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Emmanuel BN, Peter DA, Peter MO, Adedayo IS, Olaifa K. Helicobacter pylori infection in Africa: comprehensive insight into its pathogenesis, management, and future perspectives. JOURNAL OF UMM AL-QURA UNIVERSITY FOR APPLIED SCIENCES 2024. [DOI: 10.1007/s43994-024-00166-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/22/2024] [Indexed: 01/04/2025]
Abstract
AbstractHelicobacter pylori is a widespread bacterium that has effectively colonized half of the global population, with Africa having over 70% of the total burden of H. pylori infections (HPI). Considering its acknowledged classification of as bacterial carcinogens and their significant contribution to the development of gastrointestinal disorders such as gastritis, peptic ulcers, and gastric neoplasia, together with their growing resistance to antibiotics. Gaining insight into the etiology of this organism is crucial in order to investigate and develop appropriate treatment strategies. Furthermore, the rise of bacteria that are resistant to antibiotics presents an extra danger in managing this detrimental bacterium. Our review focuses on investigating the presence of H. pylori in Africa and analyzing the various factors that contribute to its extensive prevalence. We simplified the complex mechanisms that H. pylori utilizes to flourish in the human body, with a specific emphasis on its virulence factors and antibiotic resistance. These variables pose significant challenges to conventional treatment strategies. In addition, we analyze both conventional and developing diagnostic methods, as well as the current treatment approaches implemented in various African nations. In addition, we tackle the distinct healthcare obstacles of the region and put-up practical remedies. The main goal of this review is to improve the formulation of more efficient methods for the management and treatment of HPI in Africa.
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Mnichil Z, Nibret E, Hailegebriel T, Demelash M, Mekonnen D. Prevalence and associated risk factors of Helicobacter pylori infection in East Africa: a systematic review and meta-analysis. Braz J Microbiol 2024; 55:51-64. [PMID: 38040991 PMCID: PMC10920553 DOI: 10.1007/s42770-023-01190-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/16/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Helicobacter pylori is the main cause of chronic gastritis, peptic ulcer, lymphoma, and gastric cancer in humans. The prevalence and factors associated with H. pylori infection are varied across countries. Thus, a comprehensive review has not been done on prevalence and associated factors in East Africa. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and identify factors associated with H. pylori infection in East Africa. METHODS Articles written in English language were retrieved from PubMed, Scopus, and Science Direct. Relevant articles were selected and screened using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Publication bias was assessed qualitatively and qualitatively using funnel plot symmetry and Egger's test, respectively. Heterogeneity was assessed using the I2 measure. Data were analyzed using Stata software, version 14, and the "metan" command. RESULTS A total of 231 articles were retrieved from nineteen countries in East Africa. Of these, 70 articles were eligible for the review. The pooled prevalence of H. pylori in East Africa was 50.98% (95% CI: 45.05-56.90). The prevalence of H. pylori infection ranged from 7.7 to 94.5% in East African countries. The highest pooled prevalence was from Sudan (61.3%, 95% CI: 52.6-69.9), and the lowest prevalence was reported from Uganda (40.7%, 95% CI: 33-48.3). Persons with no formal education (OR: 2.03; 95% CI: 1.22-2.83), lack of hand washing habit after toilet (OR: 2.24; 95% CI: 1.45-3.02), having a history of dyspepsia (OR: 2.25; 95% CI: 1.31-3.18), living in rural areas (OR = 1.80; 95% CI: 0.38-3.23), and having unclean water source (OR = 1.5; 95% CI:0.45-3.45) were all associated with higher risk for H. pylori infection. CONCLUSION More than half of the populations of East African countries were positive for H. pylori infection. Rural residence, source of water, and alcohol consumption were significantly associated with H. pylori infection. Therefore, healthcare workers could provide health education on the aforementioned risk factors, and the government and other stakeholders could improve the source of drinking water in East Africa.
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Affiliation(s)
- Zebasil Mnichil
- Yilmana Densa Woreda Education Office, West Gojjam Zone, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Institute of Biotechnology (IOB), Bahir Dar University, Bahir Dar, Ethiopia
| | - Tamirat Hailegebriel
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia.
