Establishing a Consensus Algorithm for H. Pylori Screening, Diagnosis, Initial Management, and Referral Protocols for...

Area of Science:

• Gastroenterology
• Infectious Diseases
• Primary Care Medicine

Background:

• Helicobacter pylori (H. pylori) infection is a major cause of peptic ulcers and gastric cancer.
• High prevalence in Africa, with persistent diagnostic and treatment challenges in primary care.
• Need for effective H. pylori eradication strategies to prevent severe gastrointestinal complications.

Purpose of the Study:

• To develop a consensus-based algorithm for H. pylori management in primary care settings.
• To optimize H. pylori diagnosis and treatment using data from physicians, patient screening, and treatment outcomes.
• To provide a clinical decision-making guide for primary care physicians managing H. pylori infections.

Main Methods:

• Cross-sectional study involving 44 primary care physicians.
• Utilized data collection forms (DCF) and H. pylori rapid antibody test kits.
• Expert panel (family medicine, gastroenterology) used a modified Delphi process to create the algorithm based on physician data and test results.

Main Results:

• Study included 245 patients (female preponderance, mean age 35.0±11.5 years).
• Common symptoms: epigastric pain (74.5%), nausea/vomiting (52.7%), bloating (35%); mean symptom duration 3 weeks.
• 79.9% were treatment-naïve; 57.1% had positive antibody tests; recommended testing and eradication for persistent symptoms (>2 weeks) and specialist referral for alarm symptoms.

Conclusions:

• The proposed algorithm guides primary and secondary care physicians in selecting effective H. pylori treatment regimens.
• H. pylori antibody testing is recommended as a primary screening tool for persistent symptoms (>2 weeks).
• Confirmatory testing is advised for positive antibody tests to ensure accurate H. pylori diagnosis and management.