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World J Gastroenterol. Aug 14, 2007; 13(30): 4117-4121
Published online Aug 14, 2007. doi: 10.3748/wjg.v13.i30.4117
Histopathological profile of gastritis in adult patients seen at a referral hospital in Kenya
Ahmed Kalebi, Farzana Rana, Walter Mwanda, Godfrey Lule, Martin Hale
Ahmed Kalebi, Farzana Rana, Walter Mwanda, Department of Pathology, University of Nairobi and Kenyatta National Hospital, Kenya
Geoffrey Lule, Department of Medicine, University of Nairobi and Kenyatta National Hospital, Kenya
Martin Hale, Department of Anatomical Pathology, University of Witwatersrand and National Health Laboratory Services, Johannesburg, South Africa
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr.Ahmed Kalebi, 4th Floor, NHLS Building, Department of Anatomical Pathology, Chris Hani Baragwanath Hospital, Old Potch Road, 2135, Johannesburg, South Africa. ahmedkalebi@yahoo.com
Telephone: +27-11-4898715 Fax: +27-11-4898717
Received: March 13, 2007
Revised: April 1, 2007
Accepted: April 4, 2007
Published online: August 14, 2007
Abstract

AIM: To conduct a detailed histological study of gastritis in adult patients attending an endoscopy clinic at a Kenyan teaching and referral hospital.

METHODS: Biopsy specimens from consecutive patients were examined and graded according to the Updated Sydney System for H pylori infection, chronic inflammation, neutrophil activity, glandular atrophy and intestinal metaplasia. Also documented were gastric tissue eosinophil counts and presence of lymphoid follicles.

RESULTS: The rate of the graded variables, in the antrum and corpus respectively, were as follows: H pylori infection (91%, 86%), chronic inflammation (98%, 93%), neutrophil activity (91%, 86%), glandular atrophy (57%, 15%) and intestinal metaplasia (11%, 2%). Lymphoid follicles were noted in 11% of cases. Duodenal and gastric ulcers were documented in 32% and 2% respectively. The mean eosinophil count was 5.9 ± 0.74 eosinophils/HPF and 9.58 ± 0.93 eosinophils/HPF in the corpus and antrum respectively. Significant association was found between the degree of H pylori colonisation with chronic inflammation, neutrophil activity and antral glandular atrophy. Biopsies from the antrum and corpus showed significant histopathological discordance for all the graded variables. H pylori negative cases were associated with recent antibiotic use.

CONCLUSION: The study reaffirms that H pylori is the chief cause of gastritis in this environment. The majority of patients show a moderate to high degree of inflammation but a low degree of glandular atrophy and intestinal metaplasia. The study shows that inter-relationships between the histological variables in this African population are similar to those found in other populations worldwide including non-African populations.

Keywords: H pylori, Gastritis, Stomach, Gastric atrophy, Intestinal metaplasia, Tissue eosinophils, Peptic ulcer, African enigma, Sydney system