{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:19:28Z","timestamp":1780571968027,"version":"3.54.1"},"reference-count":46,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T00:00:00Z","timestamp":1624838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016714","name":"University of Sharjah","doi-asserted-by":"publisher","award":["NO. 1601110211-P"],"award-info":[{"award-number":["NO. 1601110211-P"]}],"id":[{"id":"10.13039\/100016714","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Helicobacter pylori (H. pylori) infection occurs among half of the general population worldwide, with high geographic variability. Even though H. pylori is the leading cause of several gastric diseases, ranging from gastritis and peptic ulcers to gastric malignancies, such as gastric cancer and mucosa-associated lymphoid tissue lymphoma, most of the infections remain asymptomatic. Early detection and eradication of H. pylori can definitely prevent severe long-term gastric diseases associated with H. pylori. In Lebanon, the prevalence of H. pylori is not well documented, especially in healthy subjects. The aim of this study is to assess H. pylori infections and the associated risk factors in Tripoli, North Lebanon. A cross-sectional study was conducted on 300 healthy Lebanese volunteers, including both children and adults. The H. pylori stool antigens were detected using the Premier Platinum HpSA test. The socio-demographic data, lifestyle characteristics, and gastrointestinal characteristics of all participants were analyzed. Out of the 300 tested volunteer subjects, 31% were found to be positive for H. pylori. A multivariate binary logistic regression analysis for factors associated with H. pylori infection revealed a significant association between H. pylori infection and gastrointestinal disturbances, the crowding index, and occupation. A significant statistical correlation was found between sheesha smoking (p = 0.001) and H. pylori infection. These findings highlight the need for the development of preventive approaches and strategic indications for the appropriate treatment of H. pylori infections in Tripoli, North Lebanon.<\/jats:p>","DOI":"10.3390\/biology10070599","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T22:43:06Z","timestamp":1624920186000},"page":"599","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Helicobacter pylori Infection in Tripoli, North Lebanon: Assessment and Risk Factors"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6036-1022","authenticated-orcid":false,"given":"Ghalia","family":"Khoder","sequence":"first","affiliation":[{"name":"Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates"},{"name":"Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Mina","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Health Sciences, Beirut Arab University, Beirut 11-5020, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5037-0208","authenticated-orcid":false,"given":"Ibrahim","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9565-1062","authenticated-orcid":false,"given":"Jibran Sualeh","family":"Muhammad","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6672-2944","authenticated-orcid":false,"given":"Rania","family":"Harati","sequence":"additional","affiliation":[{"name":"Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates"},{"name":"Department of Pharmacy Practice and Pharmaceutics, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Burucoa","sequence":"additional","affiliation":[{"name":"Laboratoire de bact\u00e9riologie, Hygi\u00e8ne, EA 4331 LITEC, CHU de Poitiers, Universit\u00e9 de Poitiers, 86000 Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1053\/j.gastro.2009.01.073","article-title":"Helicobacter pylori in health and disease","volume":"136","author":"Cover","year":"2009","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.gtc.2013.01.006","article-title":"Helicobacter pylori in gastric carcinogenesis: Mechanisms","volume":"42","author":"Wroblewski","year":"2013","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_3","first-page":"1528","article-title":"Gastric pathophysiological ins and outs of helicobacter pylori: A review","volume":"63","author":"Muhammad","year":"2013","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_4","unstructured":"International Agency for Research on Cancer (1994). Schistosomes, Liver Flukes and Helicobacter Pylori. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Lyon, 7\u201314 June 1994. IARC Monogr. Eval. Carcinog. Risks. Hum., 61, 1\u2013241."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Muhammad, J.S., Eladl, M.A., and Khoder, G. (2019). Helicobacter pylori-induced DNA Methylation as an Epigenetic Modulator of Gastric Cancer: Recent Outcomes and Future Direction. Pathogens, 8.","DOI":"10.3390\/pathogens8010023"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer. J. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.gene.2005.06.026","article-title":"Gene deregulation in gastric cancer","volume":"360","author":"Stock","year":"2005","journal-title":"Gene"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"239","DOI":"10.2147\/CMAR.S149619","article-title":"Gastric cancer: Epidemiology, prevention, classification, and treatment","volume":"10","author":"Sitarz","year":"2018","journal-title":"Cancer Manag. