Helicobacter pylori prevalence in dyspeptic patients in the Eastern Cape province - race and disease status

Objectives. We examined Helicobacter pylori infection in patients with gastric-related morbidities at Livingstone Hospital, Port Elizabeth, to determine the prevalence and risk factors for infection according to race, endoscopic diagnosis, age and sex. Methods. Gastric biopsies were collected from 254 consecutive patients and H. pylori isolated on Columbia agar base supplemented with 7% sheep's blood and Skirrow's supplement containing trimethoprim (2.5 mg), vancomycin (5 mg) and cefsulodin (2.5 mg). Amphotericin (2.5 mg) was added to the medium. Recovered isolates were identified following standard microbiology and biochemical techniques. Presumptive isolates were further confirmed by polymerase chain reaction (PCR) targeting the glmM gene. Fisher's exact test was used to assess the univariate association between H. pylori infection and the possible risk factors. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated to measure the strength of association, using EPI INFO 3.41 software. P-values <0.05 were required for significance. Results. The overall prevalence of H. pylori was 66.1% (168/254). Of the 168 positive subjects, H. pylori prevalence was highest in patients with non-ulcer dyspepsia (NUD) (32.7%; 55/168), and lowest (0%; 0/168) in those with atypical oesophageal reflux disease and gastroduodenitis, respectively. The prevalence of infection was highest among coloureds (68.4%; 89/130) and lowest in whites (59.5%; 25/ 42). Prevalence increased with age. Conclusion. The prevalence of H. pylori is high in dyspeptic patients in Eastern Cape Province. Gender, antibiotic treatment and alcohol consumption may be risk factors for infection. These findings are of clinical and epidemiological significance.