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Roth L, Michl P, Rosendahl J. [Sex-specific differences in gastroenterological diseases]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2023; 64:736-743. [PMID: 36884055 DOI: 10.1007/s00108-023-01491-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/09/2023]
Abstract
Diseases of the gastrointestinal tract present with substantial sex differences that have a potential impact on patient outcome. This fact is not sufficiently addressed either in basic research or in clinical studies. For example, most animal studies utilize male animals. Despite differences in incidence, sex may affect complication rates, prognosis, or therapeutic response. The incidence of gastrointestinal cancers is frequently higher in males, but this observation cannot solely rely on a distinct risk behaviour. Here, differences in immune response and p53 signalling may be factors responsible for this finding. Nevertheless, taking sex differences into account and improving our understanding of relevant mechanisms is crucial and will most likely have a substantial impact on disease outcome. This overview aims to highlight sex differences in the context of various gastroenterological diseases, primarily to enhance awareness. Attention to sex-specific differences is essential to improve individualized treatment.
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Affiliation(s)
- Laura Roth
- Universitätsklinik und Poliklinik für Innere Medizin I, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
- Department of Cancer Biology, Dana Farber Cancer Institute, Boston, MA, USA.
- Department of Cell Biology, Harvard Medical School, Boston, MA, USA.
| | - Patrick Michl
- Universitätsklinik und Poliklinik für Innere Medizin I, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
- Klinik für Innere Medizin IV, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Jonas Rosendahl
- Universitätsklinik und Poliklinik für Innere Medizin I, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
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de Smalen AW, Chan ZX, Abreu Lopes C, Vanore M, Loganathan T, Pocock NS. Developing an evidence assessment framework and appraising the academic literature on migrant health in Malaysia: a scoping review. BMJ Open 2021; 11:e041379. [PMID: 33462099 PMCID: PMC7813391 DOI: 10.1136/bmjopen-2020-041379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND A large number of international migrants in Malaysia face challenges in obtaining good health, the extent of which is still relatively unknown. This study aims to map the existing academic literature on migrant health in Malaysia and to provide an overview of the topical coverage, quality and level of evidence of these scientific studies. METHODS A scoping review was conducted using six databases, including Econlit, Embase, Global Health, Medline, PsycINFO and Social Policy and Practice. Studies were eligible for inclusion if they were conducted in Malaysia, peer-reviewed, focused on a health dimension according to the Bay Area Regional Health Inequities Initiative (BARHII) framework, and targeted the vulnerable international migrant population. Data were extracted by using the BARHII framework and a newly developed decision tree to identify the type of study design and corresponding level of evidence. Modified Joanna Briggs Institute checklists were used to assess study quality, and a multiple-correspondence analysis (MCA) was conducted to identify associations between different variables. RESULTS 67 publications met the selection criteria and were included in the study. The majority (n=41) of studies included foreign workers. Over two-thirds (n=46) focused on disease and injury, and a similar number (n=46) had descriptive designs. The average quality of the papers was low, yet quality differed significantly among them. The MCA showed that high-quality studies were mostly qualitative designs that included refugees and focused on living conditions, while prevalence and analytical cross-sectional studies were mostly of low quality. CONCLUSION This study provides an overview of the scientific literature on migrant health in Malaysia published between 1965 and 2019. In general, the quality of these studies is low, and various health dimensions have not been thoroughly researched. Therefore, researchers should address these issues to improve the evidence base to support policy-makers with high-quality evidence for decision-making.
