of wine, or spirits at least once a week within the past year. The frequency of consumption of foods such as fruits, vegetables, and meats is defined as follows: If they are consumed every day or 3 to 5 times a week, it is considered frequent consumption. Gluttony is defined as consuming food in an amount that reaches or exceeds twice the normal dietary intake, occurring at least once a week and lasting for more than three months. Due to language communication barriers, a noisy on-site environment and time constraints, there is some data missing in the questionnaire survey.
H. pylori antibody detection
Blood samples (2-3 mL) were taken on an empty stomach in the morning. The blood samples were coded with unique identification numbers and analyzed while blinding the identities of the participants. All blood samples were centrifuged, transported with dry ice, and stored at -80 °C. The H. pylori antibody kit (Shenzhen Bioloot Biological Products Co., Ltd.) was used for the detection of H. pylori. The immunochromatographic method was adopted, and the specific operation was as follows: 75 μL of serum sample was dropped into the sample - adding well, and the test result was interpreted 15 minutes later. The test membrane strip was compared with the standard strip for qualitative determination of the result. Criteria for positive H. pylori antibody: Red bands appeared at both the quality control line and the test line. Criteria for negative H. pylori antibody: A red band appeared at the quality control line, while no red band appeared at the test line.
Statistical analysis
SPSS 25.0 statistical software was used for statistical analysis of relevant data. Measurement data conforming to the normal distribution were expressed as mean ± SD, and the t test was used for comparison between two groups. Measurement data not conforming to the normal distribution were expressed as median (interquartile range) [M (Q1, Q3)], and the non-parametric test was used for comparison between two groups. Enumeration data were described by frequency or constituent ratio, and the χ2 test was used for comparison between groups. Indicators with statistical significance in the univariate analysis were included in the multivariate Logistic regression analysis. P values < 0.05 were considered to indicate a statistically significant difference.
RESULTS
General data
A total of 4361 participants were included in the study, among whom 1699 were male and 2662 were female. The age range was from 4 to 90 years old, with an average age of 50.1 ± 15.3 years. The overall H. pylori infection rate was 70.79% (3087/4361). The H. pylori infection rate first increased and then decreased with the increase of age, and the difference was statistically significant (Z = -2.696, P < 0.05) (The H. pylori infection rates in different regions are shown in Figure 3). The H. pylori infection rate in Hotan was the highest, reaching 88%, while that in Yanqi was the lowest, at 37.21%. The difference was statistically significant (χ2 = 250.269, P < 0.01). Among different ethnic groups, the H. pylori infection rates of Han and Hui ethnic groups were relatively low, at 60.30% and 49.25% respectively, while those of Uyghur, Kirgiz, and Tajik ethnic groups were relatively high, at 77.33%, 77.50%, and 89.05% respectively. The differences in H. pylori infection rates among ethnic groups were statistically significant (χ2 = 182.478, P < 0.01). There was also a significant difference in family income (Z = -2.534, P < 0.01). Among different altitude regions, the H. pylori infection rate showed a gradually increasing trend with the increase of altitude, and the difference was statistically significant (Z = -3.914, P < 0.01; Table 1).
Figure 3 Helicobacter pylori infection rates in different regions.
Table 1 Analysis of the demographic characteristics with Helicobacter pylori Infection, n (%).
