Prevalence of Helicobacter Pylori in Iranian Children: A Systematic Review and Meta-Analysis Study

The prevalence of Helicobacter pylori infection is reported variously in different studies in Iran. These study aimed to determine the prevalence of Helicobacter pylori infection in children in Iran.

In this systematic review and meta-analysis, we searched Medline, Scopus, EMBASE, Web of Science, and Google scholar systematically from Jan 1990 to up to December 2020. "Helicobacter pylori", "Child", "H. pylori", "Campylobacter pylori" and "Iran" were used for search. All English-language articles associated with the prevalence of H. pylori performed in Iran were evaluated, and after passing the qualification assessment (Newcastle –Ottawa Quality Assessment Scale), these were entered into the analysis. The prevalence of H. pylori in children at a 95% confidence interval was estimated using a random-effect model.

The search initially identified a total of 778 publications, and finally, 43 studies involving 16,939 children were included. The pooled prevalence of H. pylori infection in Iranian children is estimated as 43% (I2=98.1, p=0.001). Based on the diagnostic methods, the pooled prevalence in the group with stool antigen evaluation was 44% (I2=99%, p=0.001), the pooled prevalence in the serology evaluation group was 40% (I2=96%, p=0.001), in the biopsy group, 50%, in Rapid urease test/ urea breath test 40%, and in combined diagnostic tests group 56% (I2=84.5%, p=0.001), and in the not determined group the pooled estimate was 26%. The heterogeneity between groups was significant (p <0.001).

The pooled prevalence of H. pylori infection in children in Iran is estimated as 43%, which has been higher than the global prevalence. Also, a higher prevalence rate was reported in studies in which the diagnostic test was a biopsy.