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Affiliation(s)
- Allard Willem de Smalen
- Maastricht Graduate School of Governance, Maastricht University, Maastricht, The Netherlands
- United Nations University-Maastricht Economic and Social Research Institute on Innovation and Technology, Maastricht, The Netherlands
- United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia
| | - Zhie X Chan
- United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia
| | - Claudia Abreu Lopes
- United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia
| | - Michaella Vanore
- Maastricht Graduate School of Governance, Maastricht University, Maastricht, The Netherlands
- United Nations University-Maastricht Economic and Social Research Institute on Innovation and Technology, Maastricht, The Netherlands
| | - Tharani Loganathan
- Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nicola S Pocock
- United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia
- Gender Violence & Health Centre, London School of Hygiene and Tropical Medicine, London, UK
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Wang C, Liu J, Shi X, Ma S, Xu G, Liu T, Xu T, Huang B, Qu Y, Guo X, Qi X. Prevalence of Helicobacter pylori Infection in Military Personnel from Northeast China: A Cross-Sectional Study. Int J Gen Med 2021; 14:1499-1505. [PMID: 33907452 PMCID: PMC8071091 DOI: 10.2147/ijgm.s308572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/24/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Helicobacter pylori infection is an important cause of peptic ulcer disease and gastric cancer. Current knowledge regarding epidemiology of H. pylori infection in military personnel has insufficiently been updated. This cross-sectional study aimed to estimate the prevalence of H. pylori infection in military personnel and to compare the prevalences in military and civilian groups. PATIENTS AND METHODS We retrospectively enrolled the subjects who underwent 14C-urea breath tests at the Department of Gastroenterology of the General Hospital of Northern Theater Command between January 2017 and July 2020. Subjects were divided into military and civilian groups. H. pylori infection and major endoscopic findings were reviewed. RESULTS Overall, 23,496 subjects were eligible, including 2282 subjects in the military group and 21,214 subjects in the civilian group. In the overall analysis, the prevalence of H. pylori infection was not significantly different between military and civilian groups (33.9% versus 34.4%, P=0.592). In the population aged 17-25 years, the prevalence of H. pylori infection was significantly higher in the military group than in the civilian group (35.6% versus 25.9%, P=0.001). Both 14C-UBT and endoscopy were performed in 547 inpatients, including 83 military inpatients and 464 civilian inpatients. There was a significantly higher prevalence of H. pylori in inpatients with peptic ulcer and/or gastric cancer than in those without (65.5% versus 41.4%, P=0.001). CONCLUSION Among the adolescent population, H. pylori infection may be more common in military personnel as compared to the civilians. Well-designed prospective studies should be required to validate such a high prevalence and to explain its potential causes.
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Affiliation(s)
- Chunmei Wang
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China
- Graduate School, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Jun Liu
- Military Joint Teaching and Research Office, The 32684 Troop of Chinese PLA, Shenyang, People’s Republic of China
| | - Xiaoye Shi
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China
| | - Shaoze Ma
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China
| | - Guangqin Xu
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China
| | - Tingwei Liu
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China
| | - Tingting Xu
- Military Joint Teaching and Research Office, The 32684 Troop of Chinese PLA, Shenyang, People’s Republic of China
| | - Bo Huang
- Military Joint Teaching and Research Office, The 32684 Troop of Chinese PLA, Shenyang, People’s Republic of China
| | - Ying Qu
- Department of Health Care, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China
| | - Xiaozhong Guo
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China
| | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, People’s Republic of China
- Correspondence: Xingshun Qi; Xiaozhong Guo Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, Liaoning Province, 110840, People’s Republic of ChinaTel +86-24-28897603Fax +86-24-28851113 Email ;
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de Sena-Reis JS, Bezerra DD, Figueiredo CA, Barreto ML, Alcântara-Neves NM, da Silva TM. Relationship between African Biogeographical Ancestry and Helicobacter pylori infection in children of a large Latin American urban center. Helicobacter 2019; 24:e12662. [PMID: 31571359 DOI: 10.1111/hel.12662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/05/2019] [Accepted: 08/25/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIM The relationship between race/ethnicity and H pylori infection has been extensively reported, with a higher prevalence of infection observed in black individuals. Whether such differences are due to genetic factors underlying African ancestry remains to be clarified. In the present study, we evaluated the association between the proportion of individual African ancestry and H pylori infection in a sample of 1046 children living in a large Latin American urban center. MATERIALS AND METHODS Estimation of individual biogeographical ancestry was based on 370,539 SNPs and performed using the ADMIXTURE software. Multivariate logistic regression models and mediation analysis considering the influence of previously recognized socioenvironmental risk factors to H pylori infection were performed. All analyses were conducted using the statistical package STATA v.14.0. RESULTS Each 10% increase in the proportion of individual African ancestry was positively and independently associated with H pylori infection in our population (adjusted OR = 1.22, 95% CI = 1.10-1.36, P < .001). Mediation analysis demonstrated that only 9.23% of the effect of the individual African ancestry on H pylori infection was explained by factors such as household income, the absence of street paving and crowding. CONCLUSIONS The results suggest that genetic variants that covariate with African ancestry may explain an important part of the racial differences observed for the prevalence of H pylori infection.
