{"id":43128,"date":"2022-03-31T10:38:30","date_gmt":"2022-03-31T10:38:30","guid":{"rendered":"https:\/\/biomedpharmajournal.org\/?p=43128"},"modified":"2022-06-13T10:10:35","modified_gmt":"2022-06-13T10:10:35","slug":"milestones-of-knowledge-attitude-and-practice-of-saudi-population-towards-h-pylori-infection","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol15no1\/milestones-of-knowledge-attitude-and-practice-of-saudi-population-towards-h-pylori-infection\/","title":{"rendered":"Milestones of Knowledge Attitude and Practice among Saudi Population at Risk Towards Helicobacter pylori Infection"},"content":{"rendered":"

Introduction<\/strong><\/p>\n

Helicobacter pylori<\/em> gained global health concern as it<\/em> is a ubiquitous organism that presently affects approximately one-half of the world’s population and leads to chronic gastritis, as it is the most frequent chronic inflammation worldwide. In contrast, up to 85% of people infected with H. pylori are symptomless and have no health problems 1, 2<\/sup>.<\/p>\n

It is a spiral gram-negative bacterium that colonizes and grows in human gastric epithelial tissue and mucous membrane. Their presence usually go unnoticed, however, it is associated with\u00a0gastritis, dyspepsia, nausea, and loss of appetite; it is also involved in the development of other comorbidities such as gastric and duodenal ulcers, in addition to gastric cancer. As it is\u00a0accounting for roughly 89 percent of all gastric carcinomas, elimination of this infection was shown to minimize the incidence of gastric malignancies 3, 4<\/sup>. There are various laboratory\u00a0 techniques such as can be used to identify H. pylori 5, 6<\/sup>, furthermore, all diagnostic procedures serve several functions and have limited applicability.7<\/sup><\/p>\n

Precise incidence varies considerably by country, but the developing countries world has a much relatively high disease burden than that of the industrialized world. In Saudi Arabia, H. pylori\u00a0infection is considered to be hyper-endemic. Several other research findings on H. pylori in Saudi Arabia have revealed a high prevalence in patients of different ages 8<\/sup>.<\/p>\n

It is noticeable that the infection with Helicobacter pylori<\/em> has increased in Saudi Arabia, and vary considerably among populations, which may be due to the lack of awareness among the\u00a0population and associated risk factor about the possible ways of transmission and its symptoms, in addition to dangerous complications such as stomach ulcers and stomach cancer 9,10<\/sup>. Hence\u00a0low socioeconomic status has indeed been correlated with increased occurrence of H. pylori pathogens globally. The socioeconomic status of a subject throughout early life, in particular, is\u00a0believed to be a substantial criterion of the implementation of H. pylori<\/em> infection. Socio-economic background, on the other hand, is a large and diverse characteristic that includes\u00a0elements such as hygienic practices, sanitary conditions, urbanization, and access to higher education, most of which have been mentioned to affect the outcome of infection within a\u00a0community. So in the present study, we attempted to assess the awareness towards H. pylori<\/em> among the Saudi population through the Knowledge, Attitude, and Practice (KAP) survey.<\/p>\n

Methods<\/strong><\/p>\n

Design of study<\/strong><\/p>\n

A descriptive cross-sectional KAP survey was conducted in April 2019 on the Public population part of them were previously diagnosed as H. pylori<\/em> patients and suffering from gastritis, and\u00a0others were never infected to assess and evaluate the milestones of their Knowledge Attitude and Practice of Saudi population towards H. pylori<\/em>. Approval was obtained from the faculty Applied\u00a0Medical Sciences, and informed consent was also taken from the recruited subjects. Verbal participants’ informed consent in compliance with the Helsinki Declaration was taken from participants\u00a0before starting the study<\/p>\n

Sample size and Sampling Technique<\/strong><\/p>\n

A total of 1324 subjects enrolled by non-probability sampling technique namely convenience sampling method after satisfied the study inclusion criterion (all Saudi participants, both gender,\u00a0their age between 20-50 years old).<\/p>\n