- Institute of Biotechnology (IOB), Bahir Dar University, Bahir Dar, Ethiopia.
| | - Maritu Demelash
- South Mecha Woreda Education Office, West Gojjam Zone, Bahir Dar, Ethiopia
| | - Daniel Mekonnen
- Institute of Biotechnology (IOB), Bahir Dar University, Bahir Dar, Ethiopia
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Ferdaus SJ, Paul SK, Nasreen SA, Haque N, Sadekuzzaman M, Karim MR, Islam SM, Al Mamun A, Sathi FA, Basak P, Nahid RB, Aktar S, Kobayashi N. The Prevalence, Risk Factors, and Antimicrobial Resistance Determinants of Helicobacter pylori Detected in Dyspeptic Patients in North-Central Bangladesh. Infect Dis Rep 2024; 16:181-188. [PMID: 38525761 PMCID: PMC10961801 DOI: 10.3390/idr16020014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/03/2024] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
Chronic infection of Helicobacter pylori represents a key factor in the etiology of gastrointestinal diseases, with high endemicity in South Asia. The present study aimed to determine the prevalence of H. pylori among dyspeptic patients in north-central Bangladesh (Mymensingh) and analyze risk factors of infection and antimicrobial resistance (AMR) determinants in the pathogen. Endoscopic gastrointestinal biopsy samples were collected from dyspeptic patients for a one-year period from March 2022 and were checked for the presence of H. pylori via the rapid urease test and PCR and further analyzed for the status of virulence factors vacA/cagA and genetic determinants related to AMR via PCR with direct sequencing or RFLP. Among a total of 221 samples collected, 80 (36%) were positive for H. pylori, with the vacA+/cagA+ genotype being detected in almost half of them. H. pylori was most prevalent in the age group of 41-50-year-olds, with it being more common in males and rural residents with a lower economic status and using nonfiltered water, though the rates of these factors were not significantly different from those of the H. pylori-negative group. Relatively higher frequency was noted for the A2147G mutation in 23S rRNA, related to clarithromycin resistance (18%, 7/39). Amino acid substitutions in PBP-1A (T556S) and GyrA (N87K and D91N) and a 200 bp deletion in rdxA were detected in samples from some patients with recurrence after treatment with amoxicillin, levofloxacin, and metronidazole, respectively. The present study describes the epidemiological features of H. pylori infection in the area outside the capital in Bangladesh, revealing the spread of AMR-associated mutations.
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Affiliation(s)
- Syeda Jannatul Ferdaus
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | | | - Syeda Anjuman Nasreen
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Nazia Haque
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Mohammad Sadekuzzaman
- Department of Livestock Services, Central Disease Investigation Laboratory (CDIL), 48, KaziAlauddin Road, Dhaka 1000, Bangladesh;
| | - Mohammad Reazul Karim
- Department of Gastroenterology, Mymensingh Medical College, Mymensingh 2200, Bangladesh;
| | - Syed Mahmudul Islam
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh;
| | - Abdullah Al Mamun
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Fardousi Akter Sathi
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Proma Basak
- Shaheed Syed Nazrul Islam Medical College, Kishoreganj 2300, Bangladesh;
| | - Rifat Binte Nahid
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Suraiya Aktar
- Department of Microbiology, Dhaka Central International Medical College and Hospital, 2/1 Ring Road, Shyamoli, Dhaka 1207, Bangladesh;
| | - Nobumichi Kobayashi
- Department of Hygiene, School of Medicine, Sapporo Medical University, S-1 W-17, Chuo-ku, Sapporo 060-8556, Japan
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Ashenafi G, Aliyo A, Tilahun D, Gemechu T, Dedecha W, Husen O, Sisay B. Helicobacter Pylori Infection Among Patients Attending Bule Hora University Teaching Hospital, Ethiopia: Five-Year Trends. Health Serv Res Manag Epidemiol 2024; 11:23333928241253684. [PMID: 38779589 PMCID: PMC11110529 DOI: 10.1177/23333928241253684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background Around half of the world's population is infected with Helicobacter pylori (H. pylori), according to data from a recent systematic review. H. pylori infection is extremely common around the world. It is the most prevalent disease in Ethiopia and contributes to both morbidity and mortality. Patients with gastritis, peptic ulcers, and stomach cancer have been reported to harbor H. pylori. Objective The aim of this study was to determine the trends of Helicobacter Pylori infection among patients attending the Bule Hora University Teaching Hospital from 2018-2022, Bule Hora, Ethiopia. Method A hospital-based retrospective study design was conducted to recruit 314 sampled data from the logbook, which were five-year data (2018-2022) from the Bule Hora University Teaching Hospitals. Data were extracted using structured checklists. The sample size was calculated using the single-population proportion formula. Study participants were selected using a systematic random sampling technique. Data were entered in EpiData 4.6 and exported to SPSS Version 26 for analysis. Results Approximately 314 complete data from selected participants were collected and evaluated for the present study. The mean age was 29.01 (SD ± 4.93). Most of the respondents (39.2%) were in the age group of 21 to 30 years. The general prevalence of H. pylori observed in this study is 28% (95% confidence interval [CI], 23-32.9). The prevalence was higher in women (71.6%) than in men (28.4%). In terms of age category, those over 60 years of age were observed with the highest positiveness for H. pylori with 38.1% and the trend of H. pylori prevalence fluctuated from 2018 to 2022. Conclusion In total, 28% of the study participants had H. pylori, but there was variation in the prevalence of H. pylori infection between 2018 and 2022. Compared to other age groups, the 60-year-old age group had a higher prevalence of H. pylori and this prevalence continued to increase annually. The concerned parties must be interested in raising awareness and establishing criteria for the eradication of these bacteria.