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Affiliation(s)
- Jucineide Silva de Sena-Reis
- Postgraduate Program in Genetics, Biodiversity and Conservation - PPGGBC, State University of Southwest of Bahia - UESB, Jequié, Bahia, Brazil
| | - Débora Diniz Bezerra
- Postgraduate Program in Genetics, Biodiversity and Conservation - PPGGBC, State University of Southwest of Bahia - UESB, Jequié, Bahia, Brazil
| | - Camila A Figueiredo
- Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Maurício Lima Barreto
- Center for Integration of Data and Knowledge for Health (CIDACS) / FIOCRUZ, Salvador, Bahia, Brazil
| | | | - Thiago Magalhães da Silva
- Laboratory of Biology and Human Genetics, Department of Biological Sciences - DCB, UESB, Jequié, Bahia, Brazil
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Fadilah N, Hanafiah A, Razlan H, Wong ZQ, Mohamed Rose I, Rahman MM. Multiplex PCR for detection of Helicobacter pylori infection in gastric biopsies with lower inflammatory score. Br J Biomed Sci 2017; 73:180-187. [PMID: 27922429 DOI: 10.1080/09674845.2016.1220705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND No gold standard has yet been established for the diagnosis of H. pylori infection. A multiplex polymerase chain reaction (mPCR) was developed in this study for rapid, sensitive and specific detection of H. pylori from gastric biopsies. METHODS H. pylori infections were determined by in-house rapid urease test (iRUT), culture, histology and multiplex PCR. RESULTS A total of 140 (60.9%) from 230 patients were positive for H. pylori infection. H. pylori were detected in 9.6% (22/230), 17% (39/230), 12.6% (29/230) and 60% (138/230) of biopsy specimens by culture, iRUT, histology and mPCR, respectively. mPCR identified H. pylori infection in 100% of biopsies with positive histology and culture. All biopsies with positive iRUT yielded positive PCR except two cases. mPCR also detected H. pylori in additional 116, 101 and 109 biopsies that were negative by culture, iRUT and histology, respectively. Positive samples by mPCR showed lower average in H. pylori density, activity and inflammation scores. The Indians showed the highest prevalence of H. pylori infection compared to the Chinese and the Malays. In addition, Chinese patients with older age were significantly infected compared to other ethnicities. CONCLUSION PCR was able to detect the highest numbers of positive cases although the lowest average scores were recorded in the activity, inflammatory and H. pylori density.
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Affiliation(s)
- Najmiyatul Fadilah
- a Faculty of Medicine, Department of Medical Microbiology and Immunology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Alfizah Hanafiah
- a Faculty of Medicine, Department of Medical Microbiology and Immunology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Hamizah Razlan
- b Medicine, Faculty of Medicine , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Zin Qin Wong
- b Medicine, Faculty of Medicine , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Isa Mohamed Rose
- c Pathology, Faculty of Medicine , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Md Mostafizur Rahman
- a Faculty of Medicine, Department of Medical Microbiology and Immunology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
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Satpathi P, Satpathi S, Mohanty S, Mishra SK, Behera PK, Maity AB. Helicobacter pylori infection in dyspeptic patients in an industrial belt of India. Trop Doct 2016; 47:2-6. [PMID: 26774110 DOI: 10.1177/0049475515626033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The present study is done to study different aspects of Helicobacter pylori (H. pylori) such as its prevalence, association with upper gastrointestinal pathology, diagnosis and treatment outcome. Gastric antral biopsy and serology for H. pylori was done for all dyspeptic patients. Histopathology, gram stain and biopsy urease test was done from the gastric biopsy specimen. The prevalence of H. pylori infection was 58.8%. The sensitivity, specificity, positive and negative predictive value for histopathology was 96.9%, 100%, 100% and 95.8%, respectively; for biopsy urease test 80.4%, 100%, 100% and 78.2%, respectively; for gram stain 85.6%, 97.1%, 97.6% and 82.5%, respectively, and for serology 94.8%, 77.9%, 86% and 91.4%, respectively. Mostly peptic ulcer and duodenitis cases followed by chronic active gastritis were associated with H. pylori infection. Repeat biopsy revealed eradication of H. pylori in 90.7% cases. In dyspeptic patients, endoscopic biopsy not only detects H. pylori infection, but also reveals different gastric pathologies.
