Date of Conferral

2023

Degree

Ph.D.

School

Public Health

Advisor

Julia Leischner

Abstract

AbstractHelicobacter pylori (H. pylori) is one of the most common human pathogens and may play a role in the development of several distinct diseases, which include gastric ulcer, duodenal ulcer, and gastric cancer. Studying geographic territories of the United States may reveal clusters with high rates of H. pylori infection and perhaps the prevalence of gastric cancer; however, geographic mapping of patterns in the United States is scarce. The purpose of this study was to investigate changes in H pylori infection patterns in the United States between two different time points (2000–2002 and 2016–2018). The primary hypotheses of this study concerned whether socioecological predictors were associated with any regional changes in H. pylori infection patterns. Data on H pylori cases were obtained from the National Inpatient Sample, which represents a 20% stratified sample of U.S. community hospitals and, at the time of data collection, contained data from 10 million inpatient stays in 46 states. Chi-square analyses and multiple logistic regression were used to calculate odds ratios, p-values, and confidence intervals. Although the rates of H. pylori infections did not change over time, there was a regional change in the distribution of infections from the South to the Northeast regions of the United States. H. pylori infections were most prevalent in females less than 55 years of age, and race was not a significant predictor. Medicare and Medicaid usage increased between 2016 and 2018. This study revealed the extent of H. pylori infection in the U.S. and identified socioecological factors that influence its occurrence. This information may help medical and public health professionals and community leaders to create programs and policies to improve infectious outcomes.

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