PDF(Pubmed)
Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
背景：非洲一直是幽门螺杆菌患病率最高的国家（70.1%），这导致了大量的消化不良病例，胃癌,上消化道出血.然而,大多数研究使用血清患病率，这可能不会给出感染的当前状态。在测试中，粪便抗原测试很简单，快,而且有效。这项研究旨在确定胎儿的患病率，内窥镜模式,坦桑尼亚北部有症状的成人患者幽门螺杆菌感染的相关因素。
方法：以医院为基础，横断面研究于2022年10月至2023年4月在乞力马扎罗山医学中心胃肠病诊所就诊的成年人中进行.使用系统随机抽样来选择有接受食管胃十二指肠镜检查指征的参与者。问卷调查，粪便和血液样本，和内窥镜检查用于收集可变数据。数值和分类变量被总结为叙述和表格。采用Logistic回归分析评估幽门螺杆菌的相关因素。
结果：幽门螺杆菌的胎儿患病率为43.4%。慢性胃炎（51.1%）是最常见的内镜模式，而十二指肠溃疡和胃溃疡与幽门螺杆菌感染显著相关。在调整后的分析中，年龄（p<0.001）和血型（p<0.001）的增加与幽门螺杆菌感染显着相关。
结论：在这种情况下，幽门螺杆菌的繁殖率很高。幽门螺杆菌粪便抗原可以在质子泵抑制剂开始之前用作有症状患者的初始检查。此外,由于消化不良的其他原因，建议幽门螺杆菌粪便抗原检测是初步评估的一部分,如果尽管进行了适当的药物治疗试验,但症状持续存在,则在没有其他警报症状的情况下考虑食管胃十二指肠镜检查.
方法：以医院为基础，横断面研究于2022年10月至2023年4月在乞力马扎罗山医学中心胃肠病诊所就诊的成年人中进行.使用系统随机抽样来选择有接受食管胃十二指肠镜检查指征的参与者。问卷调查，粪便和血液样本，和内窥镜检查用于收集可变数据。数值和分类变量被总结为叙述和表格。采用Logistic回归分析评估幽门螺杆菌的相关因素。
结果：幽门螺杆菌的胎儿患病率为43.4%。慢性胃炎（51.1%）是最常见的内镜模式，而十二指肠溃疡和胃溃疡与幽门螺杆菌感染显著相关。在调整后的分析中，年龄（p<0.001）和血型（p<0.001）的增加与幽门螺杆菌感染显着相关。
结论：在这种情况下，幽门螺杆菌的繁殖率很高。幽门螺杆菌粪便抗原可以在质子泵抑制剂开始之前用作有症状患者的初始检查。此外,由于消化不良的其他原因，建议幽门螺杆菌粪便抗原检测是初步评估的一部分,如果尽管进行了适当的药物治疗试验,但症状持续存在,则在没有其他警报症状的情况下考虑食管胃十二指肠镜检查.
