Author(s): RH Hunt, SD Xiao, F Megraud, R LeonBarua, F Bazzoli
Helicobacter pylori (Hp) is found in half the population of the world. Its prevalence is highly variable in relation to geography, ethnicity, age, and socioeconomic factors - high in developing countries and lower in the developed world. In general, however, there has been a decreasing trend in the prevalence of Hp in many parts of the world in recent years. Direct epidemiologic comparisons of peptic ulcer disease (PUD) between developing and developed countries are complex, as peptic ulcers may be asymptomatic and the availability and accessibility of the tests required for diagnosis vary widely. In developing countries, Hp infection is a public-health issue. The high prevalence of the infection means that public-health interventions may be required. Therapeutic vaccination is probably the only strategy that would make a decisive difference in the prevalence and incidence of Hp throughout the world. The short-term approach, however - provided that resources allow for this - would be a test-and- treat strategy for those who are at risk for peptic ulcer disease or gastric cancer, as well as for those with troublesome dyspepsia.