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

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dc.contributor.authorFagan-Garcia, Katharine
dc.contributor.authorGeary, Janis
dc.contributor.authorChang, Hsiu-Ju
dc.contributor.authorMcAlpine, Laura
dc.contributor.authorWalker, Emily
dc.contributor.authorColquhoun, Amy
dc.contributor.authorvan Zanten, Sander V
dc.contributor.authorGirgis, Safwat
dc.contributor.authorArchie, Billy
dc.contributor.authorHanley, Brendan
dc.contributor.authorCorriveau, Andre
dc.contributor.authorMorse, John
dc.contributor.authorMunday, Rachel
dc.contributor.authorGoodman, Karen J
dc.date.accessioned2019-06-16T00:07:30Z
dc.date.available2019-06-16T00:07:30Z
dc.date.issued2019-06-11
dc.date.updated2019-06-16T00:07:30Z
dc.description.abstractAbstract 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.
dc.identifier.citationBMC Public Health. 2019 Jun 11;19(1):730
dc.identifier.doihttps://doi.org/10.1186/s12889-019-7065-x
dc.identifier.urihttp://hdl.handle.net/1880/110499
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.titleBurden of disease from Helicobacter pylori infection in western Canadian Arctic communities
dc.typeJournal Article
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