Reasons for non-compliance with screening for infection with Helicobacter pylori, in a multi-ethnic community in Leicester, UK.

In this study, we aimed to identify reasons for non-compliance with a screening programme for Helicobacter pylori (H pylori), in a multi-ethnic community and to assess the effectiveness of Asian language materials towards increasing compliance. A serological screening test for infection with H pylori was offered to 200 Asians and 200 non-Asians (mainly Europeans), aged 21-55 y, registered at a single general practice. Reasons for non-attendance for screening were identified by reply slip or interview. A second group of 200 Asians who were offered screening were sent information in Gujarati as well as English. When information was mailed in English only, 30% Asians and 22% non-Asians attended (P = 0.09, ns). Stated reasons for non-attendance in the Asian group were not generally language related; reasons were similar in the Asian and non-Asian groups and were most frequently related to other commitments. The use of materials in Gujarati did not improve compliance. Language problems should not be assumed to dominate reasons for non-compliance with screening in ethnic minority groups. In common with those of UK origin, subjects from ethnic minority groups may more generally have insufficient interest in preventive medicine for them to prioritise health screening above other commitments.

Results of Helicobacter pylori screening and eradication in a multi-ethnic community in central England.

OBJECTIVES: To determine the prevalence of Helicobacter pylori and risks for infection in a multi-ethnic inner city population, and to assess the effectiveness with which the infection can be eradicated in a relatively asymptomatic population of this type. DESIGN: Analysis of results from a small research-based community programme of screening and eradication. Tests were offered to matched groups of Asians and non-Asians from the general population. METHODS: Those who attended for screening had a serological screening test for infection with H. pylori. Data concerning possible risk factors for infection were collected by means of questionnaires. Subjects testing positive were offered a prescription for eradication therapy (ranitidine bismuth citrate and clarithromycin) through their general practitioner, and success of eradication therapy was assessed by urea breath test. RESULTS: The overall prevalence of infection in 155 subjects was found to be 51%. The difference between positive test rates in Asians (53%) and non-Asians (47%) was not significant (P=0.611). In Asians, age and social class were risk factors for infection, but not gender or birth outside the UK. Results were similar in those born in India and East Africa. Of the 79 people who tested positive, 64 (81%) elected to take eradication therapy. Compliance with medication was estimated to be 95% and successful eradication was achieved in 92% of cases. CONCLUSION: Social class is more important than Asian ethnic origin as a predictor of H. pylori status. Good rates of H. pylori eradication can be achieved in subjects from the general population living in inner city communities.

Dietary habits of Asian diabetics in a general practice clinic.

Initial dietary advice for Asian diabetics attending a general practice diabetic clinic was given in Asian languages. Between 2 and 3 years later a questionnaire interview was conducted to assess the effectiveness of the advice given. Forty of the 59 Asian diabetic patients in the practice attended for interview. The majority continued to use sugar or 'gur' (jaggery), Asian sweets, and Asian snacks (which have a high fat content). Fat and oil consumption per person per month was also high. Failure to achieve dietary objectives seemed to result from lack of sufficient emphasis on the types of foods usually consumed and an inadequate understanding of eating and cooking habits of Asians. We conclude that for dietary advice to be successful, emphasis must be placed on specific types of food eaten together with an understanding of the sociocultural implications of eating practices in ethnic groups.