Variables
Number
H. pylori-positive
H. pylori-negative
χ2
P value
Gender
4361
Male
1699
1214 (71.45)
485 (28.55)
0.599
0.439
Female
2662
1873 (70.36)
789 (29.64)
Age, years
4361
≤ 29
478
347 (72.59)
131 (27.41)
-2.601
0.009
30-39
615
450 (73.17)
165 (26.83)
40-49
855
610 (71.35)
245 (28.65)
50-59
1179
844 (71.59)
335 (28.41)
≥ 60
1234
836 (67.75)
398 (32.25)
Ethnicity
4361
Han
947
571 (60.30)
376 (39.70)
182.791
< 0.001
Uyghur
1650
1276 (77.33)
374 (22.27)
Kazak
1053
741 (70.37)
312 (29.63)
Hui
266
131 (49.25)
135 (50.75)
Kirgiz
200
155 (77.50)
45 (22.50)
Tajik
210
187 (89.05)
23 (10.95)
Other
35
26 (74.29)
9 (25.71)
Marriage
4177
Married
3629
2567 (70.74)
1062 (29.26)
3.136
0.371
Unmarried
359
263 (73.26)
96 (26.74)
Divorced
53
41 (77.36)
12 (22.64)
Widowed
136
91 (66.91)
45 (33.09)
Occupation
4361
Farmer
2201
1558 (70.79)
643 (29.21)
8.378
0.079
Herdsman
366
249 (68.03)
117 (31.97)
Clerk
655
458 (69.92)
197 (30.08)
Self-employed and freelance
335
225 (67.16)
110 (32.84)
Other
804
597 (74.25)
207 (25.75)
Family income (China Yuan)
3799
≤ 3000
2408
1747 (72.55)
661 (27.45)
-2.534
0.011
3000-6000
970
677 (69.79)
293 (30.21)
≥ 6000
421
282 (66.98)
139 (33.02)
Education level
3618
Primary education and below
1376
974 (70.78)
402 (29.22)
4.01
0.405
Junior high school
1024
740 (72.27)
284 (27.73)
Senior high school and secondary vocational school
534
378 (70.79)
156 (29.21)
Junior college and undergraduate
676
486 (71.89)
190 (28.11)
Postgraduate
8
8 (100)
0
BMI, kg/m2
4161
< 18.5
227
163 (71.81)
64 (28.19)
-0.081
0.935
18.5-23.9
1482
1042 (70.31)
440 (29.69)
24.0-27.9
1400
983 (70.21)
417 (29.79)
≥ 28
1052
746 (70.91)
306 (29.09)
Altitude of habitation (m)
4361
Low (< 1000)
2154
1482 (68.80)
672 (31.20)
-3.914
< 0.001
Medium (1000-2000)
1902
1348 (70.87)
554 (29.13)
Medium to high (2000-4000)
305
257 (84.26)
48 (15.74)
Correlation analysis of different lifestyles, dietary habits and H. pylori infection
The analysis results show that the prevalence of H. pylori infection is associated with numerous factors. Among the factors related to dietary habits, in descending order of their degree of correlation with the prevalence of infection, are as follows: Frequent consumption of beef (χ2= 6.058, P < 0.01), mutton (χ2= 17.496, P < 0.01), various common dried nuts, such as almonds, apricot kernels, raisins, red dates, walnuts, etc., (χ2= 16.688, P < 0.01), barbecue foods (χ2= 10.030, P < 0.01), and cured meats, such as cured pork and Chinese sausage (χ2= 5.937, P < 0.05). Moreover, the behavior of sharing tableware or not (χ2= 6.797, P < 0.01) and the situation of drinking river water or not (χ2= 13.734, P < 0.01) are also correlated with the prevalence of H. pylori infection (Table 2).
Table 2 Correlation analysis of Helicobacter pylori infection with lifestyles and dietary habits, n (%).
