There are no contemporary large-scale studies evaluating the burden of in the United States according to detailed demographics. The primary objective was to evaluate positivity in a large national healthcare system according to individual demographics and geography. We conducted a nationwide retrospective analysis of adults in the Veterans Health Administration who completed testing between 1999 and 2018. The primary outcome was positivity overall, as well as according to zip code–level geography, race, ethnicity, age, sex, and time period. Among 913,328 individuals (mean, 58.1 years; 90.2% male) included between 1999 and 2018, was diagnosed in 25.8%. Positivity was highest in non-Hispanic black (median, 40.2%; 95% confidence interval [CI], 40.0%–40.5%) and Hispanic (36.7%; 95% CI, 36.4%–37.1%) individuals and lowest in non-Hispanic white individuals (20.1%; 95% CI, 20.0%–20.2%). Although positivity declined in all racial and ethnic groups over the timeframe, the disproportionate burden of in non-Hispanic black and Hispanic compared with non-Hispanic white individuals persisted. Approximately 4.7% of the variation in positivity was explained by demographics, with race and ethnicity accounting for the vast majority. The burden of is substantial in the United States among veterans. These data should (1) motivate research aimed at better understanding why marked demographic differences in burden persist so that mitigating interventions may be implemented and (2) guide resource allocation to optimize testing and eradication in high-risk groups.

中文翻译：

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根据个人人口统计和地理分布，美国的幽门螺杆菌负担：对退伍军人医疗保健系统的全国分析


当代还没有大规模研究根据详细的人口统计数据评估美国的负担。主要目标是根据个人人口统计和地理位置评估大型国家医疗保健系统的积极性。我们对 1999 年至 2018 年间完成测试的退伍军人健康管理局成年人进行了全国范围的回顾性分析。主要结果是总体呈阳性，并且根据邮政编码级别的地理位置、种族、民族、年龄、性别和时间段进行了分析。在 1999 年至 2018 年间的 913,328 人（平均 58.1 岁；90.2% 男性）中，确诊率为 25.8%。非西班牙裔黑人（中位数为 40.2%；95% 置信区间 [CI]，40.0%–40.5%）和西班牙裔（36.7%；95% CI，36.4%–37.1%）的阳性率最高，非西班牙裔黑人的阳性率最低。西班牙裔白人（20.1%；95% CI，20.0%–20.2%）。尽管在一段时间内所有种族和族裔群体的积极性都下降了，但与非西班牙裔白人相比，非西班牙裔黑人和西班牙裔的负担仍然不成比例。大约 4.7% 的积极性变化是由人口统计数据解释的，其中种族和民族占绝大多数。在美国，退伍军人的负担是巨大的。这些数据应该（1）激发旨在更好地理解为何人口负担存在显着差异的研究，以便实施缓解干预措施；（2）指导资源分配，以优化高危人群的检测和根除。