Background

Few studies have examined the temporal trends of Helicobacter pylori prevalence worldwide. We aimed to identify the changes in global prevalence of H pylori infection between 1980 and 2022.

Methods

In this systematic review and meta-analysis, we searched PubMed, Embase, MEDLINE, Scopus, and Web of Science, with no language restrictions, for observational studies on the prevalence of H pylori infection published between Jan 1, 1980, and Dec 31, 2022. Conference papers, meta-analyses, reviews, and case reports were excluded. We divided the study timeframe into four periods: 1980–90, 1991–2000, 2001–10, and 2011–22. Summary data were extracted from each selected publication. The prevalence of H pylori and its temporal trend were analysed according to WHO region, World Bank income level, WHO universal health coverage service coverage index of the country or region, sex and age of the patient, study type, and diagnostic method. The pooled prevalence was estimated by a random-effect meta-analysis, and the significance of the associated factors was analysed by multivariable meta-regression. This study is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY), 2022100026.

Findings

Of the 56 967 records identified, 5236 were included in the quality assessment stage and 224 studies—from 71 countries or regions from all six WHO regions and including 2 979 179 individuals—were included in the final analysis. Significant heterogeneity was found between studies (I²=99·9%). The estimated global prevalence of H pylori infection decreased from 58·2% (95% CI 50·7–65·8) in the 1980–90 period to 43·1% (40·3–45·9) in the 2011–22 period. Prevalence was relatively static between 1991 and 2010 but declined sharply between 2011 and 2022, with the largest decline in the WHO African region. Overall, a lower prevalence of H pylori infection was reported in younger people, high-income countries, or countries with high levels of universal health coverage, and by retrospective studies. Studies based on serological diagnostic methods generally reported higher H pylori prevalence than studies based on non-serological methods (53·2% [49·8–56·6] vs 41·1% [38·1–44·2]) and fluctuated less over time.

Interpretation

This meta-analysis shows a declining trend of H pylori prevalence globally, particularly in the 2011–22 period. These results could help to inform future health policy on prevention and management of this important infection. However, a considerable degree of heterogeneity exists between studies and further population-based epidemiological studies are needed.

Funding

None.

中文翻译：

---

1980 年至 2022 年全球幽门螺杆菌感染流行率：一项系统回顾和荟萃分析

背景

很少有研究调查过全球幽门螺杆菌流行的时间趋势。我们旨在确定 1980 年至 2022 年间全球幽门螺杆菌感染流行率的变化。

方法

在此系统回顾和荟萃分析中，我们在没有语言限制的情况下搜索了 PubMed、Embase、MEDLINE、Scopus 和 Web of Science，以查找1980 年 1 月 1 日至 12 月 31 日期间发表的关于幽门螺杆菌感染流行率的观察性研究，2022. 会议论文、荟萃分析、评论和案例报告被排除在外。我们将研究时间范围分为四个时期：1980-90、1991-2000、2001-10 和 2011-22。从每个选定的出版物中提取摘要数据。幽门螺杆菌的流行根据WHO地区、世界银行收入水平、所在国家或地区WHO全民健康覆盖服务覆盖指数、患者性别和年龄、研究类型、诊断方法等因素分析其时间趋势。通过随机效应荟萃分析估计合并患病率，并通过多变量荟萃回归分析相关因素的显着性。本研究已在国际注册系统审查和荟萃分析协议平台 (INPLASY) 注册，2022100026。

发现

在确定的 56 967 份记录中，5236 份被纳入质量评估阶段，224 项研究——来自世卫组织所有六个区域的 71 个国家或地区，包括 2 979 179 人——被纳入最终分析。研究之间存在显着的异质性 ( I ² =99·9%)。据估计，全球H pylori感染流行率从 1980-90 年的 58·2% (95% CI 50·7–65·8) 下降到 2011–20 年的 43·1% (40·3–45·9) 22期。流行率在 1991 年至 2010 年期间相对稳定，但在 2011 年至 2022 年期间急剧下降，其中世卫组织非洲区域的下降幅度最大。总体而言，幽门螺杆菌的患病率较低在年轻人、高收入国家或全民健康覆盖水平高的国家以及通过回顾性研究报告了感染。基于血清学诊断方法的研究通常报告的幽门螺杆菌患病率高于基于非血清学方法的研究（53·2% [49·8–56·6] vs 41·1% [38·1–44·2]）和随着时间的推移波动较小。

解释

该荟萃分析显示全球幽门螺杆菌流行率呈下降趋势，尤其是在 2011-22 年期间。这些结果可能有助于为未来预防和管理这种重要感染的卫生政策提供信息。然而，研究之间存在相当程度的异质性，需要进一步的基于人群的流行病学研究。

资金

没有任何。