Prevalence of Helicobacter pylori in a First Nations population in northwestern Ontario.

OBJECTIVE To assess prevalence of Helicobacter pylori infection, reasons for referral for gastroscopy, and clinical findings of gastroscopy in a symptomatic First Nations population in northwestern Ontario from 2009 to 2011. DESIGN Three hundred four hospital charts of symptomatic patients who underwent upper endoscopy between June 2009 and March 2011 were reviewed. SETTING Meno Ya Win Health Centre in Sioux Lookout, Ont. PARTICIPANTS First Nations patients with dyspepsia undergoing gastroscopy. MAIN OUTCOME MEASURES Reason for referral, and clinical and histologic findings on gastroscopy. RESULTS The most common reasons for referral for gastroscopy were dyspepsia (59.2%) and undiagnosed anemia (18.1%). Overall, 66.8% of patients underwent biopsies; 37.9% of these patients tested positive for H pylori. Gastritis was encountered the most often, in 46.1% of patients; gastric ulcers in 6.9% of patients; and normal gastric mucosa was seen 36.8% of the time. The rate of H pylori infection is higher than in urban Canadian populations, but lower than in previous aboriginal prevalence estimates, particularly those based on seroprevalence values. CONCLUSION This study raises the clinical question of how eradication testing and treatment protocols should be addressed in remote regions with high disease prevalence. As more is learned about the role H pylori infection plays in serious gastrointestinal diseases, rural and aboriginal populations might need a special focus on testing availability and treatment close to home.