Epidemiology of Helicobacter pylori and gastric atrophy in rural south-western Uganda: the ENIGMA Uganda study

Scientists from the International Agency for Research on Cancer (IARC), together with collaborators from the Medical Research Council/Uganda Virus Research Institute (MRC/UVRI) and London School of Hygiene & Tropical Medicine (LSHTM) Uganda Research Unit, report new findings from the Ugandan arm of the Epidemiological Investigation of Gastric Malignancies (ENIGMA) study in the journal Helicobacter. ENIGMA is an IARC-led international initiative that uses a standardized framework to characterize the epidemiology of infection with Helicobacter pylori, gastric atrophy, and other risk factors as they relate to risk of gastric cancer across populations.

Using the standardized ENIGMA framework, the researchers performed a population-based study of 700 individuals aged 1–69 years living in rural south-western Uganda and found that H. pylori infection was highly prevalent and acquired early in life in this population. Overall age-standardized seroprevalence was 76%, and reached 63% among children aged 1–9 years. Interestingly, serologically defined gastric atrophy, a marker of increased gastric cancer risk, was relatively uncommon, affecting 6% of individuals aged 40 years or older in this population. This distinct epidemiological pattern warrants further validation and investigation, including in other Ugandan populations.

These findings provide important baseline data for comparison with those from other countries included in the ENIGMA study and may improve our understanding of future trends and geographical disparities in the burden of gastric cancer.

Huang Y, Knaze V, Mugisha J, Navionis A-S, Rinaldi S, Clifford GM, et al.
Epidemiology of Helicobacter pylori and gastric atrophy in rural southwestern Uganda: the ENIGMA Uganda study.
Helicobacter, Published online XX September 2026;
https://doi.org/10.1111/hel.70163

Read the article

Read articles detailing the results from the ENIGMA study in other countries:

Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile (2020)

Association between salt intake and gastric atrophy by Helicobacter pylori infection: first results from the Epidemiological Investigation of Gastric Malignancy (ENIGMA) (2023)

Nationwide survey of Helicobacter pylori seropositivity and gastric atrophy in Zambia (2024)

Read about the IARC Gastric Cancer Prevention Team