Risk Factors for and Prevalence of Helicobacter Pylori Infection among Healthy Inhabitants in Northern Jakarta, Indonesia

  • Goto, Yasuyuki (Department of Gastroenterology, Nagoya Kyoritsu Hospital) ;
  • Syam, Ari Fahrial (Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital) ;
  • Darnindro, Nikko (Cilincing District General Hospital) ;
  • Hapsari, Florentina Carolin Puspita (Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital)
  • Published : 2016.09.01

Abstract

Indonesia is a developing country, in most of which the infection rates of Helicobacter pylori (H. pylori) have been reported to be high. However, the prevalence of H. pylori infection in Indonesia has been unexpectedly reported to be low. The purpose of our study was to confirm whether the prevalence of H. pylori infection is low among healthy inhabitants in Northern Jakarta by 13C-urea breath test (UBT), and to examine the association of their lifestyle/environmental factors with H. pylori infection and to identify potential routes of transmission. We recruited a total of 196 subjects from a low-income community in Northern Jakarta, Indonesia. Of them, 193 subjects who completed a questionnaire about their lifestyle/environment and had UBT were included in this study. Odds ratios (ORs) adjusted for sex and age with 95% confidence intervals (CIs) were calculated using logistic regression model. The overall H. pylori infection rate was 15.0%. There was difference in H. pylori infection rates among Buginese (40.0%), Betawi (9.1%), Sundanese (3.7%), and Batak (9.1%). After multivariate analysis, the ORs of intake of soybean milk, cucumber more than one time a week, infrequent hand washing before meals, and alcohol consumption were 0.10 (95%CI: 0.01-0.97), 6.61 (95%CI: 1.87-23.3), 4.10 (95%CI: 1.15-14.6), and 61.9 for former drinkers (95%CI: 1.67-2300.8), respectively. Buginese (OR=7.84; 95%CI: 1.82-33.8) and Batak ethnic groups (OR=20.1; 95%CI: 1.90-213.2) were infected more frequently, compared with Javanese. The H. pylori infection rate in this study was low, as reported previously. After we scrutinized the factors, Buginese and Batak ethnic groups eat food using fingers more frequently than Javanese, Betawi, and Sundanese. In addition, infrequent hand wash practice before meal increased the risk. Our study indicated that person-person transmission was possible in this low prevalence area. The low infection rates of H. pylori among those of Javanese, Betawi, and Sundanese ethnicity could be partly due to sanitary practice.

