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Helicobacter pyrlori in Malawi, central Africa
A D Harries1, M Stewart, K M Deegan
1Liverpool School of Tropical Medicine, UK.
The Journal of Infection
|May 1, 1992
Summary
Helicobacter pylori infection is highly prevalent in Malawians with epigastric pain, affecting 88% of patients. Diagnosis methods varied in accuracy, highlighting the need for effective therapeutic strategies.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Medical Diagnostics
Background:
- Epigastric pain is a common symptom in Malawi, often linked to upper gastrointestinal issues.
- Helicobacter pylori (H. pylori) is a significant pathogen implicated in various gastrointestinal diseases.
- Understanding H. pylori prevalence and diagnostic accuracy is crucial for effective patient management in the region.
Purpose of the Study:
- To investigate the prevalence of H. pylori infection in adult Malawians presenting with chronic epigastric pain.
- To evaluate the diagnostic accuracy of different methods for H. pylori detection, including histology, culture, urease tests, and serology.
- To assess the antibiotic susceptibility patterns of H. pylori isolates and the correlation between infection and endoscopic findings.
Main Methods:
- Endoscopic examination and serological testing were performed on 160 adult patients with epigastric pain.
- H. pylori detection utilized histology and/or culture, considered the gold standard.
- Antibiotic susceptibility testing (amoxycillin, tetracycline, metronidazole) and urease tests were conducted. The Helico-G test was used for serological assessment.
Main Results:
- H. pylori was detected in 141 (88%) of the patients.
- Histology demonstrated 100% sensitivity, while culture showed 81% sensitivity for H. pylori detection.
- Duodenal ulcer was present in 25% of patients, with 95% H. pylori positivity. Gastritis was common, with severe cases linked to higher H. pylori colonization. Urease tests were 100% specific. The Helico-G test had 98% sensitivity but only 27% specificity.
Conclusions:
- H. pylori infection is highly prevalent in Malawian patients with epigastric pain.
- Histology is a highly sensitive method for H. pylori diagnosis in this population. Urease tests are highly specific.
- Antibiotic susceptibility indicates sensitivity to amoxycillin and tetracycline, but resistance to metronidazole, informing future therapeutic strategies.