Methods<\/strong><\/p>\n

A well-constructed questionnaire was designed and then administered online (through Google online survey and distributed via E. mails, and WhatsApp groups) to selected populations. A\u00a0domain to estimate knowledge, attitudes, and practices (KAPs) was set up on the World Health Organization directory to estimate Knowledge, Attitude, and Practice Surveys 11. For\u00a0perfection before administration of the questionnaire, a pilot study and validation of questions were done by professionals selected peers.<\/p>\n

The survey was available online from 4th<\/sup> of April to 4th<\/sup> of June 2019, it consists of 21 Closed-ended questions altogether in the following items which are divided into four categories as\u00a0follows: I) Baseline data and demographic data (age, gender, etc..). II) Knowledge questions (4 III) Attitude question. IV) Practice questions. The answers were graded on three-level responses:\u00a0agree, disagree, and neutral). However a survey is in the English language, we applied a novel Arabic translated modified version to participants.<\/p>\n

Statistical analysis<\/strong><\/p>\n

The obtained results, along with all demographic information, were analyzed using the SPSS (version 26) program. P-value\u00a0 \u2265 0.05 was considered the level of significance.<\/p>\n

Ethical Approval<\/strong><\/p>\n

The proposal was approved by the department of medical laboratory sciences at the faculty of applied medical science, Prince Sattam Bin Abdul-Aziz University.<\/p>\n

Results<\/strong><\/p>\n

A total of 1342 subjects participated in an online survey to assess awareness of the Saudi population towards H. pylori<\/em>. Table 1 provides a frequency of baseline, demographic data, and\u00a0respondents characteristics of the study including age, gender, education level, and history of infection with H. pylori<\/em>. The majority of subjects were females 888 (66.2%), their age ranged\u00a0from 20 to 50 years old, and half of the 671(50 %) were in age group (31-40 years old), and most of the participants from the rural areas (54.5%), and were primary\/ secondary educated (36.4%,\u00a0and 37.4%) respectively, and (49%) of formerly infected were secondary educate, the result is insignificant (P value\u22650.436). The frequency of H. pylori<\/em> was 613 (45.6%) of participants, as\u00a0well as 453 (74%) of respondents, were female that was formerly infected with H. pylori,<\/em> statistically significant (P-value \u22640.052). (57.1%) of respondents were previously infected in the\u00a0age group 31-40 years old (P-value\u22640.003).<\/p>\n

Table 1: Baseline Data of Study Participants.<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Parameters<\/strong><\/td>\nTotal<\/strong><\/p>\n

n<\/em><\/strong>=1342(%)<\/strong><\/td>\n

Former infected with H. pylori<\/em> n=613 <\/em>(%)<\/strong><\/td>\nNever infected with H. pylori<\/em> <\/strong><\/p>\n

n=<\/em><\/strong> 729 (%)<\/strong><\/td>\n

P. value<\/strong><\/td>\n<\/tr>\n
Gender<\/strong><\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Male<\/td>\n454 (33.8%)<\/td>\n160 (26%)<\/td>\n294 (40%)<\/td>\n0.052<\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Female<\/td>\n888 (66.2%)<\/td>\n453 (74%)<\/td>\n435 (60%)<\/td>\n<\/tr>\n
Age<\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 20-30 Years old<\/td>\n137 (10.2%)<\/td>\n127 (20.7%)<\/td>\n10 (1.4%)<\/td>\n <\/p>\n

0.003<\/td>\n<\/tr>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 31- 40 Years old<\/td>\n671 (50%)<\/td>\n350 (57.1%)<\/td>\n321 (44%)<\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 41- 50 Years old<\/td>\n534 (39.8)<\/td>\n136 (22.2%)<\/td>\n398 (54.6%)<\/td>\n<\/tr>\n
Residence<\/strong><\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Town<\/td>\n610 (45.5%)<\/td>\n206 (33.6%)<\/td>\n404 (55.4%)<\/td>\n0.046<\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Village<\/td>\n732 (54.5%)<\/td>\n407 (66.4%)<\/td>\n325 (44.6%)<\/td>\n<\/tr>\n
Educational Level<\/strong><\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Illiterate<\/td>\n151 (11.3%)<\/td>\n93 (15%)<\/td>\n58 (8%)<\/td>\n <\/p>\n