Variables
Number
H. pylori-positive
H. pylori-negative
χ2
P value
Smoking
4361
Yes
660
465 (70.45)
195 (29.55)
0.041
0.839
No
3701
2622 (70.85)
1079 (29.15)
Drinking
4361
Yes
521
358 (68.71)
163 (31.29)
1.229
0.268
No
3840
2729 (71.07)
1111 (28.93)
Regular consumption of fruits
4267
Yes
2798
1973 (70.51)
825 (29.49)
0.318
0.573
No
1469
1048 (71.34)
421 (28.65)
Regular consumption of vegetables
4267
Yes
3782
2673 (70.68)
1109 (29.32)
0.241
0.624
No
485
348 (71.75)
137 (28.25)
Regular consumption of beef
3943
Yes
1472
1069 (72.62)
403 (27.38)
6.058
0.014
No
2471
1703 (68.92)
768 (31.08)
Regular consumption of mutton
4100
Yes
2882
2099 (72.83)
783 (27.17)
17.496
0
No
1218
808 (66.34)
410 (33.66)
Regular consumption of dairy products
4065
Yes
685
508 (74.16)
177 (25.84)
3.594
0.058
No
3380
2385 (70.56)
995 (29.44)
Regular consumption of dried nuts
3799
Yes
1558
1167 (74.90)
391 (25.10)
16.688
0
No
2241
1542 (68.81)
699 (31.19)
Regular consumption of spicy and strong-flavored foods
4016
Yes
751
520 (69.24)
231 (30.76)
2
0.185
No
3265
2340 (71.67)
925 (28.33)
Regular consumption of barbecued foods
3728
Yes
633
484 (76.46)
149 (23.54)
10.03
0.002
No
3095
2173 (70.21)
922 (29.79)
Frequent consumption of preserved meat
3747
Yes
259
202 (77.99)
57 (22.01)
5.937
0.015
No
3488
2473 (70.90)
1015 (29.10)
Used tableware in a mixed way
3740
Yes
2069
1508 (72.89)
561 (27.11)
6.797
0.009
No
1671
1153 (69.00)
518 (31.00)
Share dental sets
3698
Yes
159
108 (67.93)
51 (32.07)
0.811
0.368
No
3539
2521 (71.24)
1018 (28.76)
Drink river water
3812
Yes
235
193 (82.13)
42 (17.87)
13.734
0
No
3577
2535 (70.87)
1042 (29.13)
Eat regularly
3830
Yes
3103
514 (70.70)
213 (29.30)
0.272
0.602
No
727
2224 (71.67)
879 (28.33)
Engorgement
3834
Yes
401
274 (68.33)
127 (31.67)
2.198
0.138
No
3433
2467 (71.86)
966 (28.14)
Multivariate logistic regression analysis of factors associated with H. pylori infection
Important variables were included in the multivariate Logistic regression model. Further analysis revealed that altitude [odds ratio (OR): 1.219, 95%CI: 1.068-1.392], regular consumption of beef (OR: 1.327, 95%CI: 1.115-1.580), regular consumption of mutton (OR: 1.351, 95%CI: 1.125-1.622), regular consumption of dried nuts (OR: 1.225, 95%CI: 1.035-1.451), regular consumption of barbecue foods (OR: 1.380, 95%CI: 1.084-1.757), and drinking river water (OR: 2.062, 95%CI: 1.374-3.094) were positively correlated with H. pylori infection (Table 3).
Table 3 Multivariate analysis of Helicobacter pylori infection.
Variable
OR
95%CI
P value
Altitude
1.219
1.068-1.392
0.003
Regular consumption of beef
1.327
1.115-1.580
0.001
Regular consumption of mutton
1.351
1.125-1.622
0.001
Regular consumption of dried nuts
1.225
1.035-1.451
0.019
Regular consumption of barbecue foods
1.380
1.084-1.757
0.009
Drink river water
2.062
1.374-3.094
0.000
DISCUSSION
This study is the first large-scale cross-sectional survey on the prevalence of H. pylori and its risk factors in Xinjiang Uygur Autonomous Region. The results show that the H. pylori infection rate in the natural population of Xinjiang Uygur Autonomous Region is 70.79%, which is significantly higher than the average H. pylori infection rate in China. Studies indicate that the global H. pylori infection rate is approximately 48.9%. Regionally, the infection rates are as follows: The Eastern Mediterranean region (59.1%), the African region (58.3%), the European region (47.5%), the Americas region (46.9%), the Western Pacific region (46.8%), and the Southeast Asian region (46.6%)[4]. A meta-analysis spanning from 1990 to 2019 shows that the H. pylori infection rate in mainland China is 44.2%, with an estimated 589 million people infected. Regionally, the infection rates are as follows: The Northwest region (51.8%), the East China region (47.7%), and the Southwest region (46.6%)[13]. The analysis of previous relevant research findings in this region indicates that the H. pylori infection rate here is at a relatively high level, with significant regional disparities ranging from 51.08% to 61.99%[14,15]. Since this region is situated in the western part of China and covers a vast region, it follows that there are differences in the levels of social and economic development, public health conditions, as well as dietary and living habits among different areas. These factors are highly likely to be the reasons for the relatively high H. pylori infection rate in this region. The study found that the H. pylori infection rate first increases and then decreases with the increase of age, which is consistent with other reports[16,17].
