Helicobacter pylori seroepidemiology in five areas of Taiwan and real-time PCR assay for detection of Helicobacter pylori in water
Date Issued
2008
Date
2008
Author(s)
Cheng, Chia-Chi
Abstract
Helicobacter pylori (H. pylori) infection is common throughout the world, and the prevalence of H. pylori varies between developing and developed countries, where prevalence among adults is typically around 80-90% and 50%, respectively. H. pylori infection is a major factor in the etiology of peptic ulcer disease､chronic gastritis､gastric cancer､gastric mucosa-associated lymphoid tissue lymphoma, and so on. Owing to the widespread prevalence and clinical significance, infection with H. pylori constitutes an issue of major public health importance and H. pylori seroepidemiology study would provide information in the management and prevention of upper digestive disease such as peptic ulcer and survey of high-risk cancer population. It is thus urgent to study seroprevelance of H. pylori in Taiwan and explore the factors associated with H. pylori infection. The previous H. pylori epidemiology reports in Taiwan had limited age range, small location distribution of Taiwan, or incomplete data on the seroepidemiology of H. pylori. In this study, we investigated the seroprevalence and the risk factors associated with H. pylori infection in five different areas covering the eastern, western, northwestern, western and southern Taiwan. Sera of 120 pairs of infants and their mothers, and 3644 people, were collected in Jan-July 1999 in five areas of Taiwan including Taoyuan, Ilan, Taichung, Taipei City and Kaohsiung City. The Helicobacter pylori antibody was detected with EIA (enzyme-linked immunosorbent assay) commercial kit (IBL: immuno-biological immunoassay). All the subjects completed a structured questionnaire regarding demographic data, residential area, numbers of children and adults in a family, travel history, sources of water supply, etc. Statistical analysis was performed using logistic regression and the chi-square test. The overall age-adjusted H. pylori seroprevalence in Taiwan was 43.9%. Age-specific stepwise increase of H. pylori seroprevalence was found in northern (Taipei), eastern (Ilan), and north-western (Taoyuan) Taiwan but a biphasic curve was found in western (Taichung) and southern (Kaohsiung) Taiwan. People younger than 20 years old had H. pylori seropositivity rate of 20.0% with significant geographic variation (p<0.001): higher positive rates in western (37.3%) and southern Taiwan (34.0%) than in northern (5.0%), north-western (11.5%) and eastern Taiwan (10.1%); river/underground/well water used as drinking water source, living in western and southern Taiwan, male gender and less children number in the family were factors associated with H. pylori infection. A significant correlation of H. pylori seropositivity and the rates of drinking river/underground/well water was found (r=0.32 and p=0.037). Higher percentage of people used well/underground/river water as drinking water source in northeastern, western, and southern Taiwan, esp southern Taiwan (52.4%). People aged older than 20 years had overall seroprevalence rate of 55% without geographic difference. Our current study shows that the age-specific seroprevalence of H. pylori in 1999 declined one decade later in comparison with the age-specific seroprevelance in 1989. Socioeconomic status and hygiene condition improvement are assumed to be responsible for the declined H. pylori prevalence. Transplacentally transferred maternal anti-H. pylori IgG disappeared in all the infants by 5 months of age. While the sources of H. pylori infection remain uncertain, epidemiological evidence suggests that water is one potential source. In our study, we thus tried to detect H pylori in water by real-time polymerase chain reaction (real-time PCR). A total of 44 water samples were collected from river/lake/spring/tap/underground water in different areas in Taiwan. H. pylori Ure A gene was examined using real-time PCR after centrifugation and DNA extraction of water samples. The recovery efficiency of serial centrifugation､DNA extraction､and real-time PCR was around 50%. H. pylori was not detected in current water samples. Although negative results, we constructed a standard protocol to detect H. pylori in water and hoped the method be applied in detecting H. pylori in water on large scale, esp the drinking water.
Subjects
Helicobacter pylori
seroprevalence
risk factors
Taiwan
real-time PCR
water
SDGs
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