Nationwide survey of Helicobacter pylori seropositivity and gastric atrophy in Zambia

Background Helicobacter pylori (H. pylori) is a common bacterial infection which predominately drives upper gastrointestinal pathology. We carried out a nationwide serological survey in response to the deficiency of robust African data on H. pylori prevalence, age of acquisition, socio‐geographic determinants, and impact on gastric physiology. Materials and Methods This was a cross‐sectional study of archival plasma samples collected during the Zambia Population‐based HIV impact Assessment (ZAMPHIA) 2016 survey. ZAMPHIA used a two‐stage door‐to‐door stratified cluster sample approach to collect samples from adults and children from age 0 to 59 years (n = 24,266). We randomly retrieved one fifth of these samples from each of Zambia's 10 provinces and used ELISA to test for H. pylori IgG antibodies, pepsinogen 1 and 2 and gastrin‐17. A pepsinogen 1:2 ratio of