{"title":"伊朗的胃病:社会和经济因素在幽门螺杆菌感染中的作用。","authors":"Hamed Zandian, Telma Zahirian Moghadam, Farhad Pourfarzi, Reza Malekzadeh, Satar Rezaei, Sevda Ghorbani","doi":"10.34172/hpp.2023.15","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong><i>Helicobacter pylori</i> infection is a major risk factor for gastric cancer in Iran, but the impact of socioeconomic factors on its prevalence is poorly understood. This study aimed to assess the socioeconomic inequalities and risk factors associated with <i>H. pylori</i> infection in Iran.</p><p><strong>Methods: </strong>This cross-sectional study was conducted based on the PERSIAN cohort study. A total of 20460 individuals aged 35 to 70 years in Ardabil, Iran were included in the study. <i>H. pylori</i> infection was determined based on stool tests and clinical records. Multilevel logistic regression models with random intercepts at household and community levels were used to identify risk factors associated with <i>H. pylori</i> prevalence. The concentration index (CIn) and concentration curve (CC) were employed to assess socioeconomic-related inequality.</p><p><strong>Results: </strong>In this study, 70.4% (CI 69.6-71.0) of the participants were infected with <i>H. pylori</i>, with a higher prevalence in women (71.2%) than men (69.6%). Age (OR: 1.37, CI: 1.17-1.61), sex (OR: 1.20, CI: 1.12-1.28), level of education (OR: 1.33, CI: 1.17-1.49), cardiac disease (OR: 1.32, CI:1.18-1.46), and BMI groups (OR: 2.49, CI: 1.11-5.58) were significantly associated with <i>H. pylori</i> infection based on the multivariable logistic regression. The results of the CIn and CC indicated that <i>H. pylori</i> were more prevalent among economically disadvantaged groups (CIn: -0.1065; [-0.1374 to -0.0755]).</p><p><strong>Conclusion: </strong>The prevalence of <i>H. pylori</i> in Iran is higher than in other developing countries, and significant socioeconomic inequality exists between the poor and the rich. To reduce the rate of gastric cancer, socio-economic and demographic factors, especially the poor and people with low levels of education, should be considered.</p>","PeriodicalId":46588,"journal":{"name":"Health Promotion Perspectives","volume":"13 2","pages":"120-128"},"PeriodicalIF":2.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439454/pdf/","citationCount":"0","resultStr":"{\"title\":\"Gastric troubles in Iran: The role of social and economic factors in <i>Helicobacter pylori</i> infection.\",\"authors\":\"Hamed Zandian, Telma Zahirian Moghadam, Farhad Pourfarzi, Reza Malekzadeh, Satar Rezaei, Sevda Ghorbani\",\"doi\":\"10.34172/hpp.2023.15\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong><i>Helicobacter pylori</i> infection is a major risk factor for gastric cancer in Iran, but the impact of socioeconomic factors on its prevalence is poorly understood. This study aimed to assess the socioeconomic inequalities and risk factors associated with <i>H. pylori</i> infection in Iran.</p><p><strong>Methods: </strong>This cross-sectional study was conducted based on the PERSIAN cohort study. A total of 20460 individuals aged 35 to 70 years in Ardabil, Iran were included in the study. <i>H. pylori</i> infection was determined based on stool tests and clinical records. Multilevel logistic regression models with random intercepts at household and community levels were used to identify risk factors associated with <i>H. pylori</i> prevalence. The concentration index (CIn) and concentration curve (CC) were employed to assess socioeconomic-related inequality.</p><p><strong>Results: </strong>In this study, 70.4% (CI 69.6-71.0) of the participants were infected with <i>H. pylori</i>, with a higher prevalence in women (71.2%) than men (69.6%). Age (OR: 1.37, CI: 1.17-1.61), sex (OR: 1.20, CI: 1.12-1.28), level of education (OR: 1.33, CI: 1.17-1.49), cardiac disease (OR: 1.32, CI:1.18-1.46), and BMI groups (OR: 2.49, CI: 1.11-5.58) were significantly associated with <i>H. pylori</i> infection based on the multivariable logistic regression. The results of the CIn and CC indicated that <i>H. pylori</i> were more prevalent among economically disadvantaged groups (CIn: -0.1065; [-0.1374 to -0.0755]).</p><p><strong>Conclusion: </strong>The prevalence of <i>H. pylori</i> in Iran is higher than in other developing countries, and significant socioeconomic inequality exists between the poor and the rich. To reduce the rate of gastric cancer, socio-economic and demographic factors, especially the poor and people with low levels of education, should be considered.</p>\",\"PeriodicalId\":46588,\"journal\":{\"name\":\"Health Promotion Perspectives\",\"volume\":\"13 2\",\"pages\":\"120-128\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439454/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Promotion Perspectives\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.34172/hpp.2023.15\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Promotion Perspectives","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.34172/hpp.2023.15","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Gastric troubles in Iran: The role of social and economic factors in Helicobacter pylori infection.
Background: Helicobacter pylori infection is a major risk factor for gastric cancer in Iran, but the impact of socioeconomic factors on its prevalence is poorly understood. This study aimed to assess the socioeconomic inequalities and risk factors associated with H. pylori infection in Iran.
Methods: This cross-sectional study was conducted based on the PERSIAN cohort study. A total of 20460 individuals aged 35 to 70 years in Ardabil, Iran were included in the study. H. pylori infection was determined based on stool tests and clinical records. Multilevel logistic regression models with random intercepts at household and community levels were used to identify risk factors associated with H. pylori prevalence. The concentration index (CIn) and concentration curve (CC) were employed to assess socioeconomic-related inequality.
Results: In this study, 70.4% (CI 69.6-71.0) of the participants were infected with H. pylori, with a higher prevalence in women (71.2%) than men (69.6%). Age (OR: 1.37, CI: 1.17-1.61), sex (OR: 1.20, CI: 1.12-1.28), level of education (OR: 1.33, CI: 1.17-1.49), cardiac disease (OR: 1.32, CI:1.18-1.46), and BMI groups (OR: 2.49, CI: 1.11-5.58) were significantly associated with H. pylori infection based on the multivariable logistic regression. The results of the CIn and CC indicated that H. pylori were more prevalent among economically disadvantaged groups (CIn: -0.1065; [-0.1374 to -0.0755]).
Conclusion: The prevalence of H. pylori in Iran is higher than in other developing countries, and significant socioeconomic inequality exists between the poor and the rich. To reduce the rate of gastric cancer, socio-economic and demographic factors, especially the poor and people with low levels of education, should be considered.