Research Article

A 10-year analysis of Helicobacter pylori positivity in gastric biopsies: Impact of seasonality and the COVID-19 pandemic a single-center experience

Number: 1 July 27, 2026

A 10-year analysis of Helicobacter pylori positivity in gastric biopsies: Impact of seasonality and the COVID-19 pandemic a single-center experience

Abstract

Objective: This study aimed to investigate the annual, seasonal, and monthly trends in Helicobacter pylori (HP) positivity over ten years and to assess the potential impact of the COVID-19 pandemic on diagnostic patterns. 

Method: A retrospective analysis was conducted on 17,091 gastric biopsies performed between 2015 and 2024. HP infection was diagnosed histologically using toluidine blue staining. The data were classified by month, season, and year, and comparisons were made across the pre-pandemic (2015-2019), pandemic (2020-2021), and post-pandemic (2022-2024) periods.
Results: The overall HP positivity rate was 29.1%. Positivity was significantly higher in males (30.3%) than in females (28.2%) (p=0.002), although the effect size was minimal. Younger individuals had a significantly higher HP positivity rate (mean age: 49.0 vs. 54.1 years, p<0.001). HP positivity showed minor monthly variation, with the highest rate in August (33.3%) and the lowest in February (27.3%) (p=0.044; minimal effect size). No significant differences were observed in seasonal positivity rates. HP positivity decreased during the pandemic years (26.4%) and showed a significant upward trend post-pandemic, reaching 32.0% in 2024 (p=0.002). However, the pandemic's overall effect on HP positivity rates was limited. 
Conclusion: Although minor seasonal and monthly fluctuations were detected, they were not clinically meaningful. The pandemic temporarily reduced HP detection rates, likely due to restricted access to healthcare services. Post-pandemic increases in positivity may reflect delayed diagnoses and rising antibiotic resistance. Continued monitoring of HP trends is essential for guiding public health strategies. 

Keywords

Helicobacter pylori, Gastric Biopsy, Seasonal Variation, Epidemiology, COVID-19 Pandemic

Supporting Institution

The authors declare the study received no funding.

Ethical Statement

The study was approved by the Ethics Committee of the Faculty of Medicine, Manisa Celal Bayar University (Date: 16.07.2025, Reference No: 20478486-3288).

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APA
Atmış, Ö., & Pehlivan, F. S. (2026). A 10-year analysis of Helicobacter pylori positivity in gastric biopsies: Impact of seasonality and the COVID-19 pandemic a single-center experience. Turkish Journal of Public Health, 1. https://doi.org/10.20518/tjph.1832864
AMA
1.Atmış Ö, Pehlivan FS. A 10-year analysis of Helicobacter pylori positivity in gastric biopsies: Impact of seasonality and the COVID-19 pandemic a single-center experience. TJPH. 2026;(1). doi:10.20518/tjph.1832864
Chicago
Atmış, Ömer, and Fatma Seher Pehlivan. 2026. “A 10-Year Analysis of Helicobacter Pylori Positivity in Gastric Biopsies: Impact of Seasonality and the COVID-19 Pandemic a Single-Center Experience”. Turkish Journal of Public Health, no. 1. https://doi.org/10.20518/tjph.1832864.
EndNote
Atmış Ö, Pehlivan FS (July 1, 2026) A 10-year analysis of Helicobacter pylori positivity in gastric biopsies: Impact of seasonality and the COVID-19 pandemic a single-center experience. Turkish Journal of Public Health 1
IEEE
[1]Ö. Atmış and F. S. Pehlivan, “A 10-year analysis of Helicobacter pylori positivity in gastric biopsies: Impact of seasonality and the COVID-19 pandemic a single-center experience”, TJPH, no. 1, July 2026, doi: 10.20518/tjph.1832864.
ISNAD
Atmış, Ömer - Pehlivan, Fatma Seher. “A 10-Year Analysis of Helicobacter Pylori Positivity in Gastric Biopsies: Impact of Seasonality and the COVID-19 Pandemic a Single-Center Experience”. Turkish Journal of Public Health. 1 (July 1, 2026). https://doi.org/10.20518/tjph.1832864.
JAMA
1.Atmış Ö, Pehlivan FS. A 10-year analysis of Helicobacter pylori positivity in gastric biopsies: Impact of seasonality and the COVID-19 pandemic a single-center experience. TJPH. 2026. doi:10.20518/tjph.1832864.
MLA
Atmış, Ömer, and Fatma Seher Pehlivan. “A 10-Year Analysis of Helicobacter Pylori Positivity in Gastric Biopsies: Impact of Seasonality and the COVID-19 Pandemic a Single-Center Experience”. Turkish Journal of Public Health, no. 1, July 2026, doi:10.20518/tjph.1832864.
Vancouver
1.Ömer Atmış, Fatma Seher Pehlivan. A 10-year analysis of Helicobacter pylori positivity in gastric biopsies: Impact of seasonality and the COVID-19 pandemic a single-center experience. TJPH. 2026 Jul. 1;(1). doi:10.20518/tjph.1832864