Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania.
PLoS One. 2024 Jul 22;19(7):e0307705. doi: 10.1371/journal.pone.0307705. eCollection 2024.
Africa has consistently had the highest prevalence (70.1%) of H. pylori, and this has led to significant cases of dyspepsia, gastric cancers, and upper gastrointestinal bleeding. However, most studies have used sero-prevalence, which might not give the current state of the infection. Among the tests, the stool antigen test is simple, quick, and effective. The study aimed to determine the feco-prevalence, endoscopic pattern, and associated factors of H. pylori infection among symptomatic adult patients in Northern Tanzania.
A hospital-based, cross-sectional study was conducted from October 2022 to April 2023 among adults attending the gastroenterology clinic at Kilimanjaro Chistian Medical Centre. A systematic random sampling was used to select the participants with indications of undergoing esophagogastroduodenoscopy. Questionnaires, stool and blood samples, and endoscopy were used to collect variable data. Numerical and categorical variables were summarized into narrations and tables. Logistic regression was used to assess the factors associated with H. pylori.
The feco-prevalence of H. pylori was 43.4%. Chronic gastritis (51.1%) was the most common endoscopic pattern, whereas duodenal ulcers and gastric ulcers were significantly associated with H. pylori infection. Increasing in age (p <0.001) and blood group (p <0.001) were significantly associated with H. pylori infection in the adjusted analysis.
The feco-prevalence of H. pylori is high in this setting. H. pylori stool antigen can be used as the initial workup for symptomatic patients before the initiation of proton pump inhibitors. Additionally, due to other causes of dyspepsia, it is advised that H. pylori stool antigen testing be part of the initial evaluation and esophagogastroduodenoscopy be considered in the absence of other alarm symptoms if symptoms persist despite an appropriate trial of medical therapy.
非洲的幽门螺杆菌感染率一直最高（70.1%），这导致了大量消化不良、胃癌和上消化道出血病例。然而，大多数研究使用的是血清流行率，这可能无法反映当前的感染状况。在这些检测方法中，粪便抗原检测简单、快速且有效。本研究旨在确定坦桑尼亚北部有症状成年患者中幽门螺杆菌感染的粪便流行率、内镜表现和相关因素。
这是一项 2022 年 10 月至 2023 年 4 月在乞力马扎罗基督教医学中心胃肠病科就诊的成年患者中进行的基于医院的横断面研究。采用系统随机抽样法选择有行食管胃十二指肠镜检查指征的参与者。采用问卷、粪便和血液样本以及内镜收集变量数据。数值和分类变量分别以叙述和表格形式进行总结。采用逻辑回归评估与 H. pylori 相关的因素。
幽门螺杆菌的粪便流行率为 43.4%。慢性胃炎（51.1%）是最常见的内镜表现，而十二指肠溃疡和胃溃疡与 H. pylori 感染显著相关。在调整分析中，年龄增加（p<0.001）和血型（p<0.001）与 H. pylori 感染显著相关。
在本研究中，幽门螺杆菌的粪便流行率较高。对于有症状的患者，在开始使用质子泵抑制剂之前，可使用 H. pylori 粪便抗原进行初步检查。此外，由于消化不良的其他原因，如果症状持续存在，尽管经过适当的药物治疗试验，但建议在没有其他警报症状的情况下，将 H. pylori 粪便抗原检测作为初始评估的一部分，并考虑进行食管胃十二指肠镜检查。
