[Prevalence trend and risk factors for Helicobacter pylori infection in Qinghai Province based on 13C urea breath test results].

Objective: To analyze the trend changes and risk factors associated with Helicobacter pylori infection in the Qinghai region from 2019 to 2025, thereby enriching regional epidemiological data for H. pylori infection. Methods: This retrospective study included patients who initially presented at Qinghai University Affiliated Hospital with upper gastrointestinal symptoms and underwent 13C urea breath testing for suspected H. pylori infection. Collected data included participant demographics (name, gender, age, ethnicity, altitude of residence), medical history, and 13C urea breath test results. Count data were statistically described using case numbers and composition ratios. Trends in the composition ratio of H. pylori positivity were plotted, while Chi-square tests and logistic regression models were used to identify influencing factors and risk factors for H. pylori infection in this region. Results: A total of 19 344 cases were included as the research subjects. The results showed that the overall composition ratio for H. pylori positivity from 2019 to 2025 was 49.64% (9 602/19 344), with an increasing trend from 2019 to 2021, peaking at 55.12% (2 557/4 639) in 2021, before declining to a minimum of 42.00% (753/1 793) in 2025. This trend remained consistent across sexes. The composition ratio showed a general downward trend in populations residing in the plateau area (altitude>2 500 m) and those aged ≥18 years. Statistically significant differences in the composition ratio for H. pylori positivity were noted between male (50.59%; 4 852/9 591) and female (48.70%; 4 750/9 753) populations (χ2=6.88, P=0.009). At 54.93% (2 396/4 362), the composition ratio for H. pylori positivity was significantly higher in the 18-40 age group than in the other groups (χ2=69.88, P<0.001). The constituent ratios for Han, Tibetan, and Hui populations were 48.40% (7 315/15 115), 56.37% (1 346/2 388), and 51.11% (941/1 841), respectively, with statistically significant differences observed among these groups (χ2=54.16, P<0.001). Statistically significant differences (χ2=6.19, P=0.013) in composition ratios were also recorded between plateau (54.08%; 444/821) and non-plateau (49.35%; 2 157/4 371) populations. The factors influencing H. pylori infection in individuals with digestive system symptoms in this region were gender, age, ethnicity, and altitude. The risk factors included altitude>2 500 m (OR=1.198, P=0.019), male sex (OR=1.211, P=0.001), Tibetan(OR=1.371, P<0.001) Hui ethnicity (OR=1.112, P=0.033), and age 18-40 years (OR=1.320, P=0.028). Conclusion: The overall composition ratio for H. pylori positivity (detection rate) among people with upper gastrointestinal symptoms in this region from 2019 to 2025 was 49.64% (9 602/19 344), showing an initial upward trend before declining. This suggested that health awareness and socioeconomic conditions gradually improved in this region. This study further enriches the epidemiological data on H. pylori infection in the Qinghai region, and has certain clinical significance for guiding prevention strategies for H. pylori infection and the screening of key populations in this area.