0.436<\/td>\n<\/tr>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Primary<\/td>\n489 (36.4%)<\/td>\n298 (49%)<\/td>\n191 (26%)<\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Secondary<\/td>\n502 (37.4%)<\/td>\n199 (32%)<\/td>\n303 (42%)<\/td>\n<\/tr>\n
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 University and above<\/td>\n200 (14.9%)<\/td>\n23 (4%)<\/td>\n177 (24%)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Table 2 displays the frequency of population awareness based on knowledge, with regard knowledge questions (80.1%) of respondents had heard about H. pylori<\/em>, nevertheless, 85.7%\u00a0agree that HP infection often disappears spontaneously, and (51.2%) didn\u2019t know that H. pylori can transmit between family members and (28.2%) were neutral. Fortunately, (83.2%) of\u00a0subjects were aware of HP symptoms, findings were statistically significant.<\/p>\n

Table 2: population perceptions towards Knowledge questions.<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
no<\/td>\n\u00a0<\/strong>Questions<\/strong><\/td>\nAgree <\/strong><\/td>\nDisagree<\/strong><\/td>\nNeutral<\/strong><\/td>\nMean \u00b1SD<\/strong><\/td>\nP. value<\/strong><\/td>\n<\/tr>\n
1<\/td>\nDo you know stomach germ ( H. pylori)<\/em><\/td>\n(1073)<\/p>\n

80.1%<\/td>\n

(226)<\/p>\n

16.8%<\/td>\n

(43)<\/p>\n

3.1%<\/td>\n

447.3\u00b1113.5<\/td>\n0.010<\/td>\n<\/tr>\n
2<\/td>\nInfection can be orally transmitted among family member<\/td>\n(255)<\/p>\n

19 %<\/td>\n

(687)<\/p>\n

51.2%<\/td>\n

(400)<\/p>\n

29.8%<\/td>\n

437.3\u00b141.3<\/td>\n0.002<\/td>\n<\/tr>\n
3<\/td>\nHP infection often disappears spontaneously<\/td>\n(1150)<\/p>\n

85.7%<\/td>\n

(75)<\/p>\n

5.6%<\/td>\n

(117) 8.7%<\/td>\n447.3\u00b1 45.7<\/td>\n0.002<\/td>\n<\/tr>\n
4<\/td>\nHP is known to cause gastric cancer<\/td>\n(576) 42.9%<\/td>\n(192)<\/p>\n

14.3%<\/td>\n

(574)<\/p>\n

42.7%<\/td>\n

447.3\u00b145.67<\/td>\n0.050<\/td>\n<\/tr>\n
5<\/td>\nHP cause nausea, pain, and discomfort in the upper abdomen<\/td>\n(1117)<\/p>\n

83.2%<\/td>\n

(51)<\/p>\n

3.7%<\/td>\n

(174)<\/p>\n

13%<\/td>\n

447\u00b1120.4<\/td>\n0.001<\/td>\n<\/tr>\n
6<\/td>\nHP can cause gastric or duodenal ulcer<\/td>\n(875)<\/p>\n

65.2%<\/td>\n

(17)<\/p>\n

1.2%<\/td>\n

(450)<\/p>\n

33.5%<\/td>\n

447.3\u00b188.6<\/td>\n0.030<\/td>\n<\/tr>\n
7<\/td>\nHP can be diagnosed through the endoscopy<\/td>\n(833) 62.1%<\/td>\n(208)<\/p>\n

15.5%<\/td>\n

(301)<\/p>\n

22.4%<\/td>\n

447.3\u00b169.6<\/td>\n0.050<\/td>\n<\/tr>\n
8<\/td>\nGenetic predisposition may be a major cause of injury<\/td>\n(291)<\/p>\n

21.7%<\/td>\n

(558)<\/p>\n

41.6%<\/td>\n

(491)<\/p>\n

36.6%<\/td>\n

446.7\u00b128.7<\/td>\n0.001<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Four questions regarding attitude summarized in table 3, (79.5%) have had an attitude that H. pylori <\/em>are affecting gender with equal propriety and (72%) lack of knowledge regarding HP is\u00a0associated with nutritional factors, food allergies, and food intolerance. Only (49.4%) agreed that untreated infected patients may develop into stomach cancer.<\/p>\n