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/0016-5085(95)90278-3","article-title":"Accuracy of invasive and noninvasive tests to diagnose Helicobacter pylori infection","volume":"109","author":"Cutler","year":"1995","journal-title":"Gastroenterology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1111\/hel.12030","article-title":"Comparative evaluation of 29 commercial Helicobacter pylori serological kits","volume":"18","author":"Burucoa","year":"2013","journal-title":"Helicobacter"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1111\/j.1572-0241.2000.01931.x","article-title":"Noninvasive antigen-based assay for assessing Helicobacter pylori eradication: A European multicenter study. The European Helicobacter pylori HpSA Study Group","volume":"95","author":"Vaira","year":"2000","journal-title":"Am. J. Gastroenterol."},{"key":"ref_12","first-page":"201","article-title":"Diagnosis of Helicobacter pylori infection","volume":"64","author":"Lehours","year":"2014","journal-title":"Rev. Prat."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"12","DOI":"10.5009\/gnl15091","article-title":"Mass Eradication of Helicobacter pylorito Prevent Gastric Cancer: Theoretical and Practical Considerations","volume":"10","author":"Lee","year":"2016","journal-title":"Gut. Liver."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1016\/S0140-6736(05)76722-2","article-title":"Diagnosis of Helicobacter pylori infection by HpSA test. European Helicobacter pylori HpSA Study Group","volume":"354","author":"Vaira","year":"1999","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1097\/00042737-200109000-00011","article-title":"Helicobacter pylori Stool Antigen test: A reliable non-invasive test for the diagnosis of Helicobacter pylori infection in children","volume":"13","author":"Bosman","year":"2001","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1093\/tropej\/fmy035","article-title":"Performances of the IDEIA HpStAR Stool Antigen Test in Detection of Helicobacter pylori Infection Before and After Eradication Treatment in Algerian Children","volume":"65","author":"Moubri","year":"2019","journal-title":"J. Trop. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3735","DOI":"10.1128\/JCM.01752-13","article-title":"Helicobacter pylori infection in infants and toddlers in South America: Concordance between [13C]urea breath test and monoclonal H. pylori stool antigen test","volume":"51","author":"Queiroz","year":"2013","journal-title":"J. Clin. Microbiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/j.1523-5378.2008.00598.x","article-title":"Evaluation of a novel monoclonal-based antigen-in-stool enzyme immunoassay (Premier Platinum HpSA PLUS) for diagnosis of Helicobacter pylori infection in Vietnamese children","volume":"13","author":"Nguyen","year":"2008","journal-title":"Helicobacter"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1136\/gut.52.6.804","article-title":"Evaluation of a novel monoclonal enzyme immunoassay for detection of Helicobacter pylori antigen in stool from children","volume":"52","author":"Koletzko","year":"2003","journal-title":"Gut"},{"key":"ref_20","first-page":"291","article-title":"Prevalence study to elucidate the transmission pathways of Helicobacter pylori at oral and gastroduodenal sites of a South Indian population","volume":"47","author":"Ahmed","year":"2006","journal-title":"Singap. Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Mobley, H.L., Mendz, G.L., and Hazell, S.L. (2001). Epidemiology of Infection. Helicobacter Pylori: Physiology and Genetics, ASM Press.","DOI":"10.1128\/9781555818005"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1177\/2050640618800628","article-title":"Prevalence of Helicobacter pylori infection in sexual partners of H. pylori-infected subjects: Role of gastroesophageal reflux","volume":"10","author":"Sgambato","year":"2018","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Sierra, M.S., Hastings, E.V., Fagan-Garcia, K., Colquhoun, A., and Goodman, K.J. (2014). Epidemiology, Transmission and Public Health Implications of Helicobacter pylori Infection in Western Countries. Helicobacter Pylori Worldw. Perspect.","DOI":"10.2174\/9781608057375114010006"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/hel.12165","article-title":"Epidemiology of Helicobacter pylori infection","volume":"19","author":"Eusebi","year":"2014","journal-title":"Helicobacter"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"17618","DOI":"10.3748\/wjg.v20.i46.17618","article-title":"Epidemiology of Helicobacter pylori infection among the healthy population in Iran and countries of the Eastern Mediterranean Region: A systematic review of prevalence and risk factors","volume":"20","author":"Eshraghian","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1053\/j.gastro.2005.11.004","article-title":"Age-specific incidence of Helicobacter pylori","volume":"130","author":"Rowland","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1053\/j.gastro.2017.04.022","article-title":"Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis","volume":"153","author":"Hooi","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1111\/apt.14561","article-title":"Systematic review with meta-analysis: The worldwide prevalence of Helicobacter pylori infection","volume":"47","author":"Zamani","year":"2018","journal-title":"Aliment. Pharm. