Helicobacter pylori in the Philippines: Social and Ecological Determinants of Seropositivity and Lack of Association With Systemic Inflammation

Helicobacter pylori (H. pylori) is a bacterium that infects the stomach and is associated with various gastrointestinal outcomes and increased cardiovascular disease risk. We examined the role of sex in and the social and ecological factors associated with H. pylori seropositivity (n = 124) and the relationship between seropositivity and systemic inflammation (n = 116) among adults in Metro Cebu, Philippines. Data were drawn from the Cebu Longitudinal Health and Nutrition Survey when participants were 21 years old. Anti-H. pylori antibody concentrations and C-reactive protein (CRP) concentrations were analyzed in dried blood spots and plasma, respectively. The seroprevalence of H. pylori in this sample was 32.3%. In logistic regression analyses adjusting for sex, higher socioeconomic status (i.e., asset index) was associated with decreased likelihood of H. pylori seropositivity (OR = 0.723, p = 0.015). Higher assets (OR = 0.688, p = 0.002) and higher hygiene (OR = 0.754, p = 0.026) were associated with decreased odds of H. pylori seropositivity. Any level of excrement near the household, relative to no excrement (low excrement OR = 3.45, p = 0.036; high excrement OR = 3.96, p = 0.021), was associated with increased odds of seropositivity. Sex was not associated with seropositivity. Seropositivity was not associated with CRP concentrations (p = 0.52). Our results support the role of both socioeconomic and hygienic determinants of H. pylori infection risk. These findings provide new insight into factors associated with H. pylori seropositivity in a population with no previously identified infection risk factors.