Prevalence difference of Helicobacter pylori infection between Tibetan and Han ethnics: A meta-analysis on epidemiologic studies
Helicobacter pylori (Hp) appears worldwide prevalent as a primary carcinogenic pathogen of human gastric cancer. China is a multi-ethnic country, and the prevalence of Hp infection may be diverse among ethnics. This meta-analysis was conducted to compare the prevalence of Hp infection between Tibetan and Han ethnics. Methods The databases, PubMed, Web of Science, Blackwell Journals, CNKI, and Wanfang were searched. Those studies which reported the prevalence of Hp infection between Tibetans and
... etween Tibetans and Hans in China were eligible. There were no limitation to Hp detection method, publication language, and observation period. RevMan 5.3 and Stata 12.0 softwares were used for heterogeneity tests and meta-analyses. Meanwhile, subgroup analysis, sensitivity analysis and publication bias evaluation were performed where applicable. Results Totally, 11 studies with 3,826 Tibetans and 19,787 Hans were analyzed. The pooled prevalence of Hp infection were 62.2% and 55.3% among Tibetans and Hans, respectively. Tibetans had higher risk of Hp infection than Hans (OR=1.38, 95% CI 1.05-1.80). In subgroup analysis, those Tibetans with upper gastrointestinal symptoms (OR=1.51, 95% CI 1.06-2.16), inhabiting in Tibet (OR=1.51, 95% CI 1.22-1.87), or in Northwestern region (OR=1.15, 95% CI 1.00-1.31) had significantly higher risk of Hp infection. Additionally, in recent ten years, Hans appeared a decreased risk of Hp infection (OR=1.81, 95% CI 1.42-2.30). Heterogeneity was common, while sensitivity analyses showed partially inconsistent results against main findings. Conclusions This study demonstrated the higher prevalence of Hp infection in Tibetans compared with Hans, especially in recent years, or in the Tibet and the northwest China, as well as symptomatic Tibetans. It suggests tailored strategy and robustness need further consider for Hp screening and eradication among Tibetans.