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Affiliation(s)
- Girma Ashenafi
- Department of Medical Laboratory Sciences, Institute of Health, Bule Hora University, Bule Hora, Oromia, Ethiopia
| | - Alqeer Aliyo
- Department of Medical Laboratory Sciences, Institute of Health, Bule Hora University, Bule Hora, Oromia, Ethiopia
| | - Dangamyelew Tilahun
- Department of Medical Laboratory Sciences, Institute of Health, Bule Hora University, Bule Hora, Oromia, Ethiopia
| | - Tibeso Gemechu
- Department of Medical Laboratory Sciences, Institute of Health, Bule Hora University, Bule Hora, Oromia, Ethiopia
| | - Wako Dedecha
- Department of Medical Laboratory Sciences, Institute of Health, Bule Hora University, Bule Hora, Oromia, Ethiopia
| | - Oliyad Husen
- Department of Medical Laboratory Sciences, Institute of Health, Bule Hora University, Bule Hora, Oromia, Ethiopia
| | - Biruk Sisay
- Department of Medical Laboratory Sciences, Institute of Health, Bule Hora University, Bule Hora, Oromia, Ethiopia
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Archampong T, Tachi K, Duah A. A Review of Helicobacter pylori Diagnostics in Africa : From the Bedside to the Laboratory. J Clin Gastroenterol 2023; 57:977-982. [PMID: 37712767 DOI: 10.1097/mcg.0000000000001920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Helicobacter pylori (H. pylori) is endemic in Africa with a prevalence estimate of 79.1%. In addition, there is a significant community burden of dyspepsia in Africa, similar to other western countries. However, the majority of infected persons do not manifest the disease. In Africa, for instance, peptic ulcer disease is prevalent, whereas gastric cancer has reportedly low incidence. Therefore, it is important that testing is focused, targeting individuals most likely to benefit from treatment. In Africa, there are currently no guidelines for H. pylori testing and treatment. Empirical treatment is common due to variable access to diagnostics and health care. To assess the spectrum of H. pylori testing in Africa, we performed a literature search in PubMed over the past 10 years, 2013 to 2023. Histology was the most widely used modality in 16 out of 18 countries. Capacity for culture was shown in 11 studies, importantly across regions of Africa. H. pylori serology was demonstrated in 8 countries, although it has limited sensitivity in identifying active infection. H. pylori test-and-treat strategy has been shown to be cost-effective. Particularly in a region with high antibiotic resistance, adopting this strategy ensures that only confirmed positive patients are treated. Furthermore, test-of-cure ought to be mandatory to guide future therapies. Health authorities can leverage polymerase chain reaction facilities, left behind by the coronavirus disease 2019 pandemic, to make molecular susceptibility testing available in the near future. A systematic approach to testing incorporating indication for endoscopy and medication use is recommended.
