The Seroprevalence and Eradication Success of Helicobacter pylori in Indigenous People of Seletar in Southern Malaysia | Chapter 14 | New Insights into Disease and Pathogen Research Vol. 3

Background: Helicobacter pylori prevalence rate varies widely from one geographical area to another and marked differences have been noted among different ethnic groups. While several studies have been carried out to review the prevalence of H. pylori among the major races in Malaysia, only one is available to study the indigenous Penan community in East Malaysia.

Aims: The aims of this study are to determine the seroprevalence of H. pylori in the indigenous Seletar community in Southern Malaysia and the effectiveness of the eradication program.

Methods: A seroepidemiological study was done to determine H. pylori infection by serological assay of H. pylori antibodies and the demographic pattern. Serological assay was carried out using the Visual H. pylori Quickpac Test. All serological positive patients were then subjected to an endoscopic study and the Campylobacter-Like Organism-test (CLO-test). Positive patients were then offered for eradication using triple therapy of Omeprazole 20mg, Amoxycillin 1gm and Metronidazole 400mg twice daily for one week. Subjects will be required to perform a Urea Breath Test (UBT) four weeks after therapy to determine the success of eradication. When attending for UBT, the medication diary will be assessed. UBT was conducted using a 13C IRIS (Infra Red Isotope Analyzer) breath test kit.

Results: We studied a total of 298 subjects with a mean age of 34.9 years. The seroprevalence was 37.9% and CLO-test positivity on Oesophago-gastro-duodenoscopy (OGDS) was 98.9%. Histopathological examination showed evidence of gastritis in 97% of the positive patients. Majority of subjects (96%) showed evidence of acute or on chronic inflammation. The follow-up of patients that came back for the UBT after completing the eradication process was 73.5%. Out of these, 63.9% showed negative UBT. However, only 48.6% complied with medication based on medication diary. Since only two subjects out of 35 who complied remains positive, the eradication success rate was 94.3%.

Conclusion: Previous studies have shown that the prevalence of H. pylori in a Malaysian cohort ranges from 26.4% to 55% with the highest in Indians of about 35.6% out of the three major races, followed by Chinese (28.6%) and Malays (28.5%). The indigenous people of Penan in East Malaysia showed 37.7% positivity, which is almost similar to our study that showed 37.9%. The prevalence is supported by the CLO-test that proved that the sensitivity of the serological assay was 98.9%. However, our study also proved that the eradication process was very efficient if subjects were compliant on medication. This study shows that despite the very low socio-economic status of the indigenous community, this is not the sole factor in determining H. pylori infection. This may also be due to genetic factors and probably a recent arrival of H. pylori in this isolated and remote community.

Author(s) Details

Dr. Ahmad Farouk Musa
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia.

Dr. Mohd Naguib Mohd Yunos
Flinders Medical Centre, Bedford Park, South Australia, Australia.

Prof. Sabariah Abdul Rahman
Department of Pathology, Faculty of Medicine, Universiti Teknologi MARA, Malaysia.

Prof. Rusli Bin Nordin
School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Selangor Darul Ehsan, Malaysia.

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Potential Risk Factors and Prevalence of Infection of Helicobacter pylori in Nigeria | Chapter 14 | Theory and Applications of Microbiology and Biotechnology Vol. 1

Aim: Potential risk factors and prevalence associated with Helicobacter pylori (H. pylori) infection in apparently healthy children in Nigeria were studied.

Study Design: To investigate the current potential risk factors associated with recent prevalence of H. pylori in apparently healthy children in Nigeria.

Place and Duration of Study: The study was conducted in two Local Government Areas, Alimosho and Ajeromi, of Lagos State, Nigeria between March and September 2014.

Methodology: Seroprevalence status of 185 asymptomatic children made up of 93 males and 92 females, aged between 2-16 years were selected by randomized stratified sampling with descriptive questionnaire. Serum immunoglobulin G H. pylori antibody of the individual subjects was determined using DiaSpot H. pylori kit while fecal samples of same group were analysed for HpSAg using immunoassay test kit of Helicobacter pylori Stool Antigen (HpSAg).

Results: Of 185 children tested for H. pylori antigen, 134 (68.7%) and 51(26.2%) were classified as seropositive and fecal HpSA positive respectively. Highest rate of 40.0% and 34.6% of the children weighing between 21 and 40 kg were positive while 29.2% and 32.5% children of parents that were traders were positive to serum H. pylori antigen and fecal HpSA respectively. Only 12.4% and 14.1% children from artisan parents were positive but different age group have no association with the infectivity or prevalence of fecal H. pylori antigen (OR=0.67, CI=0.142-0.152). Significant higher percentage of seropositivity of 59.0% and fecal positivity of 55.7% was recorded among children from 5-8 people in a room (p>0.05), while Households with regular potable water supply have lower H. pylori seropositivity and fecal positivity of 11.9% and 7.6% compared with households that sometimes have water supply. The Households that never had water supply had highest number of seropositivity of 40.0% and 18.4%, respectively. Sewage nearness to kitchen indicates 30.8% and 28.7% H. pylori seropositive and fecal positivity rate among children.  

Conclusion: Paediatric H. pylori prevalence is highly associated with water borne infection and poor sanitary practices. There is need for achievable interventions and improvement in environmental sanitation.

Author(s) Details

F. O. Olufemi
Department of Veterinary Microbiology and Parasitology, College of Veterinary Medicine, Federal University of Agriculture, Nigeria.

Quadri Remi
Department of Microbiology, College of Biological Sciences, Federal University of Agriculture, Abeokuta, Nigeria.

P. A. Akinduti
Department of Veterinary Microbiology and Parasitology, College of Veterinary Medicine, Federal University of Agriculture, Nigeria.

S. A. Bamiro
Department of Physiology, College of Medicine, Lagos State University, Lagos, Nigeria.

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