Keywords

References

  1. Abebaw W, Kibret M, Abera B (2014). Prevalence and risk factors of H. pylori from dyspeptic patients in northwest Ethiopia: a hospital based cross-sectional study. Asian Pac J Cancer Prev, 15, 4459-63. https://doi.org/10.7314/APJCP.2014.15.11.4459
  2. Akasaka S, Kosaka H, Ishikawa H, Azuma T, Moore MA (2005). Rare Helicobacter pylori infection as a factor for the very low stomach cancer incidence in Yogyakarta, Indonesia. Cancer Lett, 219, 57-61. https://doi.org/10.1016/j.canlet.2004.09.043
  3. Angelo KM, Chu A, Anand M, et al (2015). Outbreak of Salmonella Newport infections linked to cucumbers--United States, 2014. MMWR Morb Mortal Wkly Rep, 64, 144-7.
  4. Arinton IG (2011). Adjustment of cut-off values in ELISA for detection of Helicobacter pylori infection. Acta Med Indones, 43, 88-91.
  5. Asaka M, Kimura T, Kudo M, et al (1992). Relationship of Helicobacter pylori to serum pepsinogens in an asymptomatic Japanese population. Gastroenterol, 102, 760-6. https://doi.org/10.1016/0016-5085(92)90156-S
  6. Bilal R, Khaar B, Qureshi TZ, et al (2007). Accuracy of noninvasive 13C-Urea Breath Test compared to invasive tests for Helicobacter pylori detection. J Coll Physicians Surg Pak, 17, 84-8.
  7. Brown LM, Thomas TL, Ma JL, et al (2002). Helicobacter pylori infection in rural China: demographic, lifestyle and environmental factors. Int J Epidemiol, 31, 638-45. https://doi.org/10.1093/ije/31.3.638
  8. Bruden DL, Bruce MG, Miernyk KM, et al (2011). Diagnostic accuracy of tests for Helicobacter pylori in an Alaska Native population. World J Gastroenterol, 17, 4682-8. https://doi.org/10.3748/wjg.v17.i42.4682
  9. Camargo MC, Lazcano-Ponce E, Torres J, et al (2004). Determinants of Helicobacter pylori seroprevalence in Mexican adolescents. Helicobacter, 9, 106-14. https://doi.org/10.1111/j.1083-4389.2004.00206.x
  10. Go MF (2002). Review article: natural history and epidemiology of Helicobacter pylori infection. Aliment Pharmacol Ther, 16, 3-15.
  11. Goh KL, Chan WK, Shiota S, Yamaoka Y (2011). Epidemiology of Helicobacter pylori infection and public health implications. Helicobacter, 16, 1-9.
  12. Hirayama Y, Kawai T, Otaki J, Kawakami K, Harada Y (2014). Prevalence of Helicobacter pylori infection with healthy subjects in Japan. J Gastroenterol Hepatol, 29, 16-9. https://doi.org/10.1111/jgh.12795
  13. Iso N, Matsuhisa T, Shimizu K (2005). Helicobacter pylori Infection among patients visiting a clinic in Kasama City, Ibaraki Prefecture. J Nippon Med Sch, 72, 341-54. https://doi.org/10.1272/jnms.72.341
  14. Ito LS, Oba SM, Hamajima N, et al (2001). Helicobacter pylori seropositivity among 963 Japanese Brazilians according to sex, age, generation, and lifestyle factors. Jpn J Cancer Res, 92, 1150-6. https://doi.org/10.1111/j.1349-7006.2001.tb02134.x
  15. Karita M, Teramukai S, Matsumoto S (2003). Risk of Helicobacter pylori transmission from drinking well water is higher than that from infected intrafamilial members in Japan. Dig Dis Sci, 48, 1062-7. https://doi.org/10.1023/A:1023752326137
  16. Laszewicz W, Iwanczak F, Iwanczak B (2014). Seroprevalence of Helicobacter pylori infection in Polish children and adults depending on socioeconomic status and living conditions. Adv Med Sci, 59, 147-50. https://doi.org/10.1016/j.advms.2014.01.003
  17. Liu SY, Han XC, Sun J, et al (2015). Alcohol intake and Helicobacter pylori infection: A dose-response meta-analysis of observational studies. Infect Dis (Lond), 1-7. [Epub ahead of print]
  18. Malaty HM, Evans DG, Evans DJ Jr, Graham DY (1992). Helicobacter pylori in Hispanics: comparison with blacks and whites of similar age and socioeconomic class. Gastroenterol, 103, 813-6. https://doi.org/10.1016/0016-5085(92)90011-M
  19. Mercanoglu Taban B, Halkman AK (2011). Do leafy green vegetables and their ready-to-eat [RTE] salads carry a risk of foodborne pathogens? Anaerobe, 17, 286-7. https://doi.org/10.1016/j.anaerobe.2011.04.004
  20. Miftahussurur M, Shiota S, Suzuki R, et al (2015). Identification of Helicobacter pylori infection in symptomatic patients in Surabaya, Indonesia, using five diagnostic tests. Epidemiol Infect, 143, 986-96. https://doi.org/10.1017/S095026881400154X
  21. Miftahussurur M, Tuda J, Suzuki R, et al (2014). Extremely low Helicobacter pylori prevalence in North Sulawesi, Indonesia and identification of a Maori-tribe type strain: a cross sectional study. Gut Pathog, 6, 42. https://doi.org/10.1186/s13099-014-0042-0
