National rates of Helicobacter pylori recurrence are significantly and inversely correlated with human development index

Summary Background Helicobacter pylori infection is a worldwide threat to human health with recurrence rates that vary widely. The precise correlation between H. pylori recurrence and socioeconomic development has not been determined. Aim To determine H. pylori recurrence rates after successful eradication and their association with socioeconomic development metrics. Methods Bibliographical searches were performed in the MEDLINE database. We reviewed all results, filtered by inclusion criteria, extracted primary results to calculate H. pylori recurrence rates and calculated national Human Development Index (HDI) values for the periods during which the studies were conducted. Results One thousand two hundred and twenty six cases of H. pylori recurrence in 77 eligible studies were observed in 43 525.1 follow‐up patient‐years after successful eradication therapy, giving a recurrence rate of 2.82 ± 1.16% per patient‐year (weighted mean ± 95% confidence interval). H. pylori recurrence rate was inversely correlated with national HDI on linear (r = −0.633) and weighted least square (r = −0.546) regression analysis. Countries with very high HDI had a mean recurrence rate significantly lower than that of high, medium and low HDI countries (P