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Assaad, S., Chaaban, R., Tannous, F., and Costanian, C. (2018). Dietary habits and Helicobacter pylori infection: A cross sectional study at a Lebanese hospital. BMC Gastroenterol., 18.","DOI":"10.1186\/s12876-018-0775-1"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/apt.13474","article-title":"Review article: The prevalence of Helicobacter pylori and the incidence of gastric cancer across Europe","volume":"43","author":"Roberts","year":"2016","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_31","first-page":"138","article-title":"Fecoprevalence and determinants of Helicobacter pylori infection among asymptomatic children in Lebanon","volume":"55","author":"Naous","year":"2007","journal-title":"J. Med. Liban."},{"key":"ref_32","first-page":"31","article-title":"Helicobacter pylori infection in North Lebanon","volume":"10","author":"Kalaajieh","year":"2000","journal-title":"Sante"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.dld.2006.06.040","article-title":"Association of gastroduodenal disease phenotype with ABO blood group and Helicobacter pylori virulence-specific serotypes","volume":"38","author":"Sharara","year":"2006","journal-title":"Dig. Liver. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.micpath.2018.02.010","article-title":"First-line treatment of Helicobacter pylori in Lebanon: Comparison of bismuth-containing quadruple therapy versus 14-days sequential therapy","volume":"117","author":"Tarhini","year":"2018","journal-title":"Microb. Pathog."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Charafeddine, M.A., Olson, S.H., Mukherji, D., Temraz, S.N., Abou-Alfa, G.K., and Shamseddine, A.I. (2017). Proportion of cancer in a Middle eastern country attributable to established risk factors. BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3304-7"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Khoder, G., Muhammad, J.S., Mahmoud, I., Soliman, S.S.M., and Burucoa, C. (2019). Prevalence of Helicobacter pylori and Its Associated Factors among Healthy Asymptomatic Residents in the United Arab Emirates. Pathogens, 8.","DOI":"10.3390\/pathogens8020044"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ijid.2004.04.014","article-title":"HpSA fecoprevalence in patients suspected to have Helicobacter pylori infection in Istanbul, Turkey","volume":"9","year":"2005","journal-title":"Int. J. Infect. Dis."},{"key":"ref_38","first-page":"299","article-title":"Helicobacter pylori in developing countries. World Gastroenterology Organisation Global Guideline","volume":"20","author":"Hunt","year":"2011","journal-title":"J. Gastrointestin. Liver. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Wangda, S., Richter, J.M., Kuenzang, P., Wangchuk, K., Choden, T., Tenzin, K., and Malaty, H.M. (2017). Epidemiology of Helicobacter pylori infection in asymptomatic schoolchildren in Bhutan. Helicobacter, 22.","DOI":"10.1111\/hel.12439"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"5632935","DOI":"10.1155\/2019\/5632935","article-title":"Erratum to \u201cEpidemiological and Clinical-Pathological Aspects of Helicobacter pylori Infection in Brazilian Children and Adults.\u201d","volume":"2019","author":"Toscano","year":"2019","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_41","first-page":"114","article-title":"Helicobacter pylori infection in Turkish preschool and school children: Role of socioeconomic factors and breast feeding","volume":"45","author":"Ertem","year":"2003","journal-title":"Turk. J. Pediatr."},{"key":"ref_42","first-page":"2201","article-title":"Seroprevalence of Helicobacter pylori infection in children of low socioeconomic level in Belo Horizonte, Brazil","volume":"89","author":"Oliveira","year":"1994","journal-title":"Am. J. Gastroenterol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.2105\/AJPH.86.11.1539","article-title":"Socioeconomic factors in Helicobacter pylori infection among Danish adults","volume":"86","author":"Rosenstock","year":"1996","journal-title":"Am. J. Public. Health."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/0140-6736(92)90907-K","article-title":"Helicobacter pylori infection and overcrowding in childhood","volume":"339","author":"Galpin","year":"1992","journal-title":"Lancet"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1099\/0022-1317-50-12-1021","article-title":"Detection of Helicobacter pylori in faeces by culture, PCR and enzyme immunoassay","volume":"50","author":"Kabir","year":"2001","journal-title":"J. Med. Microbiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3672","DOI":"10.1128\/iai.65.9.3672-3679.1997","article-title":"Coccoid forms of Helicobacter pylori are the morphologic manifestation of cell death","volume":"65","author":"Kusters","year":"1997","journal-title":"Infect. Immun."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/10\/7\/599\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:26:17Z","timestamp":1760163977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/10\/7\/599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,28]]},"references-count":46,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["biology10070599"],"URL":"https:\/\/doi.org\/10.3390\/biology10070599","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,28]]}}}