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Factors associated with peptic ulcer perforations in Uganda: a multi-hospital cross-sectional study
Isaac Edyedu1, Francis Xaviour Okedi2, Joshua Muhumuza3
1Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, PO. Box 70, Ishaka-Bushenyi, Uganda. edyeduisa@gmail.com.
Insights
Perforated peptic ulcers disproportionately affect males, peasants, and rural populations in Uganda. Public health efforts should target these groups, with anterior gastric perforations being most common, especially in peasant farmers.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Public Health
Background:
- Perforated peptic ulcer (PPU) is a severe complication of peptic ulcer disease (PUD).
- PPU burden is high in low-income regions, with limited data on its patterns.
- Understanding PPU patterns is crucial for targeted interventions in Uganda.
Purpose of the Study:
- To identify factors associated with PPU anatomical patterns.
- To describe clinical, socio-demographic, and anatomical characteristics of PPU patients in Uganda.
Main Methods:
- Cross-sectional study of 81 consecutive PPU patients.
- Data collected via structured questionnaires on socio-demographics and clinical characteristics.
- Surgical assessment of perforation patterns; logistic regression used for analysis.
Main Results:
- PPU predominantly affected males (79.5%), peasants (56.8%), and rural residents (65.4%).
- Gastric perforations (74.1%) were more common, primarily located anteriorly (81.5%).
- Casual laborers had lower odds of gastric perforation than peasant farmers (P<0.05).
Conclusions:
- Public health campaigns should focus on males, peasants, and rural populations for PPU prevention.
- Anterior gastric perforation is the most likely site in suspected PPU cases, particularly in peasant farmers.
- This study highlights key demographic and anatomical patterns for PPU management in Uganda.
Introduction:
Perforated peptic ulcer is the worst complication of peptic ulcer disease whose burden is disproportionately higher in low-income settings. However, there is paucity of published data on the patterns of perforated peptic ulcer in the region. The aim of this study was to determine the factors associated with anatomical patterns of peptic ulcer perforation, as well as the clinical, socio-demographic, and anatomical patterns among patients in Uganda.
Methods:
This was a cross sectional study that enrolled 81 consecutive patients with perforated peptic ulcers. Using a structured pretested questionnaire the social demographic and clinical characteristics were obtained. At surgery, the patterns of the perforations were determined. Logistic regression was done in SPSS version 22 to determine the factors associated with the anatomical patterns.
Results:
Perforated peptic ulcer disease was more prevalent among males (79.5%), peasants (56.8%) and those from rural areas (65.4%). Majority of study participants were of blood group O (43.2%). Gastric perforations were more common (74.1%). Majority of the perforations were found anteriorly (81.5%). Being a casual laborer was independently associated with lower odds of having a gastric perforation compared to being a peasant farmer (P < 0.05).
Conclusion:
Public health campaigns aimed at prevention of peptic ulcer perforations should prioritize the males, peasants and those living in rural areas. When a patient in our setting is suspected to have a peptic ulcer perforation, the anterior part of the stomach should be considered as the most likely site involved more so in peasant farmers.
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