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Affiliation(s)
| | | | - Amoako Duah
- Department of Medicine, University of Ghana Medical Centre, Accra, Ghana
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Torabi J, Abeshouse M, Giibwa A, Okello Damoi J, Binoga Bakaleke M, Waye JD, Glerum K, Marin ML, Zhang L. Remote training and teleproctoring in gastrointestinal endoscopy for practicing surgeon in rural Uganda. Surg Endosc 2023; 37:8785-8790. [PMID: 37580579 DOI: 10.1007/s00464-023-10338-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/19/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND There is a significant, unmet need for endoscopy services in rural Uganda. With limited diagnostic and therapeutic interventions, patients in these communities often present with advanced disease. Practicing surgeons must continually adapt to new techniques to meet the needs of their patient populations. Here, we present a remotely proctored endoscopy training program for a surgeon practicing in an area devoid of endoscopic capabilities. METHODS This was a retrospective case series conducted between February 2020 and December 2022 at Kyabirwa Surgical Center (KSC). After a 1-week in-person training camp, one surgeon performed endoscopy under guidance of a remote proctor. Patient data and outcomes were collected retrospectively. RESULTS The previously endoscopic naïve practicing Ugandan surgeon was remotely proctored for 139 endoscopic cases and he subsequently independently performed 167 diagnostic colonoscopies and 425 upper endoscopies. Therapeutic endoscopy was conducted under remote guidance after proficiency in diagnostic endoscopy. A total of 43 therapeutic procedures were performed, including 29 esophageal stent placements, 5 variceal bandings, and 9 foreign body retrievals. All procedures were completed without complication. CONCLUSION Our center developed a remotely proctored endoscopy program that allowed for training of practicing surgeons in an area lacking endoscopic services. Despite its limitations, remotely proctored endoscopy serves as a unique but highly valuable method of expanding access to endoscopy, particularly in areas that lack adequate training opportunities.
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Affiliation(s)
- Julia Torabi
- Department of Surgery, The Mount Sinai Hospital, 1 Gustav Levy Pl, New York, NY, 10019, USA.
| | - Marnie Abeshouse
- Department of Surgery, The Mount Sinai Hospital, 1 Gustav Levy Pl, New York, NY, 10019, USA
| | | | | | | | - Jerome D Waye
- Department of Surgery, The Mount Sinai Hospital, 1 Gustav Levy Pl, New York, NY, 10019, USA
| | - Katie Glerum
- Department of Surgery, The Mount Sinai Hospital, 1 Gustav Levy Pl, New York, NY, 10019, USA
| | - Michael L Marin
- Department of Surgery, The Mount Sinai Hospital, 1 Gustav Levy Pl, New York, NY, 10019, USA
| | - Linda Zhang
- Department of Surgery, The Mount Sinai Hospital, 1 Gustav Levy Pl, New York, NY, 10019, USA
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Oraijah AA, Shaqhan MH, Alhebshi FA, Alsuwat RW, Algethami AH, Alsofyani AH, Ozayzan A, Altowairqi SA, Alqurashi HH. Prevalence of Helicobacter pylori infection among patients with dyspepsia and other gastrointestinal diseases in King Abdulaziz Specialized Hospital in Taif. J Family Med Prim Care 2022; 11:6493-6498. [PMID: 36618210 PMCID: PMC9810908 DOI: 10.4103/jfmpc.jfmpc_1351_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction To estimate the prevalence of H. pylori in patients with dyspepsia as well as the prevalence of cancerous and precancerous nonmalignant lesions in patients with H. pylori. Methods A retrospective cohort study has been conducted at King Abdulaziz Specialist Hospital (KAASH), Ministry of Health (MOH) in Taif city in the Western province of Saudi Arabia among patients who underwent endoscopy between July 2019 and July 2021. Data were collected from the endoscopy log book and consisted of four sections; demographic data (age and gender), presenting symptoms and indications of endoscopy, endoscopic findings, and histopathological findings in endoscopic biopsies. Results The study included 680 patients. Their age ranged between 12 and 97 years with an arithmetic mean of 40.9 years and a standard deviation of 16.4 years. The prevalence of dyspepsia was 45.9% while that of H. pylori was 32.5%. The prevalence of H. pylori among patients with dyspepsia was 30.1% compared with 34.5% among those without dyspepsia, P > 0.05. The prevalence rates of H. pylori among male and female patients were 32.3% and 32.7%, respectively, P > 0.05. The prevalence rate of H. pylori was highest among patients aged between 41 and 60 years (38.7%) and lowest among those aged over 60 years (19.5%), P = 0.005. Active chronic gastritis was reported among almost two-thirds (65.6%) of patients with H. pylori compared with only 9.8% of those without H. pylori, P < 0.001. Conclusion The H. pylori was a common health problem among patients suffering from dyspepsia, however, its prevalence was relatively lower than other rates reported from other developing countries.
