Prevalence of infection in China from 2014-2023: A systematic review and meta-analysis.

[BACKGROUND] stands as the predominant infectious agent linked to the onset of gastritis, peptic ulcer diseases, and gastric cancer (GC). Identified as the exclusive bacterial factor associated with the onset of GC, it is classified as a group 1 carcinogen by the World Health Organization. The elimination of plays a crucial role in the primary prevention of GC. While the prevalence has declined in recent decades, infection is still highly prevalent in China, accounting for a significant part of the disease burden of GC. Therefore, updated prevalence information for infection, especially regional and demographic variations in China, is an important basis for the design of targeted strategies that will be effective for the prevention of GC and application of policies for control.

[AIM] To methodically evaluate the occurrence of infection throughout China and establish a reference point for subsequent investigations.

[METHODS] A systematic review and meta-analysis was conducted following established guidelines, as detailed in our methodology section.

[RESULTS] Our review synthesized data from 152 studies, covering a sample of 763827 individuals, 314423 of whom were infected with . We evaluated infection rates in mainland China and the combined prevalence of was 42.8% (95%CI: 40.7-44.9). Subgroup analysis indicated the highest prevalence in Northwest China at 51.3% (95%CI: 45.6-56.9), and in Qinghai Province, the prevalence reached 60.2% (95%CI: 46.5-73.9). The urea breath test, which recorded the highest infection rate, showed a prevalence of 43.7% (95%CI: 41.4-46.0). No notable differences in infection rates were observed between genders. Notably, the prevalence among the elderly was significantly higher at 44.5% (95%CI: 41.9-47.1), compared to children, who showed a prevalence of 27.5% (95%CI: 19.58-34.7).

[CONCLUSION] Between 2014 and 2023, the prevalence of infection in China decreased to 42.8%, down from the previous decade. However, the infection rates vary considerably across different geographical areas, among various populations, and by detection methods employed.