With regard practice questions, (71.4%) didn\u2019t know that washing hands after using the toilet has a negative association with HP. While (67.7%) know washing hands before eating protects from\u00a0HP. While only (48.4%) of participants know that eating raw vegetables and fruits is linked positively with the transmission of infection and (19.3%) answered no and (32.3%) answer not\u00a0know. Drinking contaminated water may be a source of infection (75.9%) was agreed, however only (29.9%) of participants know that the source of contaminated drinking water (Well water)\u00a0has a positive association with HP. Findings were statistically significant.<\/p>\n

Table 3: Population perceptions towards attitude questions.<\/strong><\/p>\n\n\n\n\n\n\n\n
S.no<\/td>\nQuestions<\/strong><\/td>\nAgree <\/strong><\/td>\nDisagree<\/strong><\/td>\nNeutral<\/strong><\/td>\n\u00a0<\/strong>Mean \u00b1SD<\/strong><\/td>\nP. value<\/strong><\/td>\n<\/tr>\n
1<\/td>\nAffecting both men and women<\/td>\n(1066)<\/p>\n

79.5%<\/td>\n

(58)<\/p>\n

4.3%<\/td>\n

(216)<\/p>\n

16.1%<\/td>\n

446.7 \u00b1112.2<\/td>\n0.001<\/td>\n<\/tr>\n
2<\/td>\nHP is associated with nutritional factors, food allergies, and food intolerance<\/td>\n(966)<\/p>\n

72%<\/td>\n

(158)<\/p>\n

11.8%<\/td>\n

(218)<\/p>\n

16.1%<\/td>\n

447.3 \u00b192.9<\/td>\n0.003<\/td>\n<\/tr>\n
3<\/td>\nHP gastric cancer risk understanding compared to non-infected people of the same age and gender.<\/td>\n(659)<\/p>\n

49.1%<\/td>\n

(158)<\/p>\n

11.8%<\/td>\n

(525)<\/p>\n

39.1%<\/td>\n

447.3 \u00b1 53.5<\/td>\n0.075<\/td>\n<\/tr>\n
4<\/td>\nHP Gastrointestinal symptoms affect the quality of life<\/td>\n(192)<\/p>\n

14.3%<\/td>\n

(1025)<\/p>\n

76.4%<\/td>\n

(125)<\/p>\n

9.3%<\/td>\n

447.3 \u00b1 103.6<\/td>\n0.002<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Table 4: Population Perceptions Towards Practice Questions<\/strong><\/p>\n\n\n\n\n\n\n\n\n
S.no<\/td>\nQuestions<\/strong><\/td>\nAgree <\/strong><\/td>\nDisagree<\/strong><\/td>\nNeutral<\/strong><\/td>\nMean \u00b1SD<\/strong><\/td>\nP. value<\/strong><\/td>\n<\/tr>\n
1<\/td>\nWashing hands after using the toilet protects from getting infected with HP<\/td>\n(958) 71.4%<\/td>\n(109) 8.1%<\/td>\n(275)<\/p>\n

20.5%<\/td>\n

447.7 \u00b192.9<\/td>\n0.002<\/td>\n<\/tr>\n
2<\/td>\nWashing hands before eating protect from HP<\/td>\n(909)<\/p>\n

67.7%<\/td>\n

(208)<\/p>\n

15.5%<\/td>\n

(225)<\/p>\n

16.8%<\/td>\n

447.3 \u00a0\u00b182.6<\/td>\n0.003<\/td>\n<\/tr>\n
3<\/td>\nEating raw vegetables and fruits is linked to a Positive relationship with the transmission<\/td>\n(650)<\/p>\n

48.4%<\/td>\n

(259)<\/p>\n

19.3%<\/td>\n

(433)<\/p>\n

32.3%<\/td>\n

447.3 \u00b1 40.6<\/td>\n0.005<\/td>\n<\/tr>\n
4<\/td>\nDrinking contaminated water may be a source of infection<\/td>\n(1019)<\/p>\n

