Prevalence of Helicobacter pylori in Indigenous Western Australians: comparison between urban and remote rural populations

Abstract

Objectives: To determine and compare the prevalence of Helicobacter pylori in an urban and a remote rural Western Australian Indigenous community. Design: Cross‐sectional study of Helicobacter pylori status determined by urea breath tests between mid‐January 2003 and the end of June 2004. Participants: 520 self‐selected fasting participants, comprising 270 members of the Martu community at Jigalong, Punmu and Parnngurr in the East Pilbara region (129 men, 141 women; age range, 2–90 years) and 250 people from the Perth Indigenous community (96 men, 154 women; age range, 3–75 years. Results: The overall prevalence of H. pylori was 76%, but the prevalence in the remote rural community was 91%, compared with 60% in the urban community. The odds of having H. pylori were six times greater for rural than for urban participants (odds ratio [OR], 6.34; 95% CI, 3.89–10.33). Further, the overall odds of H. pylori infection in males (rural and urban combined) were greater than for females (OR, 1.61; 95% CI, 1.02–2.54). In both communities, the prevalence of infection remained relatively constant after the age of 10. Conclusions: The prevalence of H. pylori in the two Indigenous communities was two to three times higher than that in the non‐Indigenous Australian population and higher than that shown in previous studies in Indigenous Australians.

The burden of stomach cancer in indigenous populations: a systematic review and global assessment

“…In LMICs, the prevalence of stomach cancer has been found to be similar to that of H pylori infection, resulting in a much higher burden 58. Studies on the prevalence of H pylori infection among indigenous peoples confirm this pattern, suggesting high rates among Maori,59 Indigenous Australians,60 as well as Arctic aboriginal populations 61. The fact that the relationship between H pylori infection and stomach cancer is confined to non-cardia (distal) tumours, was confirmed in some studies that stratified by anatomical subsite, reporting particularly high rates of non-cardia tumours in indigenous populations 31 62…”

Epidemiology of Helicobacter pylori infection and gastric cancer in Asia

“…Within an individual country, differences in seroprevalence rates between different geographic regions and also between different ethnic groups have been reported. In Australia, the Anglo‐Celtic population had a lower seroprevalence rate compared to the aboriginal population; the rates were 38% 16 compared to 68% 17 . In China the seroprevalence rates were noted to be distinctly higher in regions with higher gastric cancer incidence rates.…”

Helicobacter pylorieradication therapy: indications, efficacy and safety

“…Socioeconomic conditions in childhood are strongly inversely correlated with the risk of infection [1] . Other higher-risk groups include the institutionalised, health workers, and some indigenous populations [4] .…”