Racial differences in Helicobacter pylori seroprevalence in Singapore: Correlation with differences in peptic ulcer frequency

Abstract

The aim of this study was to determine, first, whether racial differences exist in the seroprevalence of Helicobacter pylori infection in Singapore, and second, whether these differences correlate with racial differences in peptic ulcer frequency. A commercial serological test for immunoglobulin (Ig)G antibody to H. pylori which was 90% sensitive and 83% specific in our population was used to screen 403 adult blood donors of Chinese, Malay and Indian origin, aged between 15-60 years. Serum specimens from 84 paediatric patients admitted to the Paediatrics Department, National University of Singapore, with non-gastroenterological illnesses were also tested. In all three races, seroprevalence of H. pylori increased with age. Indians have the highest prevalence of infection followed by Chinese and Malays. Peptic ulcer prevalences are known to be highest in Chinese, followed by Indians and Malays. The Malays have the lowest prevalence of H. pylori and peptic ulcer among the three races in Singapore. Indians have a higher prevalence of H. pylori antibodies but a lower frequency of peptic ulcer than the Chinese. Racial differences in peptic ulcer frequency between Chinese and Indians are not explained by the prevalence of H. pylori infection; other environmental or genetic factors may be involved.

Immune Responses to Differentiated Forms ofHelicobacter pyloriin Children with Epigastric Pain

“…This is in agreement with the findings of Boey et al (3) for asymptomatic Malaysian children: the rate of seropositivity increased with age, and seropositivity was most common among the Indian children. A study by Kang et al (15) demonstrated that racial differences in the seroprevalence of H. pylori were more pronounced in the adult population. The study also showed that Indians had the highest prevalence of infection, followed by Chinese and Malay, but the Indian subjects had a lower frequency of peptic ulcer disease than the Chinese subjects (15).…”

Gastric cancer in Singapore

“…The prevalence of H. pylori infection in the Singapore adult population shows a distinct ethnic pattern. It is present in 70% of Indians, 43% of Chinese, and 36% of Malays [2]. The ethnic differences in gastric cancer frequency, therefore, cannot be explained by H. pylori infection alone, and may possibly be caused by host-bacterial interaction factors [3].…”

Serum pepsinogen levels in gastric cancer patients and their relationship with Helicobacter pylori infection: a prospective study

“…The HEL-pII Test kit utilizes the enzyme-linked immunosorbent assay (ELISA) technique for the detection of antibodies to H. pylori. This ELISA kit has been evaluated in our laboratory on a series of local patients with known H. pylori histological status, with a demonstrated sensitivity of 90.2% and specificity of 83.3% [13]. Serum gastrin level was measured by radioimmunoassay, using the Gamma Dab [ 125 I] Gastrin Radioimmunoassay Kit (DiaSorin, Stillwater, MN, USA).…”