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Affiliation(s)
- Abrar A. Oraijah
- Internal Medicine Resident, Ministry of Health, Taif, Saudi Arabia,Address for correspondence: Dr. Abrar A. Oraijah, Internal Medicine Resident, Ministry of Health, Taif, Saudi Arabia. E-mail: a.a.oraijah@hotmail
| | - Mohammed H. Shaqhan
- Adult Gastroenterology and Endoscopy, Ministry of Health, Taif, Saudi Arabia
| | | | - Rawan W. Alsuwat
- Internal Medicine Resident, Ministry of Health, Taif, Saudi Arabia
| | | | - Afnan H. Alsofyani
- Adult Gastroenterology and Endoscopy, Ministry of Health, Taif, Saudi Arabia
| | - Angham Ozayzan
- Internal Medicine Resident, Ministry of Health, Taif, Saudi Arabia
| | | | - Hesham H. Alqurashi
- Adult Gastroenterology and Endoscopy, Ministry of Health, Taif, Saudi Arabia
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Smith SI, Ajayi A, Jolaiya T, Onyekwere C, Setshedi M, Schulz C, Otegbayo JA, Ndip R, Dieye Y, Alboraie M, Ally R, Gunturu R, Hyasinta J, Ugiagbe R, Ndububa D, Arigbabu A. Helicobacter pylori Infection in Africa: Update of the Current Situation and Challenges. Dig Dis 2021; 40:535-544. [PMID: 34380131 DOI: 10.1159/000518959] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/09/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The burden of Helicobacter pylori infection (HPI) in Africa remains high with varying levels of prevalence among children and adults reported in different regions of the continent. Persistent and uneradicated HPI could result in gastric cancer, although less severe pathological outcomes have been reported among Africans - the so-called "African enigma." SUMMARY Analysis of endoscopic findings of the upper gastrointestinal tract demonstrates similarities with that of patients from the West. Thus, it could be asserted that the true picture of HPI in Africa is yet to be unveiled due to several challenges including inadequate health-care system, lack of treatment guidelines and standardized protocol for diagnosis, and lack of data. This review explores the prevalence, diagnosis, treatment, and health-care system in Africa as it relates to HPI, thus providing an update and highlighting the need for an African HPI guideline. KEY MESSAGES There is high prevalence of Helicobacter pylori infection (HPI) in Africa with an increasing burden of antibiotic resistance. Various methods including invasive and noninvasive methods are deployed in the diagnosis of HPI in Africa. There is a need for consensus on diagnosis and treatment of HPI in Africa.
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Affiliation(s)
- Stella Ifeanyi Smith
- Department of Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, Lagos, Nigeria.,Department of Microbiology, Mountain Top University, Ogun, Nigeria
| | - Abraham Ajayi
- Department of Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | | | - Charles Onyekwere
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | - Mashiko Setshedi
- Division of Gastroenterology, Departments of Medicine, University of Cape Town, Cape Town, South Africa
| | - Christian Schulz
- Department of Medicine 2, LMU Hospital, Ludwig-Maximillians-University, Munich, Germany
| | | | - Roland Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Yakhya Dieye
- Department of Microbiology, Institut Pasteur, Dakar, Senegal
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Reidwaan Ally
- Department of Gastroenterology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Revathi Gunturu
- Department of Pathology, Aga Khan University Hospital Nairobi, Nairobi, Kenya
| | - Jaka Hyasinta
- Department of Internal Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Rose Ugiagbe
- Department of Medicine, University of Benin Teaching Hospital, Benin, Nigeria
| | - Dennis Ndububa
- Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
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Doe MJ, Bua E, Obbo JS, Bisso F, Olupot-Olupot P. Upper gastrointestinal endoscopy findings in Mbale Regional Referral Hospital, Eastern Uganda: a 10-year retrospective analysis. Afr Health Sci 2021; 21:919-926. [PMID: 34795752 PMCID: PMC8568209 DOI: 10.4314/ahs.v21i2.54] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Endoscopy is required for formal diagnosis of many upper gastrointestinal (UGI) conditions including oesophageal cancer (OC). There is a paucity of data on endoscopy findings in East Africa as access to testing is challenging for patients. We describe the findings of 10 years of UGI endoscopy in Mbale Regional Referral Hospital (MRRH). Method Records of patients that underwent UGI endoscopy in MRRH, November 2009 – March 2019 were retrospectively analysed. Indication, macroscopic findings, histology and patient demographics were retrieved. Sub-group analyses were performed on those with a histological diagnosis of oesophageal cancer. Results 833 eligible patients received single UGI procedures during the study period. Mean age was 54.8 years, range 16-93 years and 56.9% of patients were male. The main indication was dysphagia (42%) and the most common findings OC (34%) and gastritis (28%). 151 patients had histologically proven OC with a median age of 60 years and a 2:1 male to female ratio. 145/151 (96%) of samples tested revealed squamous cell carcinoma (SCC). Conclusion Those undergoing endoscopy in MRRH are most commonly male patients presenting in their 5th decade with dysphagia. There is a high proportion of significant findings including gastritis, peptic ulcer disease, and oesophageal cancer.
