1. Introduction

Helicobacter pylori (H. pylori) are human pathogens transmitted from human to human through oral routes and cause chronic gastritis in all colonized subjects [1]. This gram-negative bacterium is a common infectious pathogen that inhabits the gastric mucosa in around 40-50% of the world’s population, leading to a global public health issue. The incidence of infection varies geographically and is over 75% in Portugal, Turkey and Kazakhstan, and some African countries [1,2]. In the Riyadh region of Saudi Arabia, Alghamdi et al. [3] reported an incidence of 34.7%. Furthermore, a recent review that included published literature from Saudi Arabia reported a prevalence ranging from 27-66% in the Middle East and North Africa region [4]. The high incidence and prevalence of H. pylori infection is a public health concern.

Evidence shows that H. pylori infection is associated with gastric cancer [5], the third leading cancer-related death and the fifth most common cancer worldwide [6]. It is also established that H. pylori is primarily related to the development of gastroduodenal disorders and, more commonly, chronic gastritis, peptic ulcers, and gastric adenocarcinoma, or lymphomas [7,8]. H. pylori gastritis is designated as an infectious disease in the Maastricht V/Florence consensus report [9]. The infection caused by H. pylori may either be asymptomatic and/or symptomatic. Epigastric pain, upper abdominal discomfort, indigestion, nausea, loss of appetite, reflux, and/or belching are among the most frequently occurring symptoms.

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Commonly transmitted through oral routes, the fecal-oral, oral-oral, and gastro-oral routes, the definite interpersonal mode of transmission is still unknown [10,11]. However, several demographic factors are associated with the H. pylori infection. High income and higher educational levels are associated with a decrease in the prevalence of H. pylori gastritis [12,13]. Additionally, age, occupation, the type of drinking water used, consumption of fruits, vegetables, or fried food are also independent risk factors for H. pylori infection [14,15,16]. Smoking and alcohol consumption were also found to be independently positively associated factors [17]. Many of these risk factors are preventable with adequate knowledge and appropriate practice. There appears to be limited knowledge about H. pylori among the general population, primarily related to transmission. Evidence shows low awareness of H. pylori infection in Canada [18], the United States [19], China [20,21,22], and South Korea [23,24]. Knowledge about screening and prevention among risk groups, early diagnosis, and treatment may prompt people to seek measures to prevent the infection [9,24]. It is essential to educate the general population, especially the university students who are a segment of the general population.

There is a paucity of studies on H. pylori among university students who may be vulnerable to the infection. Therefore, assessing their awareness regarding H. pylori will form a basis for developing educational content that can enhance their knowledge and improve screening practices among those at risk. A comparison between health science and non-health science students will provide an understanding of the depth of knowledge they possess from their courses. To our knowledge, this is the first study that compares the knowledge about H. pylori infection, testing, and management among health science and non-health science undergraduate students in Saudi Arabia.

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