Prevalence of Helicobacter Pylori and Molecular Detection of the cagA Gene in Adults with gastrointestinal Symptoms

Abstract

Background: Helicobacter pylori (H. pylori) is a known gastrointestinal disease-related pathogen. The cytotoxin-associated gene A (cagA) emerged as H. pylori virulence factors, used to identify the pathogenicity and clinical outcomes. The noninvasive technique (stool-based testing) and molecular detection of Chaga are widely used to detect for H. pylori in epidemiological studies.
Objective: To assess the prevalence of H. pylori in adult patients presenting with gastrointestinal symptoms in Iraq and to reveal the existence of the cagA gene employing polymerase chain reaction (PCR) from stool samples.
Methods: A cross-sectional study was conducted to analyze data of adult patients presented with gastrointestinal symptoms at Baquba Teaching Hospital, Diyala, Iraq. Stool specimens were collected and eventually tested for H. pylori using a rapid stool antigen test (SAT), followed by molecular detection of the cagA gene via PCR. The Chi-square tests and binary logistic regressions were employed to assess the relationship between cagA positivity and demographic features.
Results: Out of 123 examined stool samples, 14.6% (18/123) diagnosed with H. Pylori. Among these, 61.1% (11/18) were cagA-positive. Higher prevalence of H. Pylori was seen among female gender (15.9%) and residents of rural regions (18.2%) compared to males (13.3%) and those residents in urban region (10.8%). There were significant associations between cagA positivity and individuals in the age group 41–60 years (p = 0.033). However, findings of multivariate logistic regression revealed that age (Adjusted OR = 2.9, 95% CI: 1.1–7.7, p = 0.031) and rural residency (Adjusted OR = 2.5, 95% CI: 1.0–6.4, p = 0.042) were the independent predictors for cagA positivity.
Conclusion: In conclusion, moderate prevalence of H. pylori and high occurrence of the cagA gene were reported among infected Iraqi adults. Community -based health care interventions and early detection of H. pylori with affordable approaches are crucial control infection and prevent the gastric cancers.