Extremely low Helicobacter pylori prevalence in North Sulawesi, Indonesia and identification of a Maori-tribe type strain: a cross sectional study

Abstract

BackgroundSulawesi in Indonesia has a unique geographical profile with assumed separation from Sundaland. Studies of Helicobacter pylori in this region are rare due to the region’s rural location and lack of endoscopy equipment. Indirect methods are, therefore, the most appropriate for measuring H. pylori infection in these areas; with the disposable gastric brush test, we can obtain gastric juice as well as small gastric tissue samples for H. pylori culture. We investigated the prevalence of H. pylori infection and evaluated human migration patterns in the remote areas of North Sulawesi.MethodsWe recruited a total of 251 consecutive adult volunteers and 131 elementary school children. H. pylori infection was determined by urine antibody test. A gastric brush test was used to culture H. pylori. We used next-generation and polymerase chain reaction based sequencing to determine virulence factors and multi-locus sequence typing (MLST).ResultsThe overall H. pylori prevalence was only 14.3% for adults and 3.8% for children, and 13.6% and 16.7% in Minahasanese and Mongondownese participants, respectively. We isolated a single H. pylori strain, termed -Manado-1. Manado-1 was East Asian type cagA (ABD type), vacA s1c-m1b, iceA1 positive/iceA2 negative, jhp0562-positive/β-(1,3) galT-negative, oipA “on”, and dupA-negative. Phylogenetic analyses showed the strain to be hspMaori type, a major type observed in native Taiwanese and Maori tribes.ConclusionsOur data support that very low H. pylori infection prevalence in Indonesia. Identification of hspMaori type H. pylori in North Sulawesi may support the hypothesis that North Sulawesi people migrated from north.

Serologic and Urine Diagnostic Tests to Detect Helicobacter pylori Infection in Functional Dyspepsia Patients

“…This prevalence was lower compared to similar study in India by Sodhi et al and in China by Xu et al 13,14 The prevalence of H. pylori infection in this study was higher compared to several previous studies in North Sulawesi, Surabaya, and Jakarta which were 14.3%, 11.5%, and 9.5%, respectively. 15,16,17 The demography of population with H. pylori infection in this study was similar to those of several previous studies which stated that low economic status, densely populated area, not clean water, smoking, and alcohol consumption were strongly correlated with the presence of H. pylori infection.…”

Risk Factors and Prevalence of Helicobacter pylori in Five Largest Islands of Indonesia: A Preliminary Study

“…The overall H . pylori prevalence was only 14.3% for adults and 3.8% for children [ 11 ]. However our results cannot be generalized across Indonesia due to the difference of host factor and environmental condition.…”

Helicobacter pylori virulence genes in the five largest islands of Indonesia

“…Our previous study using 5 different diagnostic methods confirmed that the prevalence of H. pylori infection in Surabaya (Java island) was low (only 11.5 %) [ 18 ]. We also found a low prevalence of H. pylori infection in a minor group of North Sulawesi; the prevalence was only 14.3 % for adults and 3.8 % for children [ 19 ]. However, it remains unclear whether the low incidence of gastric cancer in Indonesia is due to low infection rates only or also owing to low H. pylori pathogenicity.…”