Department of Pharmacology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2019 Jun 4;14(6):e0217645. doi: 10.1371/journal.pone.0217645. eCollection 2019.
Eradication of Helicobacter pylori infection with standard triple therapy has been accepted to curb associated risks of chronic gastritis andpeptic ulcer disease.
To assess H. pylori eradication rate of standard triple therapy and patient related factors affecting eradication rate.
A facility based prospective follow up study was conducted in Bahir Dar City Administration, Ethiopia, on consented outpatients presented with gastritis and peptic ulcer disease and positive for H. pylori stool antigen test from May 2016 to April 2018. Eradication was confirmed with stool antigen test made after 4-6 weeks of standard triple therapy, comprising of proton pump inhibitor, clarithromycin and amoxicillin. Pre-developed questionnaire and data collection formats were used to collect variables before and after therapy. Bivariate and backward stepwise multivariate logistic regression was used to analyze data. P-value < 0.05 at 95%CI was considered as significant.
The overall H. pylori eradication rate was 90.3% (379/421). Almost 80% of the patients were urban residents. Mean (±SD) age and body weight of patients were 30.63 (± 10.74) years and 56.79 (± 10.17) kg, respectively. Self-reported adverse drug effects and area of residence of patients were factors affecting eradication rate significantly. Patients with no self-reported adverse drug effect were 3.85 (AOR: 3.85; 95%CI (1.41-5.26)) times more likely to eradicate H. pylori infection compared to those reported adverse effects. Patients living in rural area were 2.7 (AOR: 2.7; 95%CI (1.19-20.0)) times more likely to achieve eradication compared to urban residents.
H. pylori eradication rate is within the recommended level for clinical practice, indicating that modifications of the standard triple therapy observed in the different healthcare institutions are not evidence-based. Emphasis should be given to adverse drug effects of medications and tailored counseling based on area of residence could have a contribution in improving eradication rate.
根除幽门螺杆菌感染的标准三联疗法已被接受，以遏制慢性胃炎和消化性溃疡病相关风险。
评估标准三联疗法的幽门螺杆菌根除率和影响根除率的患者相关因素。
2016 年 5 月至 2018 年 4 月，在埃塞俄比亚巴赫达尔市行政部门，对因胃炎和消化性溃疡病就诊且幽门螺杆菌粪便抗原检测阳性的同意患者进行了一项基于机构的前瞻性随访研究。在标准三联疗法（质子泵抑制剂、克拉霉素和阿莫西林）后 4-6 周进行粪便抗原检测，以确认根除。使用预先制定的问卷和数据收集格式，在治疗前后收集变量。采用双变量和向后逐步多变量逻辑回归分析数据。95%CI 下 P 值<0.05 为有统计学意义。
总体幽门螺杆菌根除率为 90.3%（379/421）。近 80%的患者为城市居民。患者的平均（±SD）年龄和体重分别为 30.63（±10.74）岁和 56.79（±10.17）kg。患者的自我报告药物不良反应和居住地是影响根除率的因素。无自我报告药物不良反应的患者根除幽门螺杆菌感染的可能性是报告有不良反应的患者的 3.85 倍（优势比：3.85；95%CI（1.41-5.26））。与城市居民相比，居住在农村地区的患者根除率高 2.7 倍（优势比：2.7；95%CI（1.19-20.0））。
幽门螺杆菌根除率处于临床实践推荐水平，表明不同医疗机构观察到的标准三联疗法的修改并非基于证据。应重视药物不良反应，并根据居住地进行有针对性的咨询，这可能有助于提高根除率。