75.9%<\/td>\n

(67)<\/p>\n

4.9%<\/td>\n

(256)<\/p>\n

19.1%<\/td>\n

447.3 \u00b1 104.1<\/td>\n0.001<\/td>\n<\/tr>\n
5<\/td>\nSource of drinking water (Well water) have a positive association with HP<\/td>\n(401)<\/p>\n

29.9 %<\/td>\n

(659)<\/p>\n

49.1%<\/td>\n

(282) 21%<\/td>\n447.3\u00b139.8<\/td>\n0.054<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Discussion<\/strong><\/p>\n

The present study evaluated the knowledge, attitude, and practice of H. pylori<\/em> for perhaps the first study in Saudi Arabia to demonstrate the KAP study and associated risk factors associated\u00a0with H. pylori. The prevalence of H. pylori <\/em>infection was defined according to the different demographic data of the patients, including gender, age. The overall prevalence of H. pylori<\/em> among the participants was (45.6%), which is consistent with a previously mentioned study that\u00a0revealed a prevalence of 54.9% among Saudi patients with dyspepsia in the Jazan region of Saudi Arabia in 2004 12<\/sup>. A recent study on Saudi patients in 2018 conclude prevalence rates of\u00a046.5% 13<\/sup>, moreover, about 60% of Hispanics, 54% of African Americans, and about 20 to 29% of White Americans have detectable organisms. These variations in prevalence rates of H. pylori<\/em>\u00a0in different studies across the world might be attributed to different contributing factors including socioeconomic status, ethnicity, and geographical location also the sensitivity of\u00a0laboratory techniques used for diagnosis. The significantly highest frequency of H. pylori infection in the present study (52.2%) was revealed in the age group between 31-40 years, which\u00a0is similar to many studies that stated the high-frequency rate of H. pylori infection in middle age\u00a014, 15<\/sup>. In contrast, other studies have demonstrated a positive correlation between H. pylori\u00a0prevalence rates and an increase in age (31-40 and more than 40) 16<\/sup>.<\/p>\n

Regarding gender, our findings indicated that 66.2\u00a0% of females were infected and (74%) were formerly diagnosed as positive for H. pylori<\/em>, there was statistically significant differences in the prevalence (p-value 0.003) of H. pylori<\/em> between males and females, the crucial role of gender-associated H. pylori infection is not fully understood. This finding is in agreement with a study that reported a high prevalence of H. pylori among females 12<\/sup>. However, it conflicts with other\u00a0authors who noted a high rate of H. pylori infection among males, a large number of studies showed no gender differences 17, 18, 19<\/sup>.<\/p>\n

Residing in a rural area is considered to be a major risk factor for H. pylori distribution, among studied subject we revealed significantly high frequency (66.4%) of infected persons were from\u00a0rural areas, which is the same finding documented by Tadesse, E., Daka et al 20<\/sup>. The justification of this observation may be due to several discrepancies between rural and urban\u00a0areas, particularly in terms of person’s activities, eating habits, agricultural nature of villages, and source of drinking water. Drinking raw sheep dairy is also much more widespread among rural\u00a0dwellers than those of city dwellers. In addition to the relatively high frequency (49%) of previously infected, H. pylori were have had a low level of education and less knowledge about prevention and control. The greater academic level was strongly correlated with a faint but not statistically significant decline with H. pylori infection, which could be clarified by their different occupations; concluded by Zhu Y et al 21<\/sup>.<\/p>\n

