Burden of disease from Helicobacter pylori infection in western Canadian Arctic communities

Autor: Katharine Fagan-Garcia, Janis Geary, Hsiu-Ju Chang, Laura McAlpine, Emily Walker, Amy Colquhoun, Sander Veldhuyzen van Zanten, Safwat Girgis, Billy Archie, Brendan Hanley, Andre Corriveau, John Morse, Rachel Munday, Karen J. Goodman, CANHelp Working Group
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Atrophic gastritis
Biopsy
Peptic ulcer disease
Chronic gastritis
0302 clinical medicine
Arctic
Cost of Illness
Prevalence
030212 general & internal medicine
Child
Stomach cancer
Aged
80 and over
medicine.diagnostic_test
biology
Arctic Regions
Incidence
Incidence (epidemiology)
lcsh:Public aspects of medicine
Middle Aged
3. Good health
Breath Tests
Child
Preschool
Gastritis
Female
medicine.symptom
Research Article
Adult
medicine.medical_specialty
Canada
Adolescent
Urea breath test
030209 endocrinology & metabolism
Helicobacter Infections
Young Adult
03 medical and health sciences
Stomach Neoplasms
Internal medicine
Gastroscopy
medicine
Humans
Disease burden
Aged
Metaplasia
Helicobacter pylori
Indigenous health
business.industry
Infant
Newborn
Public Health
Environmental and Occupational Health
Infant
lcsh:RA1-1270
medicine.disease
biology.organism_classification
Gastric Mucosa
Gastric cancer
business
Zdroj: BMC Public Health, Vol 19, Iss 1, Pp 1-11 (2019)
BMC Public Health
ISSN: 1471-2458
DOI: 10.1186/s12889-019-7065-x
Popis: Background Indigenous communities across the circumpolar north have elevated H. pylori (Hp) prevalence and stomach cancer incidence. We aimed to describe the Hp-associated disease burden among western Canadian Arctic participants in community-driven projects that address concerns about health risks from Hp infection. Methods During 2008–2013, participants underwent Hp screening by urea breath test and gastroscopy with gastric biopsies. We estimated Hp prevalence and prevalence by Hp status of endoscopic and histopathologic diagnoses. Results Among 878 participants with Hp status data, Hp prevalence was: 62% overall; 66% in 740 Indigenous participants; 22% in 77 non-Indigenous participants (61 participants did not disclose ethnicity); 45% at 0–14 years old, 69% at 15–34 years old, and 61% at 35–96 years old. Among 309 participants examined endoscopically, visible mucosal lesions were more frequent in the stomach than the duodenum: the gastric to duodenal ratio was 2 for inflammation, 8 for erosions, and 3 for ulcers. Pathological examination in 308 participants with gastric biopsies revealed normal gastric mucosa in 1 of 224 Hp-positive participants and 77% (65/84) of Hp-negative participants with sharp contrasts in the prevalence of abnormalities between Hp-positive and Hp-negative participants, respectively: moderate-severe active gastritis in 50 and 0%; moderate-severe chronic gastritis in 91 and 1%; atrophic gastritis in 43 and 0%; intestinal metaplasia in 17 and 5%. Conclusions The observed pattern of disease is consistent with increased risk of stomach cancer and reflects substantial inequity in the Hp-associated disease burden in western Arctic Canadian hamlets relative to most North American settings. This research adds to evidence that demonstrates the need for interventions aimed at reducing health risks from Hp infection in Indigenous Arctic communities.
Databáze: OpenAIRE
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