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Affiliation(s)
- Matthew J Doe
- Mbale Regional Referral Hospital, P.O. Box 921, Mbale, Uganda
| | - Emmanuel Bua
- Mbale Regional Referral Hospital, P.O. Box 921, Mbale, Uganda
| | - John So Obbo
- Lira Regional Referral Hospital, Plot 9/19, 21-41 Ngetta Road Police Rd, Lira P.O.BOX 2, Lira, Uganda
| | - Fred Bisso
- Mbale Regional Referral Hospital, P.O. Box 921, Mbale, Uganda
| | - Peter Olupot-Olupot
- Mbale Clinical research Institute, www.mcri.ac.ug, P.O. Box 1966, Mbale Uganda
- Busitema University, Faculty of Health Sciences, P.O.Box 1460 Mbale /Mbale Clinical research Institute, P.O. Box 1966, Mbale, Uganda
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Ghosn Y, Hussein Kamareddine M, Tawk A, Bou-Ayash N, Bou-Ayash H, Mokamer N, Yared R, Aoun M, Khoury S, Cortas G, Jabbour G, Bedran K, Farhat S. Analysis of gastric and duodenal biopsy results in patients presenting with dyspepsia: a cross-sectional study in a middle eastern population. BMJ Open Gastroenterol 2019; 6:e000330. [PMID: 31645989 PMCID: PMC6781958 DOI: 10.1136/bmjgast-2019-000330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Correa's cascade is a 'Model for Gastric Cancer Development' described by Peleyo Correa. The reversibility of Correa's cascade remains debatable. The literature contains insufficient data on the specific stage of the cascade during which Helicobacter pylori is detected, treated, and the effect on prognosis. Herein, we aim to determine the prevalence of various precancerous and cancerous gastric lesions in patients presenting with dyspepsia, the prevalence of gastritis and H. pylori infection, the prevalence of duodenal pathology in patients presenting with dyspepsia, identify the stage of H. pylori detection in relation to Correa's cascade, and investigate a possible relationship between H. pylori and celiac disease. DESIGN Retrospective cross-sectional study conducted on a middle eastern population at a Lebanese tertiary hospital centre. 1428 patients presenting with dyspepsia underwent gastroscopy with gastric and duodenal biopsies. Variables include age, sex, presence/absence of H. pylori infection, and histopathological analysis of gastric and duodenal biopsies. RESULTS Being above 40 years of age was associated with increased likelihood of exhibiting abnormal gastric biopsy result. Gastritis and metaplasia were detected more frequently than glandular atrophy (p<0.001) with gastritis being present the most (p<0.001). The presence of H. pylori and the gastric biopsy results were not associated with any of the duodenal biopsy results. CONCLUSION The burden of H. pylori infection in patients with dyspepsia was high. H. pylori was detected at various precancerous lesions with varying significance. The prevalence of duodenal adenocarcinoma in dyspeptic patients is unexpectedly high. No association between gastric and duodenal pathologies was found.
