Epidemiology and Infection

Original Papers

Other Bacterial infections

Estimating the prevalence of active Helicobacter pylori infection in a rural community with global positioning system technology-assisted sampling

E. J. MELIUSa1a2 c1, S. I. DAVISa3, J. T. REDDa2, M. LEWINa3, R. HERLIHYa4, A. HENDERSONa3, J. SOBELa5, B. GOLDa5a6 and J. E. CHEEKa2

a1 Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA

a2 Division of Epidemiology and Disease Prevention, Office of Public Health Support, Indian Health Service, Albuquerque, NM, USA

a3 Division of Health Studies, Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA

a4 Johns Hopkins University School of Public Health, Baltimore, MD, USA

a5 Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA

a6 Emory University School of Medicine, Atlanta, GA, USA


We investigated a possible outbreak of H. pylori in a rural Northern Plains community. In a cross-sectional survey, we randomly sampled 244 households from a geocoded emergency medical system database. We used a complex survey design and global positioning system units to locate houses and randomly selected one eligible household member to administer a questionnaire and a 13C-urea breath test for active H. pylori infection (n = 166). In weighted analyses, active H. pylori infection was detected in 55·0% of the sample. Factors associated with infection on multivariate analysis included using a public drinking-water supply [odds ratio (OR) 12·2, 95% confidence interval (CI) 2·9–50·7] and current cigarette smoking (OR 4·1, 95% CI 1·7–9·6). People who lived in houses with more rooms, a possible indicator of decreased crowding in the home, were less likely to have active H. pylori infections (OR 0·7, 95% CI 0·5–0·9 for each additional room).

(Received October 03 2011)

(Revised February 24 2012)

(Accepted March 26 2012)

(Online publication May 17 2012)

Key words

  • Epidemiology;
  • gastrointestinal infections;
  • Helicobacter ;
  • Helicobacter pylori


c1 Author for correspondence: Ms. E. J. Melius, 3311 NE 163rd Street, Lake Forest Park, WA 98155, USA. (Email: bmelius@u.washington.edu)


  This paper was presented in part at the 55th Annual Epidemic Intelligence Service Conference, Centers for Disease Control and Prevention, Atlanta, GA, USA, 24–28 April, 2006 (Poster 29).