title: Extremely high prevalence of Helicobacter pylori infection in Bhutan.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  The high incidence of gastric cancer in Bhutan may be attributed to the high prevalence of H. pylori infection.
authors.affiliation: Ratha-korn Vilaichone, Gastroenterology Unit, Department of Medicine, Thammasat University Hospital, Pathumthani 12120, Thailand.
authors.forename: Ratha-korn
authors.initials: RK
authors.lastname: Vilaichone
authors.forename: Varocha
authors.initials: V
authors.lastname: Mahachai
authors.forename: Seiji
authors.initials: S
authors.lastname: Shiota
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Uchida
authors.forename: Thawee
authors.initials: T
authors.lastname: Ratanachu-ek
authors.forename: Lotay
authors.initials: L
authors.lastname: Tshering
authors.forename: Nguyen Lam
authors.initials: NL
authors.lastname: Tung
authors.forename: Toshio
authors.initials: T
authors.lastname: Fujioka
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Moriyama
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamaoka
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D001631:Bhutan / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D005260:Female; D005756:Gastritis / Q000453:epidemiology / Q000382:microbiology; D006306:Health Surveys; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010437:Peptic Ulcer / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D015415:Biomarkers
keywords: Bhutan; Helicobacter pylori; Prevalence