Prevalence of Helicobacter pylori Infection and its Association with Psychological Stress and Associated Factors among Medical Students in Dhamar, Yemen

Abstract

Background: Helicobacter pylori infection is an important cause of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. Evidence on active infection and its relationship with psychological stress among Yemeni medical students remains limited. Objective: To determine the prevalence of H. pylori infection and its association with psychological stress and selected demographic, behavioural, and clinical factors among medical students at Thamar University, Yemen. Methods: A cross-sectional study was conducted in April 2021 among 200 randomly selected medical students. Sociodemographic, behavioural, psychological, and clinical data were collected using a structured questionnaire. H. pylori infection was detected by rapid stool antigen testing. Associations were assessed using the chi-square test, with p<0.05 considered statistically significant. Results: Of 200 participants, 32 (16.0%) tested positive for H. pylori. Prevalence was highest among students aged ≤19 years (20.0%), compared with those aged 20–22 years (18.8%) and ≥23 years (4.8%) (p=0.05). Females had a higher prevalence than males (18.8% vs 11.1%), but the difference was not significant. Psychological stress/nervous behaviour was significantly associated with infection (25.9%; p<0.001). Peptic ulcer and abdominal pain were also significantly associated with H. pylori positivity (p=0.001). Conclusion: H. pylori prevalence among medical students was 16.0%. Infection was associated with younger age, psychological stress, peptic ulcer, and abdominal pain, while socioeconomic, lifestyle, and hygiene factors showed no significant associations. Further longitudinal studies using validated stress measures are needed to clarify the relationship between psychological stress and H. pylori infection.