Abstract
Background/Objective: Helicobacter pylori is a gastric pathogen capable of lifelong colonization of the human stomach and is one of the most prevalent chronic bacterial infections worldwide. This study estimated H. pylori stool-antigen positivity among adult outpatients referred for testing at a single public hospital and examined clinical, familial, sociodemographic, and environmental characteristics associated with a positive result. Methods: This single-center, hospital-based cross-sectional study included 200 adult outpatients at Ranya Training Hospital who were treated from 1 June to 1 August 2026. Data were collected through structured, face-to-face, interviewer-administered interviews, and stool-antigen positivity was assessed using a qualitative fecal-antigen immunochromatographic assay. Recent use of proton-pump inhibitors, potassium-competitive acid blockers, bismuth compounds, and antibiotics was not recorded. The total number of referrals during the study period was unavailable; 20 of 220 eligible patients who were approached did not complete the study and could not be characterized or compared with participants. Adjusted prevalence ratios (aPRs) were estimated using modified Poisson regression with robust variance. Results: Of the 200 participants, 110 tested positive (55.0%; 95% confidence interval [CI] 48.1–61.7). Positivity was associated with a composite previous gastrointestinal-history item (aPR 1.56, 95% CI 1.22–1.99), self-reported family history of H. pylori infection or peptic ulcer disease (aPR 1.54, 95% CI 1.22–1.94), and rural residence (aPR 1.32, 95% CI 1.03–1.68). One contrast between municipal tap water and filtered water was observed (aPR 0.69, 95% CI 0.51–0.94), but this hypothesis-generating finding warrants testing of whether differences in water handling, storage, or source switching contribute to the observed contrast. Conclusions: These findings describe a clinically referred sample, not population-level prevalence. The GI-history item should not be interpreted as an etiologic risk factor. The key limitation was that recent medication exposure was not recorded, which may have affected stool-antigen detection and between-group comparisons; changes in water source after symptom onset were also not recorded.