Helicobacter pylori Infection and Related Gastrointestinal Diseases in Southeast Asian Countries: An Expert Opinion Survey

Document Type : Research Articles


1 Department of Internal Medicine, University of Medicine and Pharmacy at Hochiminh City, Hochiminh, Vietnam.

2 Department of Gastroenterology, Gia-Dinh’s People Hospital, Hochiminh, Vietnam.

3 Division of Gastroenterology, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand.

4 National Gastric Cancer and Gastrointestinal diseases Research Center, Pathumthani Thailand.

5 Department of Medicine, Chulabhorn International College of Medicine (CICM) at Thammasat University, Pathumthani, Thailand.

6 Department of Gastrointestinal Endosccopy, 108 Central Military Hospital, Hanoi, Vietnam.

7 Department of Medicine, Gastroenterology Section, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Texas, USA.

8 Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan.

9 Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University, Japan.

10 GI and Liver Center, Bangkok Medical Center, Bangkok, Thailand.


Background: Helicobacter pylori (H. pylori) infection is currently considered as an infectious disease irrespective of
symptoms and stage of disease. This study aimed to survey the impact of H. pylori infection and the current management
approaches in Southeast Asian countries. Materials and methods: This is a survey among 26 experts from 9 Southeast
Asian countries (Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam),
who attended a meeting to develop the ASEAN consensus on H. pylori management in November 2015. Results: The
prevalence of H. pylori varied significantly from 20% to 69% among countries, highest in Myanmar and lowest in
Malaysia. The rate of H. pylori infection in patients with gastritis, peptic ulcer disease and gastric cancer (GC) also
varied significantly, not only among countries but also among regions within the same country. The most common
method for H. pylori diagnosis before treatment was rapid urease test, followed by urea breath test. In multi-ethnic
countries, some ethnic groups including Chinese, Batak and Minahasanese were considered as having higher risk of
GC. There have been no national screening programs for GC in all countries, and a majority of patients with GC were
diagnosed in advanced stages with very poor 5-year survival. Conclusions: The prevalence of H. pylori infection and
its infection rates in related gastrointestinal diseases were significantly different among Southeast Asian countries. The
prognosis of patients with GC in the region was very poor. The result of this survey is a platform for future international
and regional research collaboration.


Main Subjects