Prevalence of Helicobacter pylori in Indigenous Western Australians: comparison between urban and remote rural populations.

OBJECTIVES To determine and compare the prevalence of Helicobacter pylori in an urban and a remote rural Western Australian Indigenous community. DESIGN Cross-sectional study of Helicobacter pylori status determined by urea breath tests between mid-January 2003 and the end of June 2004. PARTICIPANTS 520 self-selected fasting participants, comprising 270 members of the Martu community at Jigalong, Punmu and Parnngurr in the East Pilbara region (129 men, 141 women; age range, 2-90 years) and 250 people from the Perth Indigenous community (96 men, 154 women; age range, 3-75 years. RESULTS The overall prevalence of H. pylori was 76%, but the prevalence in the remote rural community was 91%, compared with 60% in the urban community. The odds of having H. pylori were six times greater for rural than for urban participants (odds ratio [OR], 6.34; 95% CI, 3.89-10.33). Further, the overall odds of H. pylori infection in males (rural and urban combined) were greater than for females (OR, 1.61; 95% CI, 1.02-2.54). In both communities, the prevalence of infection remained relatively constant after the age of 10. CONCLUSIONS The prevalence of H. pylori in the two Indigenous communities was two to three times higher than that in the non-Indigenous Australian population and higher than that shown in previous studies in Indigenous Australians.