Helicobacter Pylori cagA+ Genotype is Associated With Consumption of Untreated Drinking Water in North-Eastern Brazil

Abstract

Introduction: This study aimed to identify the Helicobacter pylori cagA+ genotype prevalent in a region of north-eastern Brazil and find possible associations between this genotype and socioeconomic variables. Methods: This cross-sectional study included 751 patients with dyspepsia from a public endoscopy clinic. Genotyping was carried out on 98 samples from gastric tissue with positive urease test for H. pylori using polymerase chain reaction (PCR). Socioeconomic variables were collected via forms. Pearson’s χ2 test was used to analyze associations between variables and odds ratios were obtained to compare effects. Statistical significance was defined as p < 0.05 for univariate and multivariate analyses. Results: H. pylori infection was present in 52.7% of the patients and associated with low income and consumption of untreated drinking water. The prevalence of the cagA+ genotype was 25.5%. Low income was inversely related to the presence of cagA+ genotype, even after adjustment. Untreated drinking water consumption was associated with the presence of the cagA+ genotype in both the univariate ( p = 0.03; OR = 2.55; 95% CI: 1.008–6.48) and multivariate ( p = 0.03; OR = 2.89; 95% CI: 1.08–7.67) analyses. Conclusion: The findings of this study suggest that water can be an important vehicle for the transmission of pathogenic H. pylori strains and may be a public health challenge, especially in less developed regions with precarious water and sanitary conditions.