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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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Alshareef SA, Hassan AA, Abdelrahman DN, AlEed A, Al-Nafeesah A, Adam I. The prevalence and associated factors of Helicobacter pylori infection among asymptomatic adolescent schoolchildren in Sudan: a cross-sectional study. BMC Pediatr 2023; 23:582. [PMID: 37985974 PMCID: PMC10662923 DOI: 10.1186/s12887-023-04411-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Only few data have been published on Helicobacter pylori infection in adolescents in Sub-Saharan Africa, including Sudan. The aim of the present study was to investigate the prevalence and associated factors of H. pylori infection in asymptomatic adolescents schoolchildren (aged 10-19 years) in Sudan. METHODS A cross-sectional study was conducted from October to November 2022. The participants' sociodemographic and clinical characteristics were assessed using a questionnaire. The participants underwent a rapid H. pylori antibody test for the detection of H. pylori antibodies. Multivariate regression analyses were performed. RESULTS Of the 368 enrolled adolescents, 155 (42.1%) and 213 (57.9%) were boys and girls, respectively. The median (interquartile range [IQR]) age of the total sample was 15.2 years (14.0‒16.4 years). The overall prevalence of H. pylori infection was 8.4%. In the multivariable regression analyses, only the female adolescents (adjusted odds ratio [AOR], 3.04; 95% confidence interval [CI], 1.24‒7.44) were associated with H. pylori infection. Age, parental education and occupation, and body mass index were not associated with contracting H. pylori infection. CONCLUSION H. pylori infection was detected in one of 10 adolescents in Northern Sudan. Female adolescents were at a higher risk of contracting H. pylori infection. The introduction of interventional health programs such as awareness campaigns and improving personal hygiene could lead to the reduction of the risk of H. pylori infection at early ages, especially in girls, and ensure that adolescents are healthy in their present and later lives.
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Affiliation(s)
- Shimos A Alshareef
- Virology Department, Central Laboratory, Ministry of Higher Education, Khartoum, Sudan
| | - Ahmed A Hassan
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Dina N Abdelrahman
- Virology Department, Central Laboratory, Ministry of Higher Education, Khartoum, Sudan
| | - Ashwaq AlEed
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, 56219, Saudi Arabia
- Department of Pediatrics, College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Abdullah Al-Nafeesah
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, 56219, Saudi Arabia.
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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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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Mnichil Z, Nibret E, Mekonnen D, Demelash M. Sero- and Feco-Prevalence of Helicobacter pylori Infection and Its Associated Risk Factors among Adult Dyspeptic Patients Visiting the Outpatient Department of Adet Primary Hospital, Yilmana Densa District, Northwest Ethiopia. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:2305681. [PMID: 37492856 PMCID: PMC10365919 DOI: 10.1155/2023/2305681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/11/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023]
Abstract
Background Most gastric cancers in the world are attributed to Helicobacter pylori (H. pylori) infections. The prevalence of H. pylori infection is influenced by socioeconomic status, hygiene, and lifestyle of the population. This study aimed to assess sero- and feco-prevalence of H. pylori infections and its associated risk factors among adult dyspeptic patients visiting the outpatient department of Adet Primary Hospital, Yilmana Densa District, northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted from February 10, 2022 to April 10, 2022. The study participants were selected using a systematic random sampling technique. The data were collected by pretested questionnaires. Blood and stool specimens were collected from each patient for antibody and H. pylori antigen tests, respectively. The data were analyzed using Statistical Package for Social Science (SPSS) version 26.0. A logistic regression model was used to assess the strength of association between H. pylori positivity and risk factors. Results The sero- and feco-prevalence of H. pylori infection was 62% and 51.1%, respectively. In those patients who had a positive result with either the antibody (Ab) or antigen (Ag) test, rural residence (AOR = 5.55; 95% CI: 2.34-13.14; p < 0.001), alcohol consumption (AOR = 12.34; 95% CI: 2.29-66.51; p=0.003), having no awareness about H. pylori transmission (AOR = 4.76; 95% CI: 1.86-12.15; p=0.001), using pond/river as a source of drinking water (AOR = 5.22; 95% CI: 1.91-14.27; p=0.001), and open field defecation (AOR = 4.19; 95% CI: 1.67-10.52; p=0.002) were the explanatory risk factors significantly associated with H. pylori infection. Conclusion This study showed that the prevalence of H. pylori infection was very high. Most cases of gastric cancers are ascribed to H. pylori infection. Therefore, education should be given to communities so as to increase their awareness of the infection and the associated major explanatory risk factors identified in the present study.
