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Sharma P, Adhikari S, Katila S, Bajracharya A, Bohara N, Pathak S, Poudel P, Sapkota P. Helicobacter pylori Infection among Patients Undergoing Upper Gastrointestinal Endoscopy in a Tertiary Care Center. JNMA J Nepal Med Assoc 2024; 62:5-8. [PMID: 38410016 PMCID: PMC10924496 DOI: 10.31729/jnma.8393] [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: 12/29/2023] [Indexed: 02/28/2024] Open
Abstract
Introduction Helicobacter pylori is a gram-negative gut bacterium associated with dyspepsia, peptic ulcer disease, and gastric cancer, whose prevalence is still common in developing countries. Upper gastrointestinal endoscopy is the gold standard, first-line investigation for evaluating gastrointestinal disorders. The aim of the study was to find out the prevalence of Helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy in a tertiary care centre. Methods A descriptive cross-sectional study was conducted in a tertiary health care centre among the patients undergoing upper gastrointestinal endoscopy from 5 January 2020 to 5 January 2023 after obtaining ethical approval from the Institutional Review Committee. Convenience sampling method was used. The point estimate was calculated at a 99% Confidence Interval. Results Among 1,975 patients, Helicobacter pylori infection was found in 561 (28.41%) (25.79-31.03, 99% Confidence Interval). The indication for upper gastrointestinal endoscopy was mostly dyspepsia 256 (45.68%) followed by abdominal pain 205 (36.54%). The most common endoscopic finding was gastritis 445 (79.32%) followed by hiatal hernia 93 (16.58%). The commonest biopsy finding was chronic active gastritis 478 (85.20%). Conclusions The prevalence of Helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy was found to be similar to other studies done in similar settings. The persistence of H. pylori emphasizes the need of continuous research to address ever evolving H. pylori infections and resistance that are developing against available treatment modalities. Keywords endoscopy; Helicobacter pylori; upper gastrointestinal tract.
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Affiliation(s)
- Pasanda Sharma
- Department of Internal Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
| | - Samyog Adhikari
- Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
| | - Shreesuna Katila
- Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
| | - Aashra Bajracharya
- Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
| | - Nidhi Bohara
- Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
| | - Sujan Pathak
- Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
| | - Priyanka Poudel
- Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
| | - Prakash Sapkota
- Department of Internal Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
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Bhandari T, Laghu U, Ratna P, Shrestha R. Helicobacter Pylori Infection among Patients Attending the Gastroenterology Department in Tertiary Care Hospital, Kathmandu, Nepal. Int J Microbiol 2022; 2022:1508473. [PMID: 36406905 PMCID: PMC9671715 DOI: 10.1155/2022/1508473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 07/27/2023] Open
Abstract
Helicobacter pylori is one of the most pathogenic organisms that cause gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma in humans. The main aim of this study was to determine the H. pylori infection among patients undergoing upper GI endoscopy and to compare the efficacy of the diagnostic method of H. pylori infection including invasive tests (biopsy-based tests like the rapid urease test (RUT), direct smear, and culture) and the noninvasive test (HpSA). A total of 100 stool samples and 200 gastric biopsy specimens were collected (2 samples from each patient) from June to November 2019. Stool samples were processed for the detection of an H. pylori stool antigen (HpSA) by a kit method. One biopsy specimen was processed for the RUT, and another was transported to the laboratory in an Eppendorf tube containing normal saline for preparation of the smear and culture. Out of 100 participants, 26% were found to be H. pylori positive by the RUT, 11% by the direct smear, 6% by the culture, and 17% by the stool antigen test. The prevalence of H. pylori infection was found to be 14%, considering at least two of the three biopsy-based tests that gave positive results. H. pylori infection was found to be higher in the age group of 46-55 years. The overall prevalence of H. pylori infection was higher in gastric ulcer cases, followed by erosive pangastritis and gastroduodenitis. Tea drinking habits and the frequency of meal consumption more than twice a day were found to be significantly associated with H. pylori infection (P < 0.05). Hence, the RUT was found to be more efficient than the direct smear and the culture method for finding H. pylori in the biopsy sample. However, none of these methods can be considered to be the gold standard alone. Thus, the RUT combined with other tests is preferable for the detection of H. pylori.
