ABSTRACT
OBJETIVO: Avaliar a prevalência da infecção por Helicobacter pylori e sua associação com parasitoses intestinais em crianças da comunidade indígena do Parque Indígena do Xingu. MÉTODOS: Foram incluídas 245 crianças indígenas entre 2 e 9 anos, de seis aldeias da região do rio Xingu, afluente do Amazonas. H. pylori foi detectado pelo teste respiratório com ureia-13C. Foram coletadas amostras de ar expirado, em jejum e 30 minutos após a ingestão de 50 mg de ureia-13C diluída em 100 mL de água aromatizada com suco de maracujá. Foram coletadas amostras de fezes de 202/245 (82,4 por cento) crianças para exame protoparasitológico. RESULTADOS: A prevalência do H. pylori foi de 73,5 por cento. Foi observada associação significativa do H. pylori com maior idade entre as diferentes aldeias e etnias. Resultaram positivas para a presença de parasitas 97,5 por cento (198/202) das amostras de fezes, sem associação com a infecção por H. pylori. Encontrou-se, na análise multivariada, uma relação entre a infecção por giárdia e o H. pylori. As etnias Kisêjê [odds ratio (OR) = 3,36] e Kaibi (OR = 4,00), e as aldeias Tuiararé (OR = 8,10), Ngojwere (OR = 4,10), Capivara (OR = 4,88), Diauarum (OR = 1,85) e Pavuru (OR = 1,40) foram fatores de risco para a infecção por H. pylori. CONCLUSÕES: Foi encontrada alta prevalência de H. pylori e de parasitose intestinal em crianças nas comunidades presentemente investigadas. No entanto, houve diferença significativa na prevalência do H. pylori entre as diversas aldeias estudadas. Verificou-se associação entre a presença de giárdia e a infecção por H. pylori.
OBJECTIVE: To evaluate the prevalence of Helicobacter pylori infection and its association with intestinal parasitoses in children from indigenous communities of the Xingu Indian Reservation, in Brazil. METHODS: A total of 245 Native Brazilian children between 2 and 9 years of age, from six villages of the Xingu River region, a tributary of the Amazon River, were assessed. H. pylori was detected using the 13C-urea breath test. Breath samples were collected at baseline and 30 minutes after ingestion of 50 mg of 13C-urea diluted with 100 mL of water flavored with passion fruit juice and sweetener. Stool samples were collected for the stool ova and parasites exam for 202/245 (82.4 percent) children. RESULTS: The overall prevalence of H. pylori was 73.5 percent. A significant association of H. pylori with increased age was observed among the different villages and ethnic groups. Positive results for the presence of parasites - 97.5 percent (198/202) - from the stool samples collected showed no association with H. pylori. Giardia showed an association with H. pylori in the multivariate analysis. Risk factors for H. pylori infection were observed in Kisêjê and Kaibi ethnic groups (OR [odds ratio] = 3.36 and 4.00, respectively), as well as in Tuiararé, Ngojwere, Capivara, Diauarum, and Pavuru villages (OR = 8.10, 4.10, 4.88, 1.85, and 1.40, respectively). CONCLUSIONS: H. pylori infection is highly prevalent in these communities, as well as intestinal parasitoses. However, there were significant differences in the prevalence of H. pylori among the diverse villages studied. Giardia was closely associated with H. pylori infection.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Helicobacter pylori , Helicobacter Infections/ethnology , Indians, South American/statistics & numerical data , Intestinal Diseases, Parasitic/ethnology , Brazil/epidemiology , Brazil/ethnology , Breath Tests/methods , Feces/parasitology , Giardia/isolation & purification , Giardiasis/epidemiology , Giardiasis/ethnology , Helicobacter Infections/epidemiology , Intestinal Diseases, Parasitic/parasitology , Logistic Models , Prevalence , Risk Factors , UreaABSTRACT
The great variability in gastric cancer rates across Asia, with very high incidences in Japan and Korea, and exceedingly low incidences in ethnic Malays, whether in Malaysia or Indonesia, appears largely due to variation in Helicobacter pylori infection rates. While between 2% and 10.6% of gastric cancers in a recent Japanese survey were considered to be negative for bacterial infection on the basis of seropositivity and H. pylori-dependent mucosal atrophy, it is notoriously difficult to preclude past infection. The situation is greatly complicated by reported differences in the etiology of gastric cardia and non-cardia cancers. In the Western world there do appear to be tumours arising close to the esophageal-gastric junction which are not related to H. pylori and associated inflammation, but in most Asian populations these appear to be very rare. Therefore preventive efforts, and particularly screening, should be focused on markers of bacterial infection, with avoidance of unnecessary exposure to X-ray radiation.
