Extremely high prevalence of Helicobacter pylori infection in Bhutan

World J Gastroenterol. 2013 May 14;19(18):2806-10. doi: 10.3748/wjg.v19.i18.2806.

Abstract

Aim: To revealed the prevalence of Helicobacter pylori (H. pylori) infection in the Bhutanese population.

Methods: We recruited a total of 372 volunteers (214 females and 158 males; mean age of 39.6 ± 14.9 years) from three Bhutanese cities (Thimphu, Punaka, and Wangdue). The status of H. pylori infection was determined based on five different tests: the rapid urease test (CLO test), culture, histology, immunohistochemistry (IHC), and serum anti H. pylori-antibody.

Results: The serological test showed a significantly higher positive rate compared with the CLO test, culture, histology and IHC (P < 0.001, P < 0.001, P = 0.01, and P = 0.01, respectively). When the subjects were considered to be H. pylori positive in the case of at least one test showing a positive result, the overall prevalence of H. pylori infection in Bhutan was 73.4%. The prevalence of H. pylori infection significantly decreased with age (P < 0.01). The prevalence of H. pylori infection was lower in Thimphu than in Punakha and Wangdue (P = 0.001 and 0.06, respectively). The prevalence of H. pylori infection was significantly higher in patients with peptic ulcers than in those with gastritis (91.4% vs 71.3%, P = 0.003).

Conclusion: The high incidence of gastric cancer in Bhutan may be attributed to the high prevalence of H. pylori infection.

Keywords: Bhutan; Helicobacter pylori; Prevalence.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Bacterial / blood
  • Bhutan / epidemiology
  • Biomarkers / blood
  • Female
  • Gastritis / epidemiology
  • Gastritis / microbiology
  • Health Surveys
  • Helicobacter Infections / blood
  • Helicobacter Infections / diagnosis
  • Helicobacter Infections / epidemiology*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / immunology
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Peptic Ulcer / epidemiology
  • Peptic Ulcer / microbiology
  • Prevalence
  • Residence Characteristics
  • Risk Factors
  • Seroepidemiologic Studies
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / microbiology
  • Young Adult

Substances

  • Antibodies, Bacterial
  • Biomarkers