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Affiliation(s)
- Tulasi Bhandari
- Department of Microbiology, St. Xavier's College, Tribhuvan University, Kathmandu, Nepal
| | - Ujjwal Laghu
- Grande International Hospital, Dhapasi, Kathmandu, Nepal
| | - Prem Ratna
- Grande International Hospital, Dhapasi, Kathmandu, Nepal
| | - Rajani Shrestha
- Department of Microbiology, St. Xavier's College, Tribhuvan University, Kathmandu, Nepal
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Doohan D, Fauzia KA, Rathnayake J, Lamawansa MD, Waskito LA, Tuan VP, Dashdorj A, Kabamba ET, Phuc BH, Ansari S, Akada J, Matsumoto T, Uchida T, Matsuhisa T, Yamaoka Y. Pepsinogen and Serum IgG Detection Is a Valuable Diagnostic Method for Helicobacter pylori Infection in a Low-Prevalence Country: A Report from Sri Lanka. Diagnostics (Basel) 2021; 11:diagnostics11081364. [PMID: 34441303 PMCID: PMC8391933 DOI: 10.3390/diagnostics11081364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 12/28/2022] Open
Abstract
The use of serum anti-Helicobacter pylori IgG and pepsinogen (PG) detection as a diagnostic method was evaluated in Sri Lanka. Gastric biopsies were performed (353 patients), and the prevalence of H. pylori infection was 1.7% (culture) and 2.0% (histology). IgG serology testing showed an area under the curve (AUC) of 0.922 (cut-off, 2.95 U/mL; specificity, 91.56%; sensitivity, 88.89%). Histological evaluation showed mild atrophy (34.3%), moderate atrophy (1.7%), metaplasia (1.7%), chronic gastritis (6.2%), and normal tissue (56%). The PGI/PGII ratio was significantly higher in H. pylori-negative patients (p < 0.01). PGII and PGI/PGII levels were lower in patients with metaplasia than in those with normal mucosa (p = 0.049 and p < 0.001, respectively). The PGI/PGII ratio best discriminated metaplasia and moderate atrophy (AUC 0.88 and 0.76, respectively). PGI and PGII alone showed poor discriminative ability, especially in mild atrophy (0.55 and 0.53, respectively) and chronic gastritis (0.55 and 0.53, respectively). The best cut-off to discriminate metaplasia was 3.25 U/mL (95.19% specificity, 83.33% sensitivity). Anti-H. pylori IgG and PG assessment (ABC method) was performed (group B, 2.0%; group A, 92.1%). The new cut-off more accurately identified patients with metaplasia requiring follow-up (group B, 5.4%). Assessment of anti-H. pylori IgG and PG is valuable in countries with a low prevalence of H. pylori infection.
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Affiliation(s)
- Dalla Doohan
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Kartika Afrida Fauzia
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Jeewantha Rathnayake
- Department of Surgery, Teaching Hospital Peradeniya, University of Peradeniya, Kandy 20404, Sri Lanka; (J.R.); (M.D.L.)
| | - Meegahalande Durage Lamawansa
- Department of Surgery, Teaching Hospital Peradeniya, University of Peradeniya, Kandy 20404, Sri Lanka; (J.R.); (M.D.L.)
| | - Langgeng Agung Waskito
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Vo Phuoc Tuan
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh 749000, Vietnam
| | - Azzaya Dashdorj
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
| | - Evariste Tshibangu Kabamba
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Research Center for Infectious Sciences, Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan
| | - Bui Hoang Phuc
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
| | - Shamshul Ansari
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Department of Microbiology, Teaching Hospital, Chitwan Medical College, Bharatpur 44200, Nepal
| | - Junko Akada
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
| | - Takashi Matsumoto
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
| | - Tomohisa Uchida
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan;
| | - Takeshi Matsuhisa
- Department of Gastroenterology, Tama Nagayama University Hospital, Nippon Medical School, Tokyo 206-8512, Japan;
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (D.D.); (K.A.F.); (L.A.W.); (V.P.T.); (A.D.); (E.T.K.); (B.H.P.); (S.A.); (J.A.); (T.M.)
- Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX 77030, USA
- Global Oita Medical Advanced Research Center for Health (GO-MARCH), Faculty of Medicine, Oita University, Yufu 879-5593, Japan
- Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60115, Indonesia
- Correspondence: ; Tel.: +81-97-586-5740
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Boltin D, Niv Y, Schütte K, Schulz C. Review: Helicobacter pylori and non-malignant upper gastrointestinal diseases. Helicobacter 2019; 24 Suppl 1:e12637. [PMID: 31486237 DOI: 10.1111/hel.12637] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 12/12/2022]
Abstract
This review covers recent publications investigating the relationship between Helicobacter pylori infection and gastroesophageal reflux disease, Barrett's esophagus, eosinophilic esophagitis, peptic ulcer disease (PUD), H pylori gastritis, and functional dyspepsia. In the area of gastroesophageal reflux disease, new data suggest that reflux may have a role in the transmission of H pylori infection. In addition to several observational studies, data on alterations in esophageal physiology in patients with H pylori infection are presented. Further evidence for the inverse relationship between H pylori infection and Barrett's esophagus is available in the form of a meta-analysis from the North American Barrett's and Esophageal Carcinoma Consortium. The relationship between H pylori infection and eosinophilic esophagitis remains uncertain. Although new data do not indicate a significantly lower prevalence of H pylori among patients with eosinophilic esophagitis, a meta-analysis showed a 37% reduced risk of eosinophilic esophagitis among H pylori-infected patients. Novel data are presented on the genetic variability of bacterial virulence factors and their relationship with PUD. We also report data on plasma biomarkers, which may detect progression to gastric cancer in H pylori-associated PUD. A new meta-analysis was published, which assessed the risk of PUD in low-dose aspirin users with H pylori infection. Finally, we report on the ongoing attempts to stratify patients with gastritis using endoscopic methods when compared to standard biopsy examination.
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Affiliation(s)
- Doron Boltin
- Division of Gastroenterology, Rabin Medical Center, Petah Tikva, and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaron Niv
- Division of Gastroenterology, Rabin Medical Center, Petah Tikva, and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Ministry of Health of Israel, Jerusalem, Israel
| | - Kerstin Schütte
- Department of Internal Medicine and Gastroenterology, Niels-Stensen-Kliniken, Marienhospital, Osnabrück, Germany
| | - Christian Schulz
- Medical Department II, University Hospital, LMU, Munich, Germany
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