The Seroprevalence and Eradication Success of Helicobacter pylori in Indigenous People of Seletar in Southern Malaysia.
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Date
2014-03-21
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Abstract
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 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.
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Keywords
Helicobacter pylori, seroprevalence, Oesophago-gastroduo-denoscopy (OGDS), disease eradication
Citation
Musa Ahmad Farouk, Yunos Mohd Naguib Mohd, Rahman Sabasriah Abdul, Nordin Rusli Bin. The Seroprevalence and Eradication Success of Helicobacter pylori in Indigenous People of Seletar in Southern Malaysia. British Journal of Medicine and Medical Research. 2014 Mar; 4(9): 1854-1863.