Prevalence and associated factors of Helicobacter pylori seropositivity, including mode of delivery, among asymptomatic adolescents in Central Sudan: a community-based cross-sectional study

Helicobacter pylori infection remains a major global health problem, particularly in resource-limited settings, and is a leading cause of several gastrointestinal diseases. This study aimed to determine the prevalence of H. pylori seropositivity and its associated factors, including mode of delivery, among asymptomatic adolescents in Central Sudan. A community-based cross-sectional study was conducted between April and May 2025. Sociodemographic data, anthropometric measurements, and mode of delivery were collected using a structured questionnaire. H. pylori seropositivity was assessed using a rapid antibody test detecting H. pylori-specific antibodies. Univariate and multivariate binary logistic regression analyses were performed to identify associated factors. A total of 235 adolescents were enrolled, of whom 124 (52.8%) were males. The overall prevalence of H. pylori seropositivity was 24.7%. Univariate analysis showed that mode of delivery was the only factor significantly associated with H. pylori seropositivity. This association remained significant in multivariate analysis (adjusted odds ratio = 3.97; 95% confidence interval: 1.04–15.18), indicating a higher risk among adolescents delivered by cesarean section. Other factors, including age, sex, body mass index, family size, parental education and occupation, and displacement status, were not significantly associated. H. pylori positivity is relatively common among asymptomatic adolescents in Central Sudan. The use of a rapid serological antibody test represents an important limitation because it cannot distinguish between active infection and previous exposure. Consequently, the reported prevalence more accurately reflects H. pylori seropositivity than confirmed active infection. Mode of delivery may represent an important early-life risk factor, underscoring the need for further longitudinal research.