Thoughts about populations with unexpected low prevalences of Helicobacter pylori infection.
Helicobacter pylori is one of the few remaining major pathogens that accompanied humans on their travels from Africa. A recently published study reports the unexpected finding of a low H. pylori prevalence among pregnant women in Zanzibar (Farag, T.H., Stolzfus, R.J., Khalfan, S.S., Tielsch, J.M., 2007. Unexpectedly low prevalence of Helicobacter pylori infection among pregnant women on Pemba Island, Zanzibar. Trans. R. Soc. Trop. Med. Hyg. 101). The apparent epidemiology of higher prevalence with higher socioeconomic status and decrease with age are unprecedented. As with many 'unexpected' events, a search of the literature reveals evidence of low prevalence populations in Java and Malaysia, with clues dating back to the mid-twentieth century. Why some populations apparently lost H. pylori infection remains an open question. However, the tools needed to resolve the dilemma are readily available and we hope investigators will soon rise to the challenge.
Graham
David Y
DY
Department of Medicine, Michael E. DeBakey VAMC, Texas 77030, USA. dgraham@bcm.tmc.edu
Yamaoka
Yoshio
Y
Malaty
Hoda M
HM
D000328:Adult; D000349:Africa / Q000453:epidemiology; D000907:Antibodies, Bacterial / Q000032:analysis*; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors
D000907:Antibodies, Bacterial