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Affiliation(s)
- Parthasarathi Satpathi
- Associate Professor, Midnapore Medical College and Hospital, Midnapore, West Bengal, India
| | | | - Sanjib Mohanty
- Senior Consultant, CWS Hospital, Rourkela, Odisha, India
| | - Saroj K Mishra
- Dean, Asian Institute of Public Health, Bhubaneswar, Odisha, India
| | - Prativa K Behera
- Senior Director, Ispat General Hospital, Rourkela, Odisha, India
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Cezard GI, Bhopal RS, Ward HJ, Bansal N, Bhala N. Ethnic variations in upper gastrointestinal hospitalizations and deaths: the Scottish Health and Ethnicity Linkage Study. Eur J Public Health 2015; 26:254-60. [DOI: 10.1093/eurpub/ckv182] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Zhou YH. Pathway analysis for RNA-Seq data using a score-based approach. Biometrics 2015; 72:165-74. [PMID: 26259845 DOI: 10.1111/biom.12372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 06/01/2015] [Accepted: 06/01/2015] [Indexed: 11/27/2022]
Abstract
A variety of pathway/gene-set approaches have been proposed to provide evidence of higher-level biological phenomena in the association of expression with experimental condition or clinical outcome. Among these approaches, it has been repeatedly shown that resampling methods are far preferable to approaches that implicitly assume independence of genes. However, few approaches have been optimized for the specific characteristics of RNA-Seq transcription data, in which mapped tags produce discrete counts with varying library sizes, and with potential outliers or skewness patterns that violate parametric assumptions. We describe transformations to RNA-Seq data to improve power for linear associations with outcome and flexibly handle normalization factors. Using these transformations or alternate transformations, we apply recently developed null approximations to quadratic form statistics for both self-contained and competitive pathway testing. The approach provides a convenient integrated platform for RNA-Seq pathway testing. We demonstrate that the approach provides appropriate type I error control without actual permutation and is powerful under many settings in comparison to competing approaches. Pathway analysis of data from a study of F344 vs. HIV1Tg rats, and of sex differences in lymphoblastoid cell lines from humans, strongly supports the biological interpretability of the findings.
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Affiliation(s)
- Yi-Hui Zhou
- Bioinformatics Research Center, Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, U.S.A
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Baingana RK, Kiboko Enyaru J, Davidsson L. Helicobacter pylori infection in pregnant women in four districts of Uganda: role of geographic location, education and water sources. BMC Public Health 2014; 14:915. [PMID: 25190150 PMCID: PMC4164757 DOI: 10.1186/1471-2458-14-915] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 08/28/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The prevalence of Helicobacter pylori infection varies in relation to geography, ethnicity and socioeconomic factors. Available data on the prevalence of Helicobacter pylori infection in Uganda are not representative of the general population. We sought to describe the epidemiology of this infection in pregnant women in Uganda to provide background data for a study into the effect of H. pylori infection during pregnancy on the hematological response to iron supplementation. METHODS Using a cross-sectional design, H. pylori infection was assessed by the stool antigen test among 447 pregnant women attending antenatal care clinics in Apac, Mbale, Mbarara and Rakai Districts which are in different geographical regions in Uganda, and at Kawempe Health Center which serves a low-income densely populated area in Kampala City. Socio-demographic and household data were collected by face-to-face interviews using a questionnaire. Associations between H. pylori infection and socio-demographic and household characteristics were analyzed using logistic regression. RESULTS The overall prevalence of H. pylori infection was 45.2% but varied by geographical location from 18.2% in Apac District to 60.5% at Kawempe Health Centre. At 18.4%, the Langi ethnic group, who were enrolled exclusively in Apac District, had the lowest prevalence of H. pylori infection while the Gisu had the highest prevalence (58.4%). H. pylori was independently associated with enrollment at clinics not in Apac (adjusted OR = 5.68; 95% CI: 3.02-10.7) and with using water from public wells, boreholes or springs (AOR = 3.20; 95% CI: 1.19-8.61) and from rivers, lakes or streams (AOR = 5.20; 95% CI: 1.58-17.05). Urban residence (AOR = 1.71; 95% CI: 1.13-2.60) and no formal education (AOR = 1.95; 95% CI: 1.03-3.67) were also independently associated with H. pylori infection. CONCLUSIONS The unexpected variation in the prevalence of H. pylori infection in Uganda calls for population-based studies in the region and offers an opportunity to study the transmission dynamics of H. pylori infection. The association between H. pylori infection and surface water sources for household use suggests waterborne transmission of H. pylori infection highlighting the need for concerted efforts in environmental health in communities and at the household level.
