Burden of Helicobacter pylori Infections and Associated Risk Factors among Cases of Iron Deficiency Anaemia in Egypt

Abstract

Introduction: Iron deficiency anaemia (IDA) is a worldwide nutritional problem; it accounts for about half of the world’s anaemia burden. Globally, Helicobacter pylori (H. pylori) is becoming an increasingly troublesome economic and public health problem. The colonization of the organism in gastric mucosa may impair iron uptake and increase iron loss, potentially leading to iron deficiency anaemia. The mechanisms by which H. pylori is postulated to cause IDA are H. pylori -associated chronic gastritis resulting in hypo/or achlorhydria, reduced ascorbic acid secretion and reduced intestinal iron absorption, occult blood loss due to chronic erosive gastritis, and sequestration and utilization of iron by Helicobacter pylori.
 Aims: To detect H. pylori–related IDA prevalence among asymptomatic cases of anaemia and to address the possibility that such infection may play a detrimental role in their blood picture, serum iron and ferritin levels and total iron binding capacity (TIBC)
 Study Design & Methods: Facility based cross-sectional study was conducted in the period from December 2018 to May 2019. Screening was done for asymptomatic attendants of a number of private laboratories in Beheira, Alexandria and Gharbiya governorates. Three hundreds of whom were proved to be cases of IDA and were further tested for H. pylori antigen in stool.
 Results: Helicobacter pylori Ag test in stool was positive in 180 out of 300 cases of iron deficiency anaemia. The infection significantly affected the haemoglobin level, MCV, MCH and RDW in studied cases (p<0.05). Infection with H. pylori also significantly affected the serum iron, serum ferritin and TIBC in the studied cases of IDA (p<0.05).
 Conclusion: A significant association between H. pylori infection and IDA. Screening for H. pylori among unexplained cases of IDA is recommended.

Prevalence of Helicobacter pylori Infection among Anemic School-Age Children in Egypt: A Cross-Sectional Population-Based Study

“…Microcytic hypochromic anemia is the most common type (87.9%) in H. pylori-infected group in this study. This was consistent with El-Kady et al 63 who reported that H. pylori infection significantly affected the Hb level, MCV, MCH, and red blood cells distribution width in studied cases. Meanwhile, H. pylori infection significantly affected the serum iron, serum ferritin, and total iron-binding capacity (TIBC) in studied cases of IDA.…”

The Association between Helicobacter Pylori Infection and Iron Deficiency Anemia in Children: A Systematic Review and Meta-Analysis

“…There were eight cross-sectional studies, 15,17,18,[27][28][29][30][31] six RCTs, 13,[32][33][34][35][36] five case-control studies, 12,16,20,21,37 two surveys, 11,38 and one cohort study. 14 Only six studies reported participants' average age, hemoglobin, and serum ferritin levels 14,20,28,29,31,36 (►Table 2). All included studies were of high quality (►Table 3).…”

“…According to the World Bank classification of economic level, six studies 16,27,[31][32][33]35 with a total sample size of 2,086 were conducted in countries with lower middle incomes. In addition, eight studies 11,14,15,17,28,30,36,38 with a total sample size of 3,990 were from high incomes countries and eight 12,13,18,20,21,29,34,37 with a total sample size of 1,813 were from countries with upper middle incomes. Studies included in the meta-analysis were grouped according to the methods used to diagnose H. pylori.…”

“…Studies included in the meta-analysis were grouped according to the methods used to diagnose H. pylori. In total, 12 studies with a total sample size of 3,728 diagnosed H. pylori using ELISA, [11][12][13]16,17,[27][28][29][30][31]35,38 four studies with a total sample size of 2,295 used a breath test, 15,[32][33][34] and histological examination was used in six studies with a total sample size of 1,866. 14,18,20,21,36,37 ►Figs.…”