  22. Moges F, Kassu A, Mengistu G, et al (2006). Seroprevalence of Helicobacter pylori in dyspeptic patients and its relationship with HIV infection, ABO blood groups and life style in a university hospital, Northwest Ethiopia. World J Gastroenterol, 12, 1957-61. https://doi.org/10.3748/wjg.v12.i12.1957
  23. Ozaydin N, Turkyilmaz SA, Cali S (2013). Prevalence and risk factors of Helicobacter pylori in Turkey: a nationallyrepresentative, cross-sectional, screening with the $^{13}C$-Urea breath test. BMC Public Health, 13, 1215. https://doi.org/10.1186/1471-2458-13-1215
  24. Patel SK, Pratap CB, Jain AK, Gulati AK, Nath G (2014). Diagnosis of Helicobacter pylori: what should be the gold standard? World J Gastroenterol, 20, 12847-59. https://doi.org/10.3748/wjg.v20.i36.12847
  25. Peek RM Jr, Blaser MJ (2002). Helicobacter pylori and gastrointestinal tract adenocarcinomas. Nat Rev Cancer, 2, 28-37 https://doi.org/10.1038/nrc703
  26. Penalvo JL, Cespedes J, Fuster V (2012). Sesame street: changing cardiovascular risks for a lifetime. Semin Thorac Cardiovasc Surg, 24, 238-40. https://doi.org/10.1053/j.semtcvs.2012.11.004
  27. Redeen S, Petersson F, Tornkrantz E, et al (2011). Reliability of Diagnostic Tests for Helicobacter pylori Infection. Gastroenterol Res Pract, 2011, 940650.
  28. Salah BA (2009). Helicobacter pylori infection in developing countries: the burden for how long? Saudi J Gastroenterol, 15, 201-7. https://doi.org/10.4103/1319-3767.54743
  29. Saragih JB, Akbar N, Syam AF, et al (2007). Incidence of Helicobacter pylori infection and gastric cancer : an 8-year hospital based study. Acta Med Indones, 39, 79-81.
  30. Shinchi K, Ishii H, Imanishi K, et al (1997). Relationship of cigarette smoking, alcohol use, and dietary habits with Helicobacter pylori infection in Japanese men. Scand J Gastroenterol, 32, 651-5. https://doi.org/10.3109/00365529708996513
  31. Syam AF, Abdullah M, Rani AA, et al (2006). Evaluation of the use of rapid urease test: Pronto Dry to detect H pylori in patients with dyspepsia in several cities in Indonesia. World J Gastroenterol, 12, 6216-8. https://doi.org/10.3748/wjg.v12.i38.6216
  32. Syam AF, Miftahussurur M, Makmun D, et al (2015). Risk factors and prevalence of Helicobacter pylori in five largest Islands of indonesia: a preliminary study. PLoS One, 10, 140186.
  33. Syam AF, Rani AA, Abdullah M, et al (2005). Accuracy of Helicobacter pylori stool antigen for the detection of Helicobacter pylori infection in dyspeptic patients. World J Gastroenterol, 11, 386-8. https://doi.org/10.3748/wjg.v11.i3.386
  34. Tokudome S, Samsuria Soeripto WD, et al (2005). Helicobacter pylori infection appears essential for stomach carcinogenesis: observations in Semarang, Indonesia. Cancer Sci, 96, 873-5. https://doi.org/10.1111/j.1349-7006.2005.00122.x
  35. Tokudome S, Soeripto, Triningsih FX,et al (2005). Rare Helicobacter pylori infection as a factor for the very low stomach cancer incidence in Yogyakarta, Indonesia. Cancer Lett, 219, 57-61. https://doi.org/10.1016/j.canlet.2004.09.043
  36. Watanabe M, Ito H, Hosono S, et al (2015). Declining trends in prevalence of Helicobacter pylori infection by birth-year in a Japanese population. Cancer Sci, 106, 1738-43. https://doi.org/10.1111/cas.12821
  37. Webb PM, Knight T, Greaves S, et al (1994). Relation between infection with Helicobacter pylori and living conditions in childhood: evidence for person to person transmission in early life. BMJ, 308, 750-3. https://doi.org/10.1136/bmj.308.6931.750
  38. Yang X, Nishibayashi H, Takeshita T, Morimoto K (1999). Prevalence of Helicobacter pylori infection in Japan: Relation to educational levels and hygienic conditions. Environ Health Prev Med, 3, 202-6. https://doi.org/10.1007/BF02932259
  39. Zhao Y, Wang J, Tanaka T, et al (2012). Association between HLA-DQ genotypes and haplotypes vs Helicobacter pylori infection in an Indonesian population. Asian Pac J Cancer Prev, 13, 1247-51. https://doi.org/10.7314/APJCP.2012.13.4.1247
  40. Zhu Y, Zhou X, Wu J, Su J, Zhang G (2014). Risk factors and prevalence of Helicobacter pylori infection in persistent high incidence area of gastric carcinoma in Yangzhong City. Gastroenterol Res Pract, 2014, 481365.