Many studies suggest that the relatively high H. pylori infection rate in Xinjiang Uygur Autonomous Region may be related to lifestyle, medical and health conditions, and economic factors. Based on this, this paper further analyzes the correlation between different lifestyles, dietary habits, and the H. pylori infection rate[15,18,19]. Through a random sampling method, this study analyzed the H. pylori infection rate in 15 regions of Xinjiang Uygur Autonomous Region and found that there are differences in the H. pylori infection rate among different regions, ethnic groups, and altitude regions in Xinjiang Uygur Autonomous Region. This may be due to the ethnic differences of the permanent residents in different areas. In the southern regions, ethnic minorities such as Uyghur, Tajik, and Kirgiz are the main groups, while in the northern regions, nomads such as Kazakhs are predominant. And the lack of awareness of the prevention and treatment of H. pylori infection, as well as differences in hygiene and economy, result in serious cross - infection and family - clustered infection, which is consistent with previous studies[20-22]. This study shows that family income is related to H. pylori infection. The infection rate shows a downward trend with the increase of family income. Currently, relevant domestic and foreign reports suggest that the H. pylori infection rate is related to family income, hygiene conditions, and economic resources. The higher the family income, the lower the infection rate, which is consistent with the results of this study[23-26]. This survey shows that the H. pylori infection rate is relatively high in those who often consume beef and mutton. As the main sources of meat products in this region, beef and mutton are consumed frequently. Due to the characteristic cooking and eating habits in this region, they are often prepared in ways such as pilaf, boiled lamb, and barbecue, which increases the risk of H. pylori infection. This survey found that the frequent consumption of dried nuts snacks such as almonds, raisins, and red dates is related to H. pylori infection. Xinjiang Uygur Autonomous Region dried nuts are deeply loved by people because of their rich nutrition and excellent quality. In most families in this region, dried fruits are self - made by natural sun - drying. H. pylori are likely to parasitize on the surface of the food, which may increase the risk of infection. Research reports indicate that salt can disrupt the integrity of the gastric mucosa, promote the colonization of H. pylori, ultimately triggering inflammation, and accelerate the occurrence of gastric cancer[25].
There are many factors influencing H. pylori infection. Besides the factors mentioned above, studies have shown that consuming street snacks and dining out are positively correlated with H. pylori infection[27]. The results of this study indicate that the H. pylori infection rate is higher among those who frequently consume foods like barbecue and cured meat. It is speculated that this might be related to the relatively high salt content in these foods, as well as the possible generation of carcinogenic substances such as N-nitroso compounds during the processing. These substances can stimulate gastric acid secretion, causing acute damage to the gastric mucosa and increasing the incidence of H. pylori infection. Additionally, during the cooking process of barbecue foods, there may be issues such as inadequate heating and sub-standard hygiene conditions[26]. This study found that sharing tableware is associated with H. pylori infection. As a chronic infectious disease, H. pylori exhibits a family-clustering phenomenon, and sharing tableware may contribute to the transmission of H. pylori. An epidemiological review has proposed that drinking well water is a risk factor for H. pylori infection, and H. pylori DNA has been detected in samples of river water, seawater, well water, and drinking water[27,28]. Some studies also believe that the aquatic environment and sewage sludge potentially play a role in the transmission of H. pylori infection[29]. This further supports the findings of this study, namely that the H. pylori infection rate is higher among people who drink river water. In Xinjiang Uygur Autonomous Region, many farmers and herdsmen live in mountainous areas where water resources for drinking are limited. The river water they drink may not meet the hygiene standards and may not be adequately heated, both of which can increase the risk of H. pylori exposure.
