Epidemiology of Helicobacter pylori infection among the healthy population in Iran and countries of the Eastern Mediterranean Region: A systematic review of prevalence and risk factors

Table 1 Prevalence of Helicobacter pylori infection in the Iranian population

Ref.	Year	Location	Age group	Number (M/F)	Prevalence	Prevalence (%) (M/F)	Method of detection
Alborzi et al[12]	2005	Shiraz (Southern Iran)	8 mo-15 yr	593 (308/284)	82.0%	81/83	Stool antigen
Nouraie et al[13]	2009	Tehran	18-65 yr	2326 (968/1358)	69.0%	67.6/70.0	ELISA IgG-Ab
Jafarzadeh et al[14]	2005	Rafsanjan (Southeast Iran)	1-15 yr	386 (187/199)	46.6%	51.9/41.7	ELISA IgG-Ab
Jafarzadeh et al[15]	2005	Rafsanjan (Southeast Iran)	20-60 yr	200 (114/86)	67.5%	71.9/61.6	ELISA IgG-Ab
Alizadeh et al[16]	2003	Nahavand (Western Iran)	≥ 6 yr	1518 (653/865)	70.6%	66.6/73.4	ELISA IgG-Ab
Ghasemi Kebria et al[17]	2010	Golestan province (Northeast Iran)	1-83 yr	1028 (489/539)	66.4%	66.3/66.6	ELISA IgG-Ab
Jafar et al[18]	2007	Sanandaj (Western Iran)	4 mo-15 yr	458 (231/227)	64.2%	65/63	Stool antigen
Mikaeli et al[19]	1997	Ardebil and Yazd (Northwest and Central Iran)	< 20 yr	711 (NA)	47.5% (Ardebil)	NA	ELISA IgG-Ab
					30.6% (Yazd)
Mansour-Ghanaei et al[20]	2007	Rasht (Northern Iran)	7-11 yr	961 (475/486)	40.0%	49.7/50.3	Stool antigen
Mahram et al[21]	2004	Zanjan (Western Iran)	7-9 yr	278 (150/128)	52.8%	56.0/50.7	ELISA IgG-Ab

M: Male; F: Female; ELISA: Enzyme- linked immunosorbent assay; Ab: Antibody; NA: Not available.

Table 2 Risk factors for Helicobacter pylori infection and prevalence of Anti-Cag A seropositivity in the Iranian population

Ref.	Prevalence of Anti-Cag A	Main findings and risk factors
Alborzi et al[12]	NA	The prevalence of H. pylori was significantly lower in the 15-yr-old age group compared to the < 14-yr-old age group
		Sex was not a risk factor for prevalence
Nouraie et al[13]	NA	Higher maternal education was protective against H. pylori infection
		Low education, increasing age and overcrowding were risk factors for H. pylori infection
Jafarzadeh et al[14]	72.8%	Prevalence of Anti-Hp IgG and Anti-Cag A Ab were increased with age
Jafarzadeh et al[15]	67.4%	Prevalence of Anti-Cag A Ab was higher in males than females
		Prevalence of Anti-Cag A Ab was higher in those < 30 yr
Alizadeh et al[16]	NA	Female sex and age (median 37 yr) were risk factors for H. pylori infection
		Hygienic practice and crowding were not risk factors for H. pylori infection
Ghasemi Kebria et al[17]	57.7%	No significant difference between rural and urban areas regarding prevalence
		Seroprevalence increased with increasing age
Jafar et al[18]	NA	Larger family size was associated with higher prevalence
		Increasing age was associated with H. pylori infection
Mikaeli et al[19]	NA	Increasing age was the only predictor of H. pylori infection
Mansour-Ghanaei et al[20]	NA	Water supply was a predictor of H. pylori infection
Mahram et al[21]	NA	Age and sex were not risk factors for H. pylori infection

NA: Not available; H. pylori: Helicobacter pylori.

Table 3 Prevalence and risk factors of Helicobacter pylori infection in the healthy population of Eastern Mediterranean Regional Office countries

Ref.	Year	Country	Age group	Number	Prevalence	Method of detection	Risk factors
Bani-Hani et al[22]	2006	Jordan	1-9 yr	200	55.5%	ELISA IgG-Ab	Living in rural areas, poor sanitation, overcrowding, low maternal educational level, low socioeconomic status
Naous et al[23]	2007	Lebanon	1 mo-17 yr	414	21.0%	Stool antigen	Low socioeconomic status, overcrowded houses, lower family income and poor parental education
Bakka et al[24]	2002	Libya	1- > 70 yr	360	76.0%	ELISA IgG-Ab	Low socioeconomic status, low educational level
Mansour et al[25]	2010	Tunisia	Any age	250	64.0%	ELISA IgG-Ab	NA
Bener et al[26]	2000	UAE	Any age	223	78.4%	ELISA IgG-Ab	NA
Bener et al[27]	2006	UAE	Any age	151	74.1%	ELISA IgG-Ab	Unavailable drinking water, low educational level, long working duration, BMI > 25, housing conditions
Salem et al[28]	1993	Egypt	< 30 yr	89	87.6%	ELISA IgG-Ab	NA
Mohammad et al[29]	2007	Egypt	6-15 yr	286	72.38%	UBT	Low socioeconomic status, low body weight and height, living in rural areas
Naficy et al[30]	1997	Egypt	< 36 mo	187	10.0%	ELISA IgG-Ab	Only age (6-17 mo)
Bassily et al[31]	1992	Egypt	17-42 yr	169	88.0%	ELISA IgG-Ab	Lower level of education
Al Faleh et al[32]	2007	KSA	16-18 yr	1200	47.0%	ELISA IgG-Ab	Being female
							Residing in Medina region
Hanafi et al[33]	2012	KSA	Any age	456	28.3%	ELISA IgG-Ab	Rural residence, crowded housing, low socioeconomic status, use of tanks for drinking water supply, active smoking, alcohol drinking, eating raw vegetables, eating spicy food, presence of asthmatic/atopic symptoms
Khan et al[34]	2003	KSA	15-50 yr	396	51.0%	ELISA IgG-Ab	Higher age
Al-Moagel et al[35]	1989	KSA	5-90 yr	364	66.0%	ELISA IgG-Ab	Higher age
Al-knawy et al[36]	1999	KSA	2-97 yr	355	67% Mother	Saliva IgG-Ab	The infection was higher in infants when both parents were positive
					64% Father
					23% Children
Al-Balushi et al[37]	2013	Oman	15-50 yr	133	69.5%	ELISA IgG-Ab	Increasing age
							Being male

ELISA: Enzyme-linked immunosorbent assay; Ab: Antibody; NA: Not available; UAE: United Arab Emirates; KSA: Kingdom of Saudi Arabia; UBT: Urea breath test.