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Affiliation(s)
- Rhona Kezabu Baingana
- />Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - John Kiboko Enyaru
- />Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Lena Davidsson
- />Kuwait Institute for Scientific Research, Food and Nutrition Program, Environment and Life Sciences Research Center, Kuwait, Saudi Arabia
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Lee YY, Raj SM, Graham DY. Helicobacter pylori infection--a boon or a bane: lessons from studies in a low-prevalence population. Helicobacter 2013; 18:338-46. [PMID: 23607896 PMCID: PMC3974589 DOI: 10.1111/hel.12058] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Helicobacter pylori (H. pylori) infection is etiologically associated with gastric cancer and peptic ulcer diseases which are both important public health burdens which could be largely eliminated by H. pylori eradication. However, some investigators urge caution based on the hypothesis that eradication of H. pylori may result in an increase in the incidence of gastroesophageal reflux disease, esophageal adenocarcinoma, and childhood asthma. The ethnic Malays of northeastern Peninsular Malaysia have long had a low prevalence of H. pylori infection and, as expected, the incidence of gastric cancer and its precursor lesions is exceptionally low. The availability of a population with a low H. pylori prevalence and generally poor sanitation allows separation of H. pylori from the hygiene hypothesis and direct testing of whether absence of H. pylori is associated with untoward consequence. Contrary to predictions, in Malays, erosive esophagitis, Barrett's esophagus, distal esophageal cancers, and childhood asthma are all of low incidence. This suggests that H. pylori is not protective rather the presence of H. pylori infection is likely a surrogate for poor hygiene and not an important source of antigens involved in the hygiene hypothesis. Helicobacter pylori in Malays is related to transmission from H. pylori-infected non-Malay immigrants. The factors responsible for low H. pylori acquisition, transmission, and burden of H. pylori infection in Malays remain unclear and likely involves a combination of environmental, host (gene polymorphisms), and strain virulence factors. Based on evidence from this population, absence of H. pylori infection is more likely to be boon than a bane.
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Affiliation(s)
- Yeong Yeh Lee
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | | | - David Y. Graham
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA
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Lee YY, Ismail AW, Mustaffa N, Musa KI, Majid NA, Choo KE, Mahendra Raj S, Derakhshan MH, Malaty HM, Graham DY. Sociocultural and dietary practices among Malay subjects in the north-eastern region of Peninsular Malaysia: a region of low prevalence of Helicobacter pylori infection. Helicobacter 2012; 17:54-61. [PMID: 22221617 DOI: 10.1111/j.1523-5378.2011.00917.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM The prevalence of Helicobacter pylori infection is exceptionally low among the Malays in the north-eastern region of Peninsular Malaysia. The reasons are unknown. Our aim was to compare environmental factors that differed in relation to H. pylori prevalence among Malays born and residing in Kelantan. METHODS A case-control study was conducted among Malays in Kelantan who underwent upper endoscopy between 2000 and 2008. Helicobacter pylori status was determined by gastric histology. Sociocultural and dietary factors were assessed using a validated investigator-directed questionnaire administered after 2008, and the data were analyzed using logistic regression analysis. RESULTS The study group consisted of 161 subjects (79 H. pylori positive and 82 controls). Univariable analysis identified five poor sanitary practices associated with an increased prevalence of H. pylori infection: use of well water, use of pit latrine, less frequent boiling of drinking water, and infrequent hand wash practice after toilet use and before meals. Multivariable logistic regression analysis identified three variables inversely associated with H. pylori infection: frequent consumption of tea (OR: 0.023, 95% CI: 0.01-0.07), frequent use of "budu" or local anchovy sauce (OR: 0.09, 95% CI: 0.1-0.7), and frequent use of "pegaga" or centenella asiatica (OR: 0.25, 95% CI: 0.1-0.65). CONCLUSIONS Under the assumption that sanitary, sociocultural, and dietary habits have not changed over the years, we can conclude that an increased risk of H. pylori was associated with unsanitary practices whereas protection was associated with consumption of tea and locally produced foods, "pegaga" and "budu." These dietary factors are candidates for future study on the effects on H. pylori transmission.
