Helicobacter Pylori Infection in Waste Pickers: A Case Control Seroprevalence Study.

Background: The epidemiology of () infection in waste pickers had not been previously studied. This study aims to determine the association of seropositivity and waste picking activity; and to determine socio-demographic, clinical, work, and behavioral characteristics associated with seropositivity in waste pickers.

Methods: Through a case-control study design, we examined 90 waste pickers and 90 age- and gender-matched control subjects for the presence of anti- IgG antibodies using enzyme-linked immunoassays. Seroprevalence association with socio-demographic, clinical, work and behavioral characteristics of the waste pickers were also investigated.

Results: Antibodies to were found in 60 (66.7%) of the 90 waste pickers and in 51 (56.7%) of the 90 controls (P = 0.16). Stratification by age showed that waste pickers aged 14 -30 years old had significantly higher frequency of infection than controls of the same age group (56.5% versus 35.6%, respectively; P = 0.04). The seroprevalence of infection was not influenced by gender, age, educational level, socioeconomic status, residence, or housing conditions of waste pickers. The presence of underlying diseases and the frequency of gastritis were similar among positive and negative waste pickers. Logistic regression analysis showed that the duration (years) in the waste picking activity was positively associated with exposure (OR = 2.76; 95% CI: 1.22 - 6.25; P = 0.01). In contrast, consumption of alcohol was negatively associated with exposure (OR = 0.27; 95% CI: 0.09 - 0.78; P = 0.01). Other work or behavioral characteristics of waste pickers including washing hands before eating, eating from the garbage, animal contacts, consumption of unpasteurized milk, unwashed raw vegetables, fruits, or untreated water, and contact with soil were not associated with exposure.

Conclusions: This is the first report on the seroprevalence of infection among waste pickers and the factors contributing to such exposure. Results warrant for further research on the potential role of contact with garbage for infection.