Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona

Harris, Robin B.; Brown, Heidi E.; Begay, Rachelle L.; Sanderson, Priscilla R.; Chief, Carmenlita; Monroy, Fernando P.; Oren, Eyal

doi:10.3390/ijerph19020797

Cited by 19 publications

(22 citation statements)

References 38 publications

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“…pylori infection in Native American and Indigenous communities in Alaska is usually higher than their non-native counterparts and is comparable to that of developing countries, which may help explain the high rate of gastric cancer [40][41][42][43][44]. In a random sample of households of three communities on the Navajo Nation, we reported 56.4% prevalence and 72% of households had at least one person with a positive Urea Breath Test [5]. A retrospective study among Navajos living in New Mexico, reported seroprevalence for H. pylori of 74.4%; furthermore, 69.23% of patients with intestinal metaplasia were also positive for H. pylori [40].…”

Section: Discussionmentioning

confidence: 99%

“…Gastric cancer is a complex disease with multiple etiologies each with a differing suite of risk factors [55]. Environmental factors have been shown to play an important role and will need to be considered [5,56]. While it is decreasing in most of the United States, a recent study showed that rates are almost universally higher among American Indians/Alaska Natives compared with geographically proximal White populations [53].…”

Section: Discussionmentioning

confidence: 99%

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Helicobacter<em> Pylori</em> in Native Americans in Northern Arizona

Monroy¹,

Brown²,

Sanderson³

et al. 2022

Preprint

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Background: In Arizona Helicobacter pylori prevalence of infection among Navajo adults is about 62% and gastric cancer incidence rate is 3-4 times higher than that of the non-Hispanic White population. Aim: The aim of this study was to estimate the prevalence of specific H. pylori virulence factors (cagA and vacA) among Navajo patients undergoing and their association with gastric disease. Methods: Virulence genes, cagA and vacA, in H. pylori were investigated in gastric biopsies from 96 Navajo patients over age 18 who were undergoing esophagogastroduodenoscopy. Biopsies from the antrum and fundus were used for molecular characterization to determine cagA type and number of EPIYA motifs and presence of alleles in the signal (s) and medium (m) regions of the vacA gene. Results: H. pylori infection was found in 22.9% of the biopsy samples. The cagA gene amplified in 57.6% of samples and showed a predominant “Western cagA” type, with the EPIYA-ABC motif (45.4%), most prevalent. The vacA allele s1bm1 was the most prevalent (54.5%). Conclusions: H. pylori genotypes were predominantly cagA Western-type and ABC EPIYA motifs. The vacA s1bm1 genotype was the most prevalent and seemed to be associated with gastritis. American Indian/Alaska Native populations are at higher risk for gastric cancer. It is important to identify genotypes of H. pylori and virulence factors involved in the high prevalence of H. pylori and associated disease among the Navajo population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Helicobacter<em> Pylori</em> in Native Americans in Northern Arizona

Monroy¹,

Brown²,

Sanderson³

et al. 2022

Preprint

Self Cite

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show abstract

“…H. pylori infection in Native American and Indigenous communities in Alaska is usually higher than their non-native counterparts and is comparable to that of developing countries, which may help explain the high rate of gastric cancer [ 40 , 41 , 42 , 43 , 44 ]. In a random sample of households of three communities on the Navajo Nation, we reported 56.4% prevalence and 72% of households had at least one person with a positive Urea Breath Test [ 5 ]. A retrospective study among Navajos living in New Mexico, reported seroprevalence for H. pylori of 74.4%; furthermore, 69.23% of patients with intestinal metaplasia were also positive for H. pylori [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…Gastric cancer is a complex disease with multiple etiologies each with a differing suite of risk factors [ 60 ]. Environmental factors have been shown to play an important role and will need to be considered [ 5 , 61 ]. While it is decreasing in most of the United States, a recent study showed that rates are almost universally higher among American Indians/Alaska Natives compared with geographically proximal White populations [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…Colonization by the bacterium primarily occurs during childhood; an estimated 50% of children in developing countries and 10% of children in the United States have been colonized before the age of 10 [ 3 , 4 ]. Prevalence of infections with H. pylori is highly variable owing to age, race/ethnicity, gender, and socioeconomic factors, with most suggesting the higher prevalence in older age groups results from living conditions during their childhood [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Helicobacter pylori in Native Americans in Northern Arizona

Monroy

Brown²,

Sanderson

et al. 2022

Diseases

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Background: In Arizona Helicobacter pylori prevalence of infection among Navajo adults is about 62% and gastric cancer incidence rate is 3–4 times higher than that of the non-Hispanic White population. Aim: The aim of this study was to estimate the prevalence of specific H. pylori virulence factors (cagA and vacA) among Navajo patients undergoing and their association with gastric disease. Methods: Virulence genes, cagA and vacA, in H. pylori were investigated in gastric biopsies from 96 Navajo patients over age 18 who were undergoing esophagogastroduodenoscopy. Biopsies from the antrum and fundus were used for molecular characterization to determine cagA type and number of EPIYA motifs and presence of alleles in the signal (s) and medium (m) regions of the vacA gene. Results: H. pylori infection was found in 22.9% of the biopsy samples. The cagA gene amplified in 57.6% of samples and showed a predominant “Western cagA” type, with the EPIYA-ABC motif (45.4%), most prevalent. The vacA allele s1bm1 was the most prevalent (54.5%). Conclusions: H. pylori genotypes were predominantly cagA Western-type and ABC EPIYA motifs. The vacA s1bm1 genotype was the most prevalent and seemed to be associated with gastritis. American Indian/Alaska Native populations are at higher risk for gastric cancer. It is important to identify genotypes of H. pylori and virulence factors involved in the high prevalence of H. pylori and associated disease among the Navajo population.

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Racial, Ethnic, and Geographic Disparities in Digestive Diseases Mortality in the United States, 2000–2019

Aldhaleei,

Wallace,

et al. 2024

Clinical Gastroenterology and Hepatology

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Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona

Cited by 19 publications

References 38 publications

Helicobacter<em> Pylori</em> in Native Americans in Northern Arizona

Helicobacter<em> Pylori</em> in Native Americans in Northern Arizona

Helicobacter pylori in Native Americans in Northern Arizona

Racial, Ethnic, and Geographic Disparities in Digestive Diseases Mortality in the United States, 2000–2019

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