High prevalence of Helicobacter heilmannii-associated gastritis in a small, predominantly rural area: further evidence in support of a zoonosis?

BACKGROUND

Primary hosts of Helicobacter heilmannii are domestic animals--cats, dogs and pigs, but rarely is it detected in gastric biopsies from humans. We found H. heilmannii in gastric biopsies obtained from patients living in a predominantly rural area.

METHODS

We evaluated geographic and demographic data from the area and calculated both the total prevalence and the prevalence in each community in this area. Chi-squared test and exploratory data analysis were used for statistical evaluation. Histologic and clinical data were recorded.

RESULTS

Forty-three communities, mostly rural, were identified in the area, the size of which is about 200 km2. H. heilmannii was detected in 33 patients (prevalence 2%) living in 20 communities. The prevalence of H. heilmannii statistically significantly varied in those communities from 0.06%-1.1%. It was possible to infer that there is a negative correlation between prevalence and community size. Chronic active gastritis was diagnosed in all patients. The active inflammation became inactive after eradication of H. heilmannii via common anti-Helicobacter therapy.

CONCLUSION

A high prevalence of H. heilmannii-associated gastritis in a small, predominantly rural area and statistically significant differences in prevalence from one community to the next, i.e. highest in the smallest village and lowest in a small town with a rather urban lifestyle, were found. In our opinion, these prevalence rates may be a consequence of transmission of the infection from domestic animals, because animal-human contact is generally more common in villages than in towns.