The bacteria Helicobacter Pylori (H. pylori) is a common cause of gastric cancer, which is the leading cause of death among Tibetans. It has a notable impact on global health, with an estimated prevalence of 50% across populations worldwide with its occurrence more pronounced in developing nations. H. pylori stands out as a significant culprit behind chronic and atrophic gastritis, peptic ulcers, gastric lymphoma, and gastric carcinoma, making it a modifiable risk factor for a range of gastric health issues.
The prevalence of H. pylori infection varies greatly depending on age, associated diseases, geographic regions, race/ethnicity, socioeconomic status, and hygienic conditions. There is also individual-level variation in the inflammatory response to an infection in a host and the virulence of the infection. In children, a systematic review and meta-analysis, including 198 studies published from database inception to October 25, 2021, showed that the global prevalence of H. pylori infection was 32.3% in children under 18 years of age (41.6% among children aged 13-18, 33.9% aged 7-12, and 26.0% aged 0-6). This under-18 prevalence was roughly twice as large in low- and middle-income countries vs. high-income countries (43.2% vs. 21.7%).
The majority of infections are asymptomatic; the current guidelines for screening and treatment of H. pylori infection are unclear. The Smart Kids Initiative (SKI) has received funding to conduct screening for H. pylori infection and gastric cancer for the Tibetan population. Because no study has been conducted to assess how the two chronic infections drive each other, and because quinolone antibiotics are commonly used to treat both, we see an opportunity for TB-H.-pylori-gastric cancer service integration as well.