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Affiliation(s)
- Zebasil Mnichil
- Yilmana Densa Woreda Education Office, West Gojjam Zone, Bahir Dar, Ethiopia
- Department of Biology, College of Science, Bahir Dar University, 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
| | - 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
| | - Maritu Demelash
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- North Mecha Woreda Education Office, West Gojjam Zone, Bahir Dar, Ethiopia
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Borka Balas R, Meliț LE, Mărginean CO. Worldwide Prevalence and Risk Factors of Helicobacter pylori Infection in Children. CHILDREN 2022; 9:children9091359. [PMID: 36138669 PMCID: PMC9498111 DOI: 10.3390/children9091359] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/22/2022] [Accepted: 09/03/2022] [Indexed: 01/17/2023]
Abstract
Helicobacter pylori is usually acquired during childhood. The reports from the last two decades pointed out a decrease in H. pylori prevalence across geographical areas worldwide compared to previously reported data. Most of the studies performed in America found an overall H. pylori infection prevalence of approximately 50%. The most important risk factors in America include being male, poor adherence or difficult access to treatment, and the lack of in-home water service. Despite the descending trend in prevalence worldwide, the overall prevalence in Africa remains very high (70%). Nevertheless, the prevalence of H. pylori in children without gastrointestinal who underwent screening was reported to be only 14.2%. The main risk factors in Africa are having a traditional pit or no toilet, poverty, birth order, source of drinking water, or being a farmer. Asia seems to have the widest variations in terms of H. pylori prevalence. Several risk factors were reported in Asia to be associated with this infection, such as lower income and educational level, house crowding, rural residence, ethnicity, the use of tanks as water supplies, alcohol drinking, active smoking, eating spicy food or raw uncooked vegetables, poor living conditions and sanitation. The overall prevalence of H. pylori infection in European children is almost 25%. Portugal has the highest prevalence of all European countries at 66.2% in children 13 years of age. The risk factors in European individuals consist of living in rural areas, eating unwashed fruits and vegetables, not washing hands after school, low parental education and unemployment, and short education duration. Further studies are required to identify the precise mechanisms involved in the discrepancies of H. pylori prevalence worldwide.
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Tran V, Saad T, Tesfaye M, Walelign S, Wordofa M, Abera D, Desta K, Tsegaye A, Ay A, Taye B. Helicobacter pylori (H. pylori) risk factor analysis and prevalence prediction: a machine learning-based approach. BMC Infect Dis 2022; 22:655. [PMID: 35902812 PMCID: PMC9330977 DOI: 10.1186/s12879-022-07625-7] [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: 08/18/2021] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background Although previous epidemiological studies have examined the potential risk factors that increase the likelihood of acquiring Helicobacter pylori infections, most of these analyses have utilized conventional statistical models, including logistic regression, and have not benefited from advanced machine learning techniques. Objective We examined H. pylori infection risk factors among school children using machine learning algorithms to identify important risk factors as well as to determine whether machine learning can be used to predict H. pylori infection status. Methods We applied feature selection and classification algorithms to data from a school-based cross-sectional survey in Ethiopia. The data set included 954 school children with 27 sociodemographic and lifestyle variables. We conducted five runs of tenfold cross-validation on the data. We combined the results of these runs for each combination of feature selection (e.g., Information Gain) and classification (e.g., Support Vector Machines) algorithms. Results The XGBoost classifier had the highest accuracy in predicting H. pylori infection status with an accuracy of 77%—a 13% improvement from the baseline accuracy of guessing the most frequent class (64% of the samples were H. Pylori negative.) K-Nearest Neighbors showed the worst performance across all classifiers. A similar performance was observed using the F1-score and area under the receiver operating curve (AUROC) classifier evaluation metrics. Among all features, place of residence (with urban residence increasing risk) was the most common risk factor for H. pylori infection, regardless of the feature selection method choice. Additionally, our machine learning algorithms identified other important risk factors for H. pylori infection, such as; electricity usage in the home, toilet type, and waste disposal location. Using a 75% cutoff for robustness, machine learning identified five of the eight significant features found by traditional multivariate logistic regression. However, when a lower robustness threshold is used, machine learning approaches identified more H. pylori risk factors than multivariate logistic regression and suggested risk factors not detected by logistic regression. Conclusion This study provides evidence that machine learning approaches are positioned to uncover H. pylori infection risk factors and predict H. pylori infection status. These approaches identify similar risk factors and predict infection with comparable accuracy to logistic regression, thus they could be used as an alternative method. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07625-7.
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Affiliation(s)
- Van Tran
- Department of Mathematics, Colgate University, 13 Oak Dr., Hamilton, NY, USA
| | - Tazmilur Saad
- Department of Mathematics, Colgate University, 13 Oak Dr., Hamilton, NY, USA
| | - Mehret Tesfaye
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sosina Walelign
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Moges Wordofa
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dessie Abera
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassu Desta
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmet Ay
- Department of Mathematics, Colgate University, 13 Oak Dr., Hamilton, NY, USA. .,Department of Biology, Colgate University, 13 Oak Dr., Hamilton, NY, USA.
| | - Bineyam Taye
- Department of Biology, Colgate University, 13 Oak Dr., Hamilton, NY, USA.
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Genetic polymorphism relationship of four SNP in beta defensins genes 1 and 2 with susceptibility and effect of triple therapy of Helicobacter pylori infection in Iraq. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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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: 15] [Impact Index Per Article: 5.0] [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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