Helicobacter pylori infection rates at a family practice in Pohnpei, Federated States of Micronesia.
Upper Gastrointestinal Disease (UGID), especially duodenal ulcers, gastric ulcers, and gastritis, are responsible for a significant number of out-patient visits, hospital admissions, and deaths worldwide. The connection between H. pylori and UGID, including gastric cancer, has been well established. H. pylori has also been shown to increase the risk of gastric adenocarcinoma and mucosal associated lymphoid tissue (MALT) tumors by 2-6 fold, and recent declines in rates of gastric cancer in some countries have precisely followed decreases in childhood H. pylori infection rates. We undertook this study because during six years of practice we had observed a very high rate of patients with UGID who were H. pylori positive. A total of 6933 patient visits (not including repeat visits by patients already enrolled) were screened during the study period, of which 403 patients fit the inclusion criteria and agreed to participate Each were tested for H. pylori, using Quidell's QuickVue gII H. pylori Test Kit. Patients found to be positive were treated appropriately with antibiotics. An opportunistically selected control group was used to compare with the case sample of UGID. 99% of this UGID group was positive for H. pylori, compared with 94% of control group (odds ratio 6.367; 95% confidence interval 1.7-23). There was no significant gender difference in either group. 98% of women and 100% of men in the UGID group tested positive, and 96% of men and 92% of women in the control group tested positive (odds ratio was not significantly different). The finding that 99% of patients with UGI symptoms and 94% of asymptomatic controls at our clinic are infected with H. pylori strongly suggests that H. pylori are endemic in Pohnpei. Given the potential harm of antibiotics overuse and the relatively low cost of testing at this point, we would propose testing for H. pylori whenever patients present with repeated UGI symptoms, especially those with history and/or symptoms of PUD.
Isaac
Bryan A
BA
C/- Pohnpei Family Clinic.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005194:Family Practice; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008403:Mass Screening; D008849:Micronesia / Q000453:epidemiology; D008875:Middle Aged