{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T06:59:35Z","timestamp":1782889175203,"version":"3.54.5"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43 TW009744"],"award-info":[{"award-number":["D43 TW009744"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1066118"],"award-info":[{"award-number":["OPP1066118"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Hypochlorhydria (gastric pH &gt;4) increases susceptibility to diarrhoea, iron deficiency, and gastric cancer. We sought to clarify the prevalence of this condition and its predisposing factors in Zambia by pooling data from previous studies conducted in hospital and community settings.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Gastric pH was measured in participants from five separate studies by collecting gastric aspirate from fasted adults and children under 3 years of age undergoing gastroscopy. Gastric pH was correlated with serological testing for Human Immunodeficiency Virus (HIV) and<jats:italic>Helicobacter pylori<\/jats:italic>(<jats:italic>H<\/jats:italic>.<jats:italic>pylori<\/jats:italic>) infections.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>We studied 597 individuals (487 adults and 110 children). Hypochlorhydria was present in 53% of adults and 31% of children. HIV infection was detected in 41% of adults and 11% of children.<jats:italic>H<\/jats:italic>.<jats:italic>pylori<\/jats:italic>serology was available for 366 individuals: 93% of adults and 6% of children were seropositive. In univariate analysis, hypochlorhydria was significantly associated with HIV seropositivity (OR 1.7; 95% CI 1.2\u20132.4; p = 0.004) and<jats:italic>H<\/jats:italic>.<jats:italic>pylori<\/jats:italic>antibody seropositivity (OR 4.9; 95% CI 2.8\u20138.6; p&lt;0.0001), and with advancing age in HIV negative individuals (p = 0.0001). In multivariable analysis, only<jats:italic>H<\/jats:italic>.<jats:italic>pylori<\/jats:italic>was associated with hypochlorhydria (OR 4.0; 95% CI 2.2\u20137.2; p&lt;0.0001) while excluding possible exposure to proton pump inhibitors.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Hypochlorhydria is common in our population, with<jats:italic>H<\/jats:italic>.<jats:italic>pylori<\/jats:italic>being the dominant factor. Only young HIV seronegative individuals had a low prevalence of hypochlorhydria. This may have implications for the risk of other health conditions including gastric cancer.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0256487","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T17:35:59Z","timestamp":1630085759000},"page":"e0256487","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Helicobacter pylori infection and hypochlorhydria in Zambian adults and children: A secondary data analysis"],"prefix":"10.1371","volume":"16","author":[{"given":"Phoebe","family":"Hodges","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6521-2501","authenticated-orcid":true,"given":"Violet","family":"Kayamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,8,27]]},"reference":[{"issue":"6","key":"pone.0256487.ref001","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1097\/MOG.0b013e328365efc7","article-title":"Gastric secretion","volume":"29","author":"S Chu","year":"2013","journal-title":"Curr Opin Gastroenterol"},{"key":"pone.0256487.ref002","volume-title":"StatPearls","author":"R Fatima","year":"2021"},{"issue":"1","key":"pone.0256487.ref003","first-page":"41","article-title":"Prevalence of achlorhydria in a normal population and its relation to serum gastrin","volume":"31","author":"M Bins","year":"1984","journal-title":"Hepatogastroenterology"},{"issue":"2","key":"pone.0256487.ref004","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1007\/s00535-012-0634-8","article-title":"Gastric hypochlorhydria is associated with an exacerbation of dyspeptic symptoms in female patients","volume":"48","author":"W Iwai","year":"2013","journal-title":"J Gastroenterol"},{"issue":"5","key":"pone.0256487.ref005","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/S0188-4409(00)00099-0","article-title":"A comprehensive review of the natural history of Helicobacter pylori infection in children","volume":"31","author":"J Torres","year":"2000","journal-title":"Arch Med Res"},{"issue":"1","key":"pone.0256487.ref006","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3109\/00365528609034615","article-title":"Gastric cancer risk in achlorhydric patients. 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