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Affiliation(s)
- Youssef Ghosn
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | | | - Antonios Tawk
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Naseem Bou-Ayash
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Haneen Bou-Ayash
- Faculty of Health and Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nader Mokamer
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Rawad Yared
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Mouna Aoun
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Salem Khoury
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - George Cortas
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Gide Jabbour
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Khalil Bedran
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Said Farhat
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
- Saint George Hospital University Medical Center, Beirut, Lebanon
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Smith S, Fowora M, Pellicano R. Infections with Helicobacter pylori and challenges encountered in Africa. World J Gastroenterol 2019; 25:3183-3195. [PMID: 31333310 PMCID: PMC6626727 DOI: 10.3748/wjg.v25.i25.3183] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/02/2019] [Accepted: 05/31/2019] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is the causative agent of gastritis, peptic ulcer disease, mucosa associated lymphoid tissue lymphoma and gastric cancer (GC). While this bacterium infects 50% of the world's population, in Africa its prevalence reach as high as 80% as the infection is acquired during childhood. Risk factors for H. pylori acquisition have been reported to be mainly due to overcrowding, to have infected siblings or parent and to unsafe water sources. Despite this high H. pylori prevalence there still does not exist an African guideline, equivalent to the Maastricht V/Florence Consensus Report of the European Helicobacter and Microbiota Study Group for the management of this infection. In this continent, although there is a paucity of epidemiologic data, a contrast between the high prevalence of H. pylori infection and the low incidence of GC has been reported. This phenomenon is the so-called "African Enigma" and it has been hypothesized that it could be explained by environmental, dietary and genetic factors. A heterogeneity of data both on diagnosis and on therapy have been published. In this context, it is evident that in several African countries the increasing rate of bacterial resistance, mainly to metronidazole and clarithromycin, requires continental guidelines to recommend the appropriate management of H. pylori. The aim of this manuscript is to review current literature on H. pylori infection in Africa, in terms of prevalence, risk factors, impact on human health, treatment and challenges encountered so as to proffer possible solutions to reduce H. pylori transmission in this continent.
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Affiliation(s)
- Stella Smith
- Department of Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, Lagos PMB 2013, Nigeria
| | - Muinah Fowora
- Department of Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, Lagos PMB 2013, Nigeria
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12
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Aminde JA, Dedino GA, Ngwasiri CA, Ombaku KS, Mahop Makon CA, Aminde LN. Helicobacter pylori infection among patients presenting with dyspepsia at a primary care setting in Cameroon: seroprevalence, five-year trend and predictors. BMC Infect Dis 2019; 19:30. [PMID: 30621610 PMCID: PMC6325826 DOI: 10.1186/s12879-019-3677-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 01/02/2019] [Indexed: 01/19/2023] Open
Abstract
Background Almost half the world’s population is infected with Helicobacter pylori (H. pylori) with the highest reported prevalence from Africa. This infection is associated with several morbid gastrointestinal conditions. Understanding the trends in seroprevalence and the factors associated with H. pylori seropositivity in dyspeptic persons can provide a guide for public health policies. Methods This was a retrospective study, carried out with outpatient records of Wum District Hospital (WDH) from January 2012 to December 2016. We reviewed records of all patients for whom a H. pylori serology test was requested. The Cochran-Armitage trend test and multiple regression models were used to explore seroprevalence trends and predictors of seropositivity respectively. Results We included 451 records, 63.6% (n = 287) were female. The mean age of the study population was 40.7 years, and the overall H. pylori seroprevalence was 51.5% (95% CI: 47–56%). The use of recommended eradication regimen appears to be low and declining. On average, H. pylori seroprevalence declined by 6.8% annually (p < 0.0001). Occupational status independently predicted seropositivity, with students having lower odds of being seropositive than employed persons (aOR = 0.09, 95% CI: 0.02–0.49, p = 0.016). Conclusion Despite decreasing trends, the seroprevalence of Helicobacter pylori infection is high in dyspeptic patients attending this primary care setting. Improving living standards and establishing national guidelines for eradication can possibly aid the control of this infection.
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Affiliation(s)
- Jeannine A Aminde
- Faculty of Health Sciences, University of Buea, Buea, Cameroon. .,Etoug-Ebe Baptist Hospital, Yaounde, Cameroon.
| | | | - Calypse A Ngwasiri
- Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon.,Bamendjou District Hospital, Bamendjou, Cameroon
| | | | | | - Leopold Ndemnge Aminde
- Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon.,Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
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Hamrah MH, Hamrah MS, Hassan Hamrah M, Kanda M, Hamrah AE, Dahi AE, Homayoun F, Hamrah MH, Fotouhi A, Sakamoto J. Prevalence of Helicobacter Pylori Infection in Dyspeptic Patients in Andkhoy Afghanistan. Asian Pac J Cancer Prev 2017; 18:3123-3127. [PMID: 29172289 PMCID: PMC5773801 DOI: 10.22034/apjcp.2017.18.11.3123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: The prevalence of Helicobacter pylori (H. pylori) infection is reported to be more than 50% worldwide.
