Trends in Helicobacter pylori Infection Among Maori, Pacific, and European Birth Cohorts in New Zealand

BackgroundThe aim of this paper is to estimate the seroprevalence of Helicobacter pylori infection in the New Zealand population by ethnicity and year of birth. MethodsA systematic search identified seven studies in New Zealand that reported prevalence of H.pylori infection among 4463 participants. Prevalence data were pooled to estimate the Maori, Pacific, and European seroprevalence of H.pylori in four birth cohorts (1926-40, 1941-55, 1956-70, and 1971-85), by assuming that infection is acquired in childhood and seroprevalence is stable with aging. The best estimates of national seroprevalence were obtained by geographic regional weighting and corrections for selection and measurement bias. ResultsInfection rates among all ethnic groups declined in more recent birth cohorts. Prevalence was highest among Pacific peoples (ranging from 39-83%) followed by Maori (18-57%) and then European (7-35%). The absolute ethnic differences in seroprevalence decreased in subsequent cohorts, but the relative ethnic differences increased. ConclusionsThere is scope to much further reduce Maori and especially Pacific people's risk of H.pylori infection. Solutions to reduce H.pylori prevalence and its sequelae should focus on people at greatest risk of the infection. Further evaluation of strategies to address H.pylori infection is warranted. Interventions to be evaluated could include household crowding reduction and eradication therapy for asymptomatic infected persons to reduce their risk of noncardia stomach cancer.