Helicobacter pylori infection among non-Native educators in Alaska

Abstract

Objectives. To determine seroprevalence of H. pylori infection in non-Native educators residing in urban or rural settings in Alaska, and to determine potential risk factors associated with infection in this population. Study design. A cross-sectional survey of non-Native educators residing in urban or rural settings in Alaska. Methods. Participants completed a questionnaire detailing aspects of residential life; H. pylori antibody status was determined by a commercial assay. Results. Of the 203 non-Native participants, 49 (24%) had antibody to H. pylori. Univariate analysis demonstrated that the mean age of seropositive participants was higher than of seronegatives (48 vs. 42 years, respectively, p=.001). In addition, participants who had experienced childhood crowding were more likely to test seropositive for H. pylori (p=.058). On multivariate analysis, only age ≥ 40 was associated with infection. No difference in median hemoglobin or ferritin levels were noted among seropositive and seronegative participants. There was no increased risk of seropositivity among participants who had lived in an Alaska Native village or in a developing country for > 6 months. Conclusions. Overall, 24% of non-Native educators residing in rural Alaska tested positive by serology for H. pylori. Age ≥ 40 years was associated with infection. Median hemoglobin or ferritin levels did not differ significantly among seropositive and seronegative participants.

Characterization of Helicobacter pylori cagA andvacAGenotypes among Alaskans and Their Correlation with Clinical Disease

“…We know of only one study investigating the prevalence of H. pylori infection in non-Native Alaskans. Those authors found an H. pylori seroprevalence of 24% in non-Native school teachers who were living in rural Alaska and were predominantly Caucasian persons born in the contiguous 48 U.S. states; testing for pathogenic genes was not performed in that study (27). In Alaska Native persons, the H. pylori seroprevalence is more than three times higher than what was found in that study (35).…”

An updated systematic review and meta‐analysis on the association between Helicobacter pylori infection and iron deficiency anemia

“…Limiting the analysis to studies that adjusted for confounders in children showed a significantly increased likelihood of anemia by 26%: OR 1.26 (95% CI 1.02–1.55), with significant heterogeneity among the studies (Pv=.02). Such association was not observed when combining results of studies of adults (OR 0.95, 95% CI 0.70–1.27).…”

“…The 44 studies that scored 12 points or less in the quality assessment score were therefore excluded from the meta‐analysis. Fifty observational studies addressed the outcomes IDA, ID, and/or anemia and met inclusion criteria (Table ) . These studies varied in their design, study population, and method of detecting H. pylori infection; in their classification of IDA, ID, and/or anemia; and in their findings (Table ).…”

“…A combined analysis of 30 studies that addressed the association between H. pylori infection and ID showed an increased likelihood of ID among H. pylori ‐infected vs uninfected individuals, pooled OR 1.33 (95% CI 1.15–1.54) Pv<.001. Significant heterogeneity was noted among the studies: χ 2 =49.25, df =29, Pv=.01, I 2 =41.1%, which was reduced (χ 2 =36.5, df =26, Pv=.08, I 2 =28.7%) after excluding three studies, without changing the combined point estimate, OR 1.35 (95% CI 1.18–1.55) Pv<.001.…”

“…A stronger positive association between H. pylori infection and ID was found in a subgroup analysis of studies that adjusted for confounders 2,3,12,[30][31][32]35,37,40,42,44,46,48,50,52 (OR 1.41, 95% CI 1.17-1.71), Pv<.001. Separate meta-analyses of pediatric 3,12,31,32,35,37,40,46,48,50,52 and adult 2,30,42,44,46 studies that adjusted for confounders showed similar results (OR 1.43, 95% CI 1.15-1.78) and (OR 1.37, 95% CI 1.01-1.86), respectively, while such association was nonsignificant (OR 1.21, 95% CI 0.94-1.56; Pv=.13) in a meta-analysis of unadjusted results. 14,25,29,33,34,36,38,39,41,43,45,47,49,51,59…”