Subject(s)
Asia/epidemiology , Asian People/statistics & numerical data , Helicobacter Infections/ethnology , Helicobacter pylori , Humans , Incidence , Malaysia/epidemiology , Mass Screening , Stomach Neoplasms/ethnologyABSTRACT
Se ha planteado la posibilidad de una predisposición racial para adquirir la infección del estómago por el Helicobacter pylori. Sin embargo, no se ha tenido en cuenta el nivel socioeconómico de los pacientes. Objetivo: Comparar la prevalencia de la infección por Helicobacter pylori en la población japonesa residente en el Perú y en peruanos nativos, con similares condiciones socioeconómicas. Material y métodos: Estudio prospectivo realizado en el Policlínico Peruano-Japonés (Lima-Perú), donde incluimos a dos grupos de pacientes: japoneses y peruanos nativos con síntomas crónicos del tracto gastrointestinal superior, ambos de nivel socioeconómico medio y alto. Se excluyeron pacientes con úlcera péptica. Para diagnosticar la infección se utilizó la prueba de la ureasa, la Reacción en Cadena de la Polimerasa (PCR) y serología con ELISA IgG. Resultados: Evaluamos 168 pacientes de raza japonesa (edad promedio 54.6±12.62 años, 75% mujeres), y los comparamos con 161 peruanos (edad 42.12±14.48 años, 61.5% mujeres). Utilizando la prueba de la ureasa, la prevalencia de infección por el Helicobacter pylori en peruanos fue de 47.8% y en japoneses de 47.0% (p=0.88). Utilizando PCR, en peruanos fue de 49.7% y en japoneses 43.5% (p=0.28). Conclusiones: En el Perú, las personas de raza y ascendencia japonesa pura comparados con población peruana del mismo estrato social y similar grupo etáreo, tienen similar prevalencia de la infección por el Helicobacter pylori, con lo que podemos postular que en el Perú y en estos grupos étnicos no existe predisposición racial para adquirir la infección.
Objective: To compare the prevalence of Helicobacter pylori infection in native Peruvians and Japaneses residing in Peru. METHODS: Prospective study carried out at [quot ]Policlinico Peruano-Japonés[quot ] (Lima-Perú). We included Peruvians and Japaneses residing in Peru with chronic symptoms of the upper gastrointestinal tract. Both groups were from medium to high socioeconomic status. We excluded patients with peptic ulcer. PCR, rapid ureasa test and IgG ELISA were used to diagnose the infection. RESULTS: We evaluated 168 Japaneses (mean age 54.6 +/- 12.62 years, 75% female), and 161 Peruvians (mean age of 42.12 +/- 14.48 years, 61.5% female). Using the rapid ureasa test, the prevalence of Helicobacter pylori infection in Peruvians was 47.8%, and in Japaneses 47.0% (p=0.88). Using PCR, in Peruvians was 49.7% and in Japaneses 43.5% (p=0.28). CONCLUSION: Peruvians and Japaneses residing in Peru have a similar prevalence of Helicobacter pylori infection, after controlling factors such as socioeconomic status and age, suggesting that in Peru and in these ethnic groups, there is no racial predisposition to acquire the infection.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Gastritis/ethnology , Helicobacter pylori , Helicobacter Infections/ethnology , Prospective Studies , Socioeconomic Factors , Gastritis/diagnosis , Gastritis/microbiology , Helicobacter Infections/diagnosis , Helicobacter Infections/microbiology , Japan/ethnology , Peru/epidemiology , PrevalenceABSTRACT
Se presentan los resultados de nuestras investigaciones en el campo de la epidemiología de la infección por el H. pylori en el Perú durante las últimas dos décadas. La prevalencia de la infección por H. pylori en Lima está disminuyendo en personas de nivel socioeconómico medio y alto, manteniéndose estacionaria en la población de nivel socioeconómico bajo. Esta disminución se está evidenciando tanto en la población peruana como en la japonesa residente en esta ciudad, y está asociada a la disminución de las enfermedades vinculadas a esta bacteria: úlcera péptica y adenocarcinoma de estómago. La infección es ligeramente más frecuente en el sexo masculino y se adquire en edades tempranas de la vida, siendo probablemente el agua y la vía oral-fecal, las formas de transmisión más importantes. Hasta el momento en nuestro país no existe evidencia que permita afirmar la mayor predisposición de ciertas razas para adquirir la infección. No hay diferencias enla infección por el H. pylori entre las poblaciones de la costa, la sierra y la selva del Perú; siendo en la población de altura más frecuente la gastritis crónica atrófica secundaria a la infección por H. pylori que en la población a nivel del mar.