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WGO Practice Guideline: Helicobacter pylori in Developing Countries
Globally, different Hp strains are associated with differences in virulence, interplaying with host factors and environmental factors, with subsequent differences in the expression of disease.
Age, ethnicity, gender, geography and socio-economic status are all factors that influence the incidence and prevalence of Hp infection. The overall prevalence is high in developing countries and lower in developed countries. Within countries, there may be a similarly wide variation in the prevalence between more affluent urban populations and rural populations.
The principal reasons for variation involve socioeconomic differences between populations. Transmission of Hp is largely by the oral–oral or fecal–oral routes. A lack of proper sanitation, of safe drinking water, and of basic hygiene, as well as poor diets and overcrowding, all play a role in determining the overall prevalence of infection.
Table 1 Helicobacter pylori infection globally
| Country | % |
| Mexico, Central/ South America | 70–90% |
| Africa | 70–90% |
| Asia | 50–80% |
| Eastern Europe | 70% |
| Western Europe | 30–50% |
| United States and Canada | 30% |
| Australia | 20% |
Table 2 Prevalence of Helicobacter pylori in developing countries
| Region and country | Adults(>21 y) | Children |
| Africa | ||
| Ehtiopia | >95% | 48% (2–4 y) to 80% (6 y) |
| Gambia | >95% | 95% (5 y) |
| Nigeria | 91% | 82% (5–9 y) |
| Asia | ||
| Bangladesh | >90% | 58% (0–4 y) to 82% (8–9 y) |
| China | 55% | 41% (3–12 y) |
| India | 88% | 22% (0–4 y) to 87% (10–19 y) |
| Siberia | 85% | 30% (5 y) to 63% (15–20 y) |
| Sri Lanka | 72% | 67% (6–19 y) |
| Middle East | ||
| Egypt | 90% | 50%(3y) |
| Jordan | 82% | |
| Libya | 94% | 50% (1–9 y) to 84% (10–19 y) |
| Saudi Arabia | 80% | 40% (5-9 y) |
| Turkey | 80% | 64% (6–17 y) |
| Central America | ||
| Guatemala | 65% | 51% (5–10 y) |
| Mexico | 43% (5–9 y) |
| South America | ||
| Bolivia | 54%(5y) | |
| Brazil | 82% | 30% (6–8 y) to 78% (10–19 y) |
| Chile | 72% | 36% (3–9 y) |
| Peru | 52% (3 y) |
