The Loiano-Monghidoro population-based study of Helicobacter pylori infection: prevalence by C-13-urea breath test and associated factors

Objectives: As part of a cross-sectional study on cholelithiasis, 1533 out of 1840 residents in Loiano/Monghidoro, a rural area in Northern Italy (792 men, 741 women, age range 28-80 years), agreed to be further evaluated in relation to their Helicobacter pylori status. Methods: Each participant performed a C-13-urea breath test (C-13-UBT) and provided information on sociodemographic, lifestyle and clinical characteri stics. Results: The C-13-UBT was positive in 1041 subjects (67.9%; men: 69%; women : 67%) and was positively associated with increasing age (P < 0.001), alcoh ol consumption (P < 0.01), a higher number of siblings (P < 0.001) and a pe rsonal history of peptic ulcer (P < 0.01), but inversely with a nonmanual o ccupation (P < 0.001). Overall, H. pylori infection was unrelated to smokin g, house pets, and a family history of gastroduodenal diseases. The prevale nce of H. pylori infection was 72% in subjects reporting one or more dyspep tic symptoms and 65% among asymptomatic participants (P < 0.001); a multiva riate analysis showed that only epigastric pain was significantly, although weal cly, associated with C-13-UBT positivity. Conclusions: This large population-based study showed a prevalence of H. py lori infection higher than that reported by serologic surveys in urban area s. Current H. pylori infection was strongly associated with indicators of l ower socioeconomic status, alcohol consumption and increasing age. A role o f H. pylori infection in determining epigastric pain was suggested.