THIMPHU - Oita University is helping Bhutan tackle gastric cancer by supporting local production of rapid tests for Helicobacter pylori, a bacterium linked to the disease, and training doctors to perform endoscopies aimed at detecting cancer earlier.
In late July, an endoscopic examination was underway at a general hospital in the capital, Thimphu. Oita University vice president Yoshio Yamaoka, a professor specializing in environmental and preventive medicine, watched as a Bhutanese doctor carried out the procedure smoothly according to established protocols.
Yamaoka, who spent many years conducting research at U.S. medical schools, studied the prevalence of H. pylori in the Himalayan kingdom in 2010 as part of research across Asia.
Bhutan had only one doctor capable of performing endoscopies at the time, prompting Yamaoka to bring three endoscopes from Thailand to conduct his research.
Surveys carried out in 2014 and 2015 found that more than 70 percent of people in Bhutan were infected with H. pylori.
"It was also a particularly virulent strain," Yamaoka recalled.
Efforts to tackle the problem gained momentum after Lotay Tshering, who had been Bhutan's sole endoscopist in 2010, became prime minister in 2018.
Yamaoka and Tshering had long discussed the need to address gastric cancer, and eliminating the disease was subsequently adopted as a national policy.
In fiscal 2021, Yamaoka's gastric cancer project was selected for a science and technology cooperation program jointly run by the Japan International Cooperation Agency and the Japan Agency for Medical Research and Development. The five-year project was allocated a budget of 500 million yen ($3.1 million).
Working with ADTEC, a pharmaceutical manufacturer based in Usa, Oita Prefecture, the team developed a rapid test kit that can detect H. pylori from stool samples in about 10 minutes while keeping testing costs low.
The Royal Centre for Disease Control in Thimphu has obtained the necessary approvals and plans to begin producing the kits itself. Director Chimmi Dorji said early detection of H. pylori infection would enable more effective measures against gastric cancer.
Alongside the testing program, Yamaoka has worked to increase the number of doctors in Bhutan able to perform endoscopies.
Japanese specialists travel to the country for about two months at a time to train Bhutanese doctors, with 21 having taken part so far. Eight Bhutanese endoscopists have also traveled to Japan for training.
Bhutan now has 24 endoscopists, compared with just one when Yamaoka began his research there in 2010.
Yamaoka has traveled to Bhutan more than 20 times from Oita as part of his work.
"In the past in Bhutan, the incidence rate was virtually the same as the mortality rate. In other words, if you were diagnosed with cancer, you died," Yamaoka said. "Through early detection, I want to make gastric cancer a curable disease."