It has been associated with peptic ulcer disease, gastric carcinoma, and mucosal-associated lymphoid tissue lymphoma.
The seroprevalence of H. pylori varies greatly among societies and geographical locations. The objective of this
study was to determine the seroprevalence and factors associated with H. pylori infection among dyspeptic patients
in Afghanistan. Materials and Methods: This cross-sectional study was designed to determine the seroprevalence of
H. pylori among dyspeptic patients in an outpatient clinic in Andkhoy, Afghanistan from January 2017 to April 2017.
Data were obtained from patients using a questionnaire, including socio-demographic data and history of smoking
and dyspeptic symptoms. Serum samples were also collected from the patients and tested for H. pylori antibodies
using the enzyme-linked immunosorbent assay. Results: A total of 152 patients with dyspepsia were included in the
analysis; 59 were men (40.0%), and 93 were women (60.0%). The overall seroprevalence of H. pylori was 75.6%. The
predictor of seroprevalence of H. pylori was found to be illiteracy (odds ratio [OR] 4.99, 95% confidence interval [CI]
1.03¬24.17), epigastric pain (OR 12.01, 95% CI 3.56- 40.52), and rural population (OR 9.66, 95% CI 3.36- 27.82).
There was an inverse association between employed status and seroprevalence of H. pylori (OR 0.08, 95% CI 0.01-
0.52). Conclusions: The seroprevalence of H. pylori was high among patient with dyspepsia in an outpatient clinic
in Afghanistan. Illiteracy, unemployment and rural populations, and epigastric pain were significantly associated with
H. pylori infection.
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Affiliation(s)
- Mohammad Hussain Hamrah
- Curative Clinic, Andkhoy, Afghanistan.,Arya University Faculty of Medicine, Mazar-i-Sharif, Afghanistan.
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Feng A, Chuang E, Wu SH, Wang JC, Chang SN, Lin CL, Kao CH. The effect of statins on the occurrence of peptic ulcer. Eur J Intern Med 2015; 26:731-5. [PMID: 26226858 DOI: 10.1016/j.ejim.2015.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/13/2015] [Accepted: 07/14/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND This study was to determine the association between the use of statins and the occurrence of peptic ulcer diseases (PUD). METHODS Using the National Health Insurance Research Database to conduct a population-based cohort study. We identified 48,562 patients who were newly diagnosed with hyperlipidemia during the period of 1998 to 2011 and who were divided into two groups based on their use of statins. The non-statin cohort (without statin treatment, 24,139 patients) were 1:1 frequency matched with sex, age, year of diagnosis of hyperlipidemia and index-year to the statin cohort (24,423 patients). The relative risk of patients with and without statins treatment on the occurrence of PUD and concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin were analyzed using the univariable and multivariable Cox proportional hazards regression model. RESULTS The incidence of PUD increased with age in both cohorts and female had a higher occurrence rate than male in both cohorts. Compared with the non-statin cohort, the statin cohort was associated with a significant lower risk of PUD for all age group. The concomitant use of aspirin and/or NSAIDs had higher incidence of PUD than those without in both cohorts. Analyzing the cumulative defined daily dose (DDD) of statins indicated that high-dose groups (≧ 575 DDD) exhibited significantly decreased risk compared with non-statin users. CONCLUSION The results of the present study indicated that statins might be associated with the protection of peptic ulcer in a dose-respondent manner.
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Affiliation(s)
- Anning Feng
- Division of Cardiology, Cheng Hisn General Hospital, Taipei, Taiwan; Nation Yang-Ming University, Taipei, Taiwan
| | - Eric Chuang
- UC Berkeley Mishler Lab Undergraduate Researcher, Intended B.S. Molecular and Cell Biology, University of CA, Berkeley, USA
| | - Szu-Hsien Wu
- Department of Physical Medicine and Rehabilitation, Veterans General Hospital Taipei, Taipei, Taiwan; National Yang-Ming University, Taipei, Taiwan
| | - Jia-Chi Wang
- Department of Physical Medicine and Rehabilitation, Veterans General Hospital Taipei, Taipei, Taiwan; National Yang-Ming University, Taipei, Taiwan
| | - Shih-Ni Chang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
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