Goh K L, Parasakthi N
Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Eur J Gastroenterol Hepatol. 2001 Feb;13(2):177-83. doi: 10.1097/00042737-200102000-00014.
Malaysia is a multiracial country where three major Asian races live together: Malay, Chinese and Indian. In addition, there are a number of native or indigenous races, particularly in East Malaysia. Differences in prevalence of gastric diseases between races have been noted, particularly with respect to peptic ulcer disease and gastric cancer. The aim of this study is to determine the prevalence rates and risk factors for Helicobacter pylori infection among various races in Malaysia.
A large-scale prospective seroepidemiological study in West and East Malaysia using the HEL-p II commercial enzyme-linked immunosorbent assay kit (AMRAD, Melbourne, Australia) to detect H. pylori antibodies. Populations surveyed in West Malaysia were a rural community from Kuala Pilah, and blood donors from Kuala Lumpur and Kota Baru. Subjects studied in East Malaysia were volunteer blood donors from Kota Kinabalu, and blood donors and healthy volunteers from Sibu. Statistical analyses using multiple logistic regression analysis were carried out to identify independent risk factors for H. pylori infection
A total of 2,381 subjects were evaluated. H. pylori prevalence varied from different areas of study and ranged from a low of 26.4% in blood donors from Kota Baru to a high of 55.0% in Kota Kinabalu. The most striking differences, however, were noted in the prevalence rates among different racial groups. Prevalence rates among the Malays ranged from 11.9 to 29.2%, while the Chinese ranged from 26.7 to 57.5%, and those of Indians in two studies were 49.4 and 52.3%. In every location, Malays had a significantly lower prevalence compared with the other races. The highest prevalence rates were recorded among the indigenous races in Kota Kinabalu, East Malaysia. There was no difference between males and females in the studies. An increasing trend with age was noted in the majority of studies; however, no increase in prevalence rates was noted among the Malays.
The pattern of infection in a multiracial population in Malaysia points to a 'racial cohort' phenomenon. The infection appears to be confined to a racial group, with the Malays having consistently low prevalence rates. This observation may provide clues to the mode of transmission of infection.
马来西亚是一个多种族国家，马来族、华族和印度族这三大亚洲种族共同生活。此外，还有一些本土或原住民种族，尤其是在东马来西亚。不同种族之间的胃病患病率存在差异，特别是在消化性溃疡疾病和胃癌方面。本研究的目的是确定马来西亚不同种族中幽门螺杆菌感染的患病率及危险因素。
在马来西亚西部和东部进行大规模前瞻性血清流行病学研究，使用HEL-p II商用酶联免疫吸附测定试剂盒（澳大利亚墨尔本的AMRAD公司）检测幽门螺杆菌抗体。在马来西亚西部调查的人群包括来自瓜拉庇拉的一个农村社区、吉隆坡和哥打巴鲁的献血者。在东马来西亚研究的对象是哥打基纳巴卢的志愿献血者、诗巫的献血者和健康志愿者。采用多元逻辑回归分析进行统计分析，以确定幽门螺杆菌感染的独立危险因素。
共评估了2381名受试者。幽门螺杆菌患病率因研究地区不同而有所差异，范围从哥打巴鲁献血者的低患病率26.4%到哥打基纳巴卢的高患病率55.0%。然而，最显著的差异在于不同种族群体的患病率。马来族的患病率在11.9%至29.2%之间，华族在26.7%至57.5%之间，在两项研究中印度族的患病率分别为49.4%和52.3%。在每个地点，马来族的患病率均显著低于其他种族。东马来西亚哥打基纳巴卢的原住民种族患病率最高。在这些研究中，男性和女性之间没有差异。大多数研究中都注意到患病率随年龄增长呈上升趋势；然而，马来族的患病率并未增加。
马来西亚多民族人群中的感染模式显示出“种族队列”现象。感染似乎局限于一个种族群体，马来族的患病率一直较低。这一观察结果可能为感染传播方式提供线索。
