The Prevalence of Helicobacter Pylori Treatment Resistance in Refugee Patients at a Rural Australian Primary Health Service

Helicobacter pylori (H.pylori) is a common upper gastrointestinal infection, and a known cause of peptic ulcer disease and gastric cancer. H.pylori infection is up to two to three-fold more prevalent in adults in low-middle income countries. As Australian refugees continue to resettle in regional and rural areas, research into the healthcare issues faced by refugees living in these areas and how to best access appropriate treatments in essential. Our study aimed to determine the prevalence of H.pylori infection, treatment approaches and resistance in refugee patients at a rural primary health service. This study is a cross-sectional analysis of paediatric and adult refugee patients at a rural Australian primary health service from January 2018-January 2021. Descriptive analytics were performed to establish a profile of H.pylori infections and treatment resistance within this patient population. Of the 163 patients tested for H.pylori, 73% were positive for the infection. After the first round of treatment, there was a 45% rate of treatment failure. This study suggests that the prevalence of H.pylori is far greater in Australian refugees compared with the general Australian population. In addition, this study demonstrates high levels of treatment resistance to first-line therapies and explores strategies utilised by a rural health service to provide specialised care. Should research into infection prevalence and treatment resistance in other refugee groups be similarly high, we would recommend a review of current screening and treatment guidelines to ensure all Australian refugee patients receive gold standard, high quality care.