What is the prevalence of Helicobacter pylori (H. pylori) infection in South India?

From the Guidelines

The prevalence of Helicobacter pylori (H. pylori) infection in South India is approximately 50%, with the highest prevalence found in developing countries. This is based on the fact that the worldwide prevalence of H. pylori infections is approximately 50%, with the highest being in developing countries 1.

Key Points to Consider

• The prevalence of H. pylori infection can vary significantly depending on regional factors such as socioeconomic conditions, sanitation, and access to clean water.
• In South India, the prevalence may be higher in rural areas compared to urban settings due to differences in living conditions.
• Risk factors for H. pylori infection in South India include overcrowded living conditions, poor sanitation, lower socioeconomic status, and sharing of drinking water sources.

Diagnosis and Treatment

• The infection is typically diagnosed through endoscopic biopsy with rapid urease test, histopathology, urea breath test, or stool antigen testing.
• Standard treatment involves triple therapy consisting of a proton pump inhibitor (PPI) plus two antibiotics, such as amoxicillin and clarithromycin, for 14 days 1.
• However, regional antibiotic resistance patterns may necessitate quadruple therapy or other combinations in some cases, highlighting the importance of considering local resistance patterns when selecting a treatment regimen 1.

Regional Variations

• South Indian states like Tamil Nadu, Kerala, Karnataka, and Andhra Pradesh may show varying rates of H. pylori infection, with some studies indicating a gradual decline in prevalence over recent decades, particularly in urban centers with improved living conditions.
• It is essential to consider these regional variations when assessing the prevalence of H. pylori infection in South India.

From the Research

Prevalence of Helicobacter pylori Infection

• The prevalence of Helicobacter pylori (H. pylori) infection varies globally, with higher rates found in Central/South America and Asia 2.
• A systematic review and meta-analysis found that the global prevalence of H. pylori infection decreased from 58.2% in the 1980-90 period to 43.1% in the 2011-22 period 3.
• The prevalence of H. pylori infection is higher in countries with high gastric cancer incidence 2.

Regional Prevalence

• In Asia, the prevalence of H. pylori infection is relatively high, but specific data for South India is not provided in the available studies 2, 3.
• The WHO African region showed the largest decline in H. pylori prevalence between 2011 and 2022 3.

Factors Influencing Prevalence

• The prevalence of H. pylori infection is influenced by factors such as age, income level, and universal health coverage 3.
• Younger people, high-income countries, and countries with high levels of universal health coverage tend to have lower prevalence rates 3.

Diagnostic and Treatment Strategies

• The "test-and-treat" strategy is recommended for managing H. pylori infection, with the choice of testing method based on patient age, symptoms, and medication use 4.
• Treatment regimens should be selected based on regional resistance patterns and prior antibiotic exposure 5, 4.