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Affiliation(s)
- Yeong Yeh Lee
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
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Prevalence of Helicobacter pylori infection among patients referred for endoscopy: Gender and ethnic differences in Kedah, Malaysia. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2012. [DOI: 10.1016/s2222-1808(12)60013-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Epidemiology of Helicobacter pylori among multiracial community in Northern Peninsular, Malaysia: effect of age across race and gender. ASIAN PAC J TROP MED 2011; 4:72-5. [PMID: 21771421 DOI: 10.1016/s1995-7645(11)60037-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 10/27/2010] [Accepted: 11/15/2010] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To study the epidemiology of Helicobacter pylori (H. pylori) infection according to age group. METHODS H. pylori infection data among 1 965 consecutive patients referred to the Endoscopy Unit collected at Sungai Petani Hospital for oesophagogastro-duodenoscopy (OGD). The patients were divided into 9 age groups (10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90-99 years). In addition these groups were further divided into three minor group namely young adults (10-39), older adults (40-69) and geriatric groups (70-99). RESULTS Overall prevalence of infection of H. pylori was analyzed and found that the prevalence increase with age (P<0.05). When the patients divided by ethnic and gender group with age, prevalence rate among young adults and older adults significantly higher (P<0.05) compared to geriatric groups across all races and gender (P<0.05). Furthermore, significantly higher number of males were infected compared to female (P<0.05) but such trend was only observed among older adult groups. In addition, there is a significant differences in H. pylori infection prevalence rates among ethnic groups (highest in Indians adults, followed Chinese and low in Malays, P<0.05). CONCLUSIONS The overall prevalence of H. pylori did increase with age group across ethnicity and gender, in Northern Peninsular Malaysia.
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Rahim AA, Lee YY, Majid NA, Choo KE, Raj SM, Derakhshan MH, Graham DY. Helicobacter pylori infection among Aborigines (the Orang Asli) in the northeastern region of Peninsular Malaysia. Am J Trop Med Hyg 2010; 83:1119-22. [PMID: 21036849 DOI: 10.4269/ajtmh.2010.10-0226] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Whether the exceptionally low prevalence of Helicobacter pylori (HP) infection reported among Malays is also present among aborigines (the Orang Asli) living in northeastern Peninsular Malaysia is unknown. We studied asymptomatic Orang Asli from settlements situated 210 km from the city of Kota Bharu. The HP infection status was confirmed by a validated serology test. Nineteen percent of 480 Orang Asli tested positive for HP infection. The prevalence was 40.6% in the birth cohort of the 1940s and declined steadily in later cohorts to under 10% among 12-30 year olds. This may be related to the phases of relocation from the jungles into resettlement camps and ultimately into designated villages near rivers. The low prevalence pattern after the 1970s was probably partly a result of improvement in sanitation and hygiene practice in these villages but other unidentified factors may also be operating.
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Affiliation(s)
- Amry Abdul Rahim
- Universiti Sains Malaysia, School of Medical Sciences, Kubang Kerian, Kelantan, Malaysia.
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Yeh LY, Raj M, Hassan S, Aziz SA, Othman NH, Mutum SS, Naik VR. Chronic atrophic antral gastritis and risk of metaplasia and dysplasia in an area with low prevalence of Helicobacter pylori. Indian J Gastroenterol 2010; 28:49-52. [PMID: 19696988 DOI: 10.1007/s12664-009-0017-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 12/20/2008] [Accepted: 01/30/2009] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The Northeastern region of Peninsular Malaysia is an area with exceptionally low prevalence for Helicobacter pylori infection. The risk of intestinal metaplasia and dysplasia in patients with chronic atrophic gastritis (CAG) and its association with Helicobacter pylori is unknown in this region. METHODS This was a cross-sectional study on gastric biopsies from 234 consecutive patients (mean age 53.5 [14.8] years) who underwent upper gastrointestinal endoscopy between January 2006 and December 2006. RESULTS There were 137 (59%) men and 185 (79%) Malay patients. Among 234 biopsies, CAG was found in 99 and non-atrophic gastritis in 135. Intestinal metaplasia and dysplasia were detected in 8 and 6 atrophic gastritis biopsies, respectively, and in 10 and 3 of non-atrophic gastritis biopsies, respectively. H. pylori were detected in 16 (9 Malays, 7 non- Malays) biopsies (p=0.024); intestinal metaplasia was detected in 4 biopsies (p=0.3) and dysplasia in 5 biopsies (p=0.3). Of the 218 biopsies negative for H. pylori, intestinal metaplasia was found in 14 and dysplasia in 4. The risk of intestinal metaplasia as well as dysplasia was associated with presence of H. pylori infection (p=0.029 and p<0.001 respectively). CONCLUSION Even in a setting of low prevalence of H. pylori, intestinal metaplasia and dysplasia were significantly associated with H. pylori infection. The frequency of intestinal metaplasia and dysplasia was similar different between biopsies with atrophic gastritis and non-atrophic gastritis.
