Helicobacter pyloriin First Nations and Recent Immigrant Populations in Canada

Abstract

The diminishing prevalence of Helicobacter pylori infection among most segments of the Canadian population has led to changes in the etiologies and patterns of associated upper gastrointestinal diseases, including fewer peptic ulcers and their complications. Canadian Aboriginals and recent immigrants are among populations in which the prevalence of H pylori infection remains high and, therefore, the health risks imposed by H pylori remain a significant concern. Population-based strategies for H pylori eradication in groups with a low prevalence of infection are unlikely to be cost effective, but such measures are attractive in groups in which the prevalence rates of infection remain substantial. In addition to a lower prevalence of peptic ulcers and dyspepsia, the public health value of eradication may be particularly important if this leads to a reduction in the prevalence of gastric cancer in high prevalence groups. Therefore The Canadian Helicobacter Study Group held a conference that brought together experts in the field to address these issues, the results of which are reviewed in the present article. Canadians with the highest prevalence of H pylori infection are an appropriate focus for considering the health advantages of eradicating persistent infection. In Canadian communities with a high prevalence of both H pylori and gastric cancer, there remains an opportunity to test the hypothesis that H pylori infection is a treatable risk factor for malignancy.

Friend and foe: factors influencing the movement of the bacterium Helicobacter pylori along the parasitism–mutualism continuum

“…These results paralleled US studies (Jones et al. ). As spontaneous elimination is uncommon, it is not surprising that infection in immigrants reflects that of their native country, but together, these results argue that transmission dynamics are specific to the region in question.…”

“…A Canadian review of H. pylori prevalence found that first generation individuals who immigrated as adults (>20 years of age) had a rate of infection, and a rate of gastric cancer consistent with their country of origin, with an odds ratio of 9.7 times that of second generation individuals. These results paralleled US studies (Jones et al 2012). As spontaneous elimination is uncommon, it is not surprising that infection in immigrants reflects that of their native country, but together, these results argue that transmission dynamics are specific to the region in question.…”

“…Horizontal transmission is likely to increase in unsanitary, highly crowded environments, making multiple infection and recombination among strains more common in dense populations (Jones et al. ; Kodaman et al. ).…”

Gastric adenocarcinoma: the role ofHelicobacter pyloriin pathogenesis and prevention efforts

“…Individuals from high-risk countries remain at risk throughout their lifetime, even if they immigrate to low-risk developed countries. H. pylori plays an important causal role in most gastric cancers, and its prevalence is also higher in immigrant populations and in economically deprived minority populations 3 4. While international guidelines support a test-and-treat strategy for H. pylori in high-risk individuals, such as those with family history of gastric cancer or chronic atrophic gastritis,5 primary care physicians in low-risk countries may be unaware of this.…”

Indigenous populations health protection: A Canadian perspective

“…H. pylori is one of the most common pathogens affecting half of the world’s population, particularly in developing countries. In Canada, there are three identified groups, including Aboriginal people, which are associated with higher risk of infection by H. pylori [24]. The pathogen causes illnesses and conditions such as chronic gastritis and peptic ulcers, and increases the risk of gastric cancer [23-25].…”