The multivariate Logistic regression analysis of this study shows that the altitude of the regions, a preference for beef and mutton, dried nuts, barbecue foods, and drinking river water are independent risk factors for H. pylori infection. Xinjiang’s unique geographical feature of “three mountains enclosing two basins” leads to diverse landforms and significant altitude differences. High-altitude areas are inhabited by nomadic ethnic groups. The unique dietary patterns, scarce living resources, and insufficient awareness of disinfection and hygiene all increase the risk of H. pylori infection. The multiple poor living and dietary hygiene habits contribute to the relatively high H. pylori infection rate in this region. Therefore, more intensive publicity and education on H. pylori infection, more accurate screening methods, and more effective eradication strategies should be adopted to reduce the H. pylori infection rates among different populations in this region.
This study has certain limitations. Firstly, this study employed the immunochromatographic antibody method to detect H. pylori infection. Due to the fact that the antibodies produced by previous infections will persist in the body for a certain period of time, this detection method may lead to the statistical result of the H. pylori infection rate being slightly higher than the actual level. Secondly, there are some missing data in the study. After discovering this issue, we carried out a meticulous verification of the original questionnaires and data entry processes, and supplemented the missing data of some variables. However, there is still a small amount of data that cannot be filled. Given that the data sources of this study are real and reliable, the sample size is large, and it has broad representativeness, we judge that the remaining data can still accurately reflect the actual situation and will not have a serious impact on the accuracy of the research results. In conclusion, this study is the first large - scale cross - sectional survey on H. pylori infection among the general population in the Xinjiang Uygur Autonomous Region. The research findings not only provide detailed data for understanding the status of H. pylori infection and analyzing the risk factors for infection in the Xinjiang Uygur Autonomous Region, but also provide valuable references for the prevention and treatment of H. pylori infection in the local area. In addition, the results of this study can also provide guidelines for policymakers, helping to address the problem of the high prevalence of H. pylori and promoting the precise formulation and effective implementation of prevention and control measures.
CONCLUSION
In conclusion, this study clearly indicates that the infection rate of H. pylori in Xinjiang Uygur Autonomous Region is relatively high, and there are significant differences between regions and ethnic groups. The analysis shows that the altitude of the place of residence, the preference for beef, mutton, dried nuts, barbecued foods, and the consumption of river water are independent risk factors for the infection. In order to reduce the infection rate among different populations, it is necessary to vigorously strengthen the popularization of knowledge about H. pylori infection, promote accurate and efficient screening methods, formulate scientific, reasonable, and practical eradication strategies, and safeguard the health of the public in an all-round way.
ACKNOWLEDGEMENTS
We express our gratitude to all individuals who agreed to participate in this study, as well as the medical and technical personnel involved. Additionally, we would like to thank Shenzhen Bioloot Biological Products Co., Ltd. for providing the H. pylori antibody detection kit.
Footnotes
Provenance and peer review: Unsolicited article; Externally peer reviewed.
Peer-review model: Single blind
Specialty type: Gastroenterology and hepatology
Country of origin: China
Peer-review report’s classification
Scientific Quality: Grade A, Grade A, Grade A, Grade B
Novelty: Grade A, Grade A, Grade B, Grade B
Creativity or Innovation: Grade A, Grade B, Grade B, Grade C
Scientific Significance: Grade A, Grade A, Grade B, Grade B
P-Reviewer: Hussein AM; Ullah W S-Editor: Li L L-Editor: A P-Editor: Wang WB
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