Knowledge<\/strong><\/p>\n

Concerning Knowledge towards H. pylori<\/em>, according to findings participants appears to have limited knowledge about\u00a0H. pylori<\/em>, because (80%) of respondents react with agreeing when we\u00a0ask do they know HP, but (51.2%) didn\u2019t know that it can be orally transmitted between family members, and only (49%) hadn\u2019t known HP infected patients can develop gastric cancer.\u00a0Surprisingly, the correlation between H. pylori and ulcers would be more well-known than the link between H. pylori<\/em> and gastric cancer, this is in line with Shin DW’s opinion 22<\/sup>, and Chen\u00a0SY et al 23<\/sup>. Indeed the current level of knowledge, behaviors, and risk perception in the present population is fake and unauthenticated. Unless knowledge about\u00a0H. pylori<\/em>\u00a0transmission\u00a0was significantly pauper and inadequate, however, we can say overall knowledge was relatively good, because (83.2%) was agree and aware about symptoms, (62.2%) declare that HP diagnosis\u00a0through endoscopy, and (85.7%) implemented the need for treatment with an antibiotic. Our result is in agreement with Shin DW 22<\/sup><\/p>\n

Attitudes<\/strong><\/p>\n

Regarding attitude questions about (79.5%) know that H. pylori infect both men and women in equal proportions. found that most people viewed their own risk for developing gastric cancer as\u00a0average or low 24<\/sup>. The majority of participants (76.7%) mistakenly believed that HP Gastric symptoms haven\u2019t an impact on their quality of life. Additionally (72%) have had a\u00a0misconception that HP is associated with nutritional factors, food allergies, and food intolerance. Only a few studies studied attitudes towards H. pylori<\/em>, Shin et al.22<\/sup> who identified that almost\u00a0all respondents viewed their own risk as “identical” or “reduced” when compared with people their age and gender. While according to Oh et al.25<\/sup>, the majority of people believe everyone’s\u00a0risk of having stomach cancer is moderate or negligible.<\/p>\n

Practices<\/strong><\/p>\n

In general, better hand hygiene after using the toilet and then before eating\/preparing a meal, proper food practices, and basic sanitation from a clean source were related to decreased H.\u00a0pylori infection. Present findings revealed that 71.4% of the Saudi population agreed that hand hygiene before and after meals correlate with diminish incidence of H. pylori in the community.\u00a0Fortunately only (48.4%) agreed with eating raw vegetables and fruits linked to the Positive relationship with the transmission, and reminder 19.3%, 32.3%) disagreed and were neutral\u00a0respectively. Interestingly, Abebaw et al [26] revealed hand hygiene before eating was correlated with the increased prevalence of H. pylori<\/em>, and cleaning them after the toilet had no impact on H.\u00a0pylori incidence rate. However, such an outcome, contradicts what is commonly believed about this association, like hand washing “mostly not” after toilet and “not always” before meals were\u00a0correlated with elevated H. pylori occurrence 27<\/sup>.<\/p>\n

A frustrating conception revealed from our studied population can lead to negligence H. pylori<\/em> infection as it is considered a class I human carcinogen, that is linked to the development of gastric carcinomas, and gastric cancer is one of the murderous cancers in KSA, with an increasing incidence during the last years.<\/p>\n

Prospective<\/strong><\/p>\n

More cohort researches with large samples size to perfectly determining both bacterial identity and antibiotic resistance profile is contraindicated. Any variables that were not estimated in the\u00a0current study (such as smoking, eating behavior, lifestyle, and occupation), will be the focus of posterior studies of such populations. With this foresight, health authorities and patient-centered\u00a0techniques such as assessment, surveillance, and prevention and awareness programs can indeed be optimized to measure gastric cancer triggered by H. pylori infection in these high-risk subpopulations.<\/p>\n

Conclusion<\/strong><\/p>\n

The current study concludes that H. pylori is prevalent in the Saudi population. It is well evident that there is confined knowledge about H. pylori among the public, mostly about transmission\u00a0and its correlation with gastric cancer. General population education must be implemented to increase population awareness towards H. pylori<\/em>, especially among at-risk populations.<\/p>\n

Acknowledgment<\/strong><\/p>\n

This publication was supported by the Deanship of scientific research at Prince Sattam bin Abdul-Aziz University. Author appreciated to\u00a0Department of Medical Laboratory Sciences at the faculty of Applied Medical Sciences, Prince Sattam Bin Abdul-Aziz University.<\/p>\n

Conflict of Interest<\/strong><\/p>\n

The author declares that has no conflict interests.<\/p>\n

Funding Sources
\n<\/strong><\/p>\n

There is no funding source.<\/p>\n

References<\/strong><\/p>\n

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