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Affiliation(s)
- Lee Yeong Yeh
- Department of Medicine, University Sains Malaysia, Kelantan, Malaysia.
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Sasidharan S, Uyub AM. Development and evaluation of a new growth medium for Helicobacter pylori. ACTA ACUST UNITED AC 2009; 56:94-7. [PMID: 19309485 DOI: 10.1111/j.1574-695x.2009.00554.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The present study was aimed at modifying the original formulation of Commercial Eugon agar (CEA) to develop a new H. pylori growth medium. Initial studies were carried out to determine the number of H. pylori colonies recovered on in-house H. pylori agar (IHPA), IHPA without L-cysteine and sodium sulfite (IHPA-NC), IHPA without L-cysteine (IHPA-C), IHPA without sodium sulfite (IHPA-N) and CEA as the control. Significant differences (P < 0.001) in the number of colonies recovered were observed between IHPA-N, IHPA-NC and IHPA-C. Incorporation of sodium sulfite decreased the number of colonies recovered, indicating that sodium sulfite was inhibitory to H. pylori growth. Removal of L-cysteine reduced the number of colonies recovered, suggesting that L-cysteine is necessary for the growth of H. pylori. In the subsequent study, incorporation of K(2)HPO(4) further increased the number of colonies recovered compared with IHPA-N (P < 0.001), and 0.25% (w/v) of K(2)HPO(4) yielded the highest numbers of colonies (P < or = 0.04). Finally, thirty other H. pylori clinical isolates were evaluated for their growth in the IHPAP-N, a new medium consisting of 1.5% (w/v) pepticase, 0.5% (w/v) peptone, 0.4% (w/v) sodium chloride, 0.03% (w/v) L-cysteine, 0.55% (w/v) dextrose, 0.25% (w/v) K(2)HPO(4) and 1.5% (w/v) agar. The number of colonies recovered in IHPAP-N was significantly (P < 0.005) higher than that of CEA. IHPAP-N with 0.25% K(2)HPO(4) and without sodium sulfite were adequate solid media for the growth of H. pylori.
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Sasidharan S, Uyub AM. Prevalence of Helicobacter pylori infection among asymptomatic healthy blood donors in Northern Peninsular Malaysia. Trans R Soc Trop Med Hyg 2009; 103:395-8. [PMID: 19211121 DOI: 10.1016/j.trstmh.2008.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Revised: 11/22/2008] [Accepted: 11/22/2008] [Indexed: 01/30/2023] Open
Abstract
Helicobacter pylori infection is recognized as being strongly associated with chronic gastritis, duodenal ulceration and, probably, gastric carcinoma. Seroepidemiological studies have shown that a large proportion of healthy people have antibodies against H. pylori. A serological study was conducted in asymptomatic healthy blood donors in Northern Peninsular Malaysia to assess the seropositivity for H. pylori and to investigate the relationship with ethnic group, gender, ABO blood group and age. A total of 5370 serum samples collected from 3677 male and 1693 female donors in different age groups, and who had no gastrointestinal complaints, were studied with an in-house ELISA for the presence of H. pylori IgG and IgA antibodies. Seven hundred and sixty subjects (14.2%) were seropositive. The overall seropositivity did not differ with ethnicity, gender, ABO blood group and age among asymptomatic healthy blood donors in Northern Peninsular Malaysia.
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Affiliation(s)
- S Sasidharan
- School of Biological Sciences, University of Science, Malaysia, 11800 Minden, Pulau Pinang, Malaysia.
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