Gastric Ulcers to rise in Indigenous Communities?
The prevalence of the bacteria which causes stomach ulcers and gastritis may be two to three times higher in Indigenous Australian communities than in the non-Indigenous population, according to research results published in the current issue of the Medical Journal of Australia.
This finding is significantly different from that of earlier studies, which suggested than infection with Helicobacter pylori was not as common in Indigenous Australians.
Co-author, Barry Marshall, Clinical Professor at the NHMRC Helicobacter Research Laboratory at the University of Western Australia and colleagues say the high prevalence of the bacteria, which is spread through contact with faeces, is most likely caused by poor hygiene rather than contaminated drinking water because the communities studied do have a clean water supply.
The study set out to determine the prevalence of H. pylori in an urban and a remote rural Western Australian Indigenous community. A simple breath test was used to detect the presence of the bacteria. Two hundred and seventy people in a community in the East Pilbara region aged between 2 and 90 years and 250 people from the Perth Indigenous community aged between 3 and 75 years were tested.
The overall prevalence of H. pylori was 76 per cent but the prevalence in the remote rural community was 91 per cent compared with 60 per cent in the urban community.
Generally, in first world countries, the organism affects 25-40 per cent of the population with infection becoming less common as living standards rise.
Professor Marshall said the Perth Indigenous group experienced similar levels of infection to Californian adults of 40 years ago - possibly representing a 40-year lag in improvements in Indigenous health.
"Our findings appear to parallel those seen in developing countries, but add strength to the proposition that H. pylori spreads from person to person by means of the faecal-oral route rather than through contaminated water," he said.
Intensive health education might help reduce the incidence of H. pylori in the Pilbara, and there may also be a case for yearly screening of all Indigenous children.
"The bacterial infection is acquired in early childhood and, unless treated, apparently remains for life," Professor Marshall said.
"If medical practitioners treating Indigenous people decide to tackle the high prevalence of H. pylori infection, they will need extra resources to detect and manage this very common infectious disease," he said.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT Professor Barry MARSHALL 0407995232.
Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471