Prevalence of Helicobacter Pylori among Patients undergoing Gastrodudenoscopy in a Hospital in Western Nepal

Abstract

Introduction: Helicobacter pylori (H. pylori) related chronic gastritis is a major health problem worldwide, specially in the developing countries. The prevalence of H. pylori infection has been reported to vary between and even within countries. There are limited data on this infection in Western Nepal. Our objective was to study the prevalence of H. pylori infection and its association with presenting complains and upper gastrointestinal diseases.
 Methods: Medical records of patients undergoing gastrodudenoscopy and biopsy for various upper gastrointestinal symptoms from 1st of January 2015 to 30th of June 2017 were reviewed for presence of H. pylori infection, demographics, indications for gastrodudenoscopy, and histopathology findings. T-test, Chi-square test, and Fisher exact test were applied.
 Results: Two hundred fifty six patients (135 male and 121 female) with a mean age of 47 (SD = 16.5) underwent gastroscopic biopsy and had an overall H. pylori prevalence of 24.6%. H. pylori infection was most commonly noted between 41 to 60 years of age. Gender did not seem to be significantly associated (p = 0.82) but gastrointestinal bleed was significantly associated with H. pylori infection (p = 0.006). The most common histopathological diagnosis was gastritis followed by gastrodudenitis; however, none of the diagnosis were found to be significantly associated with H. pylori infection.
 Conclusion: The overall prevalence of H. pylori infection was 24.6% and was most common between 40 to 60 years of age. Heart burn was the most common symptom and gastrointestinal bleed was the only significantly associated symptom with H. pylori infection.

Helicobacter Pylori Infection Among Patients Undergoing Upper Gastrointestinal Endoscopy For Dyspepsia

“…The majority of patients detected with H. pylori were from the age group of 41-60 years in the current study. The prevalence of H. pylori was, similarly higher in the same age group by Shakya et al 8 Our study did not show any significant difference in H. pylori prevalence among the gender. This was consistent with the previously published studies.…”

“…This was consistent with the previously published studies. [7][8][9] A study by Adlekha et al from India and KC et al from Nepal also showed no significant sex predilection for H. pylori infection. 10,11 The prevalence of H. pylori in patients with dyspepsia was 53.2% in the current study.…”

“…by Shrestha et al and as low as 24.6 % by Shakya et al respectively. 6,8 This difference in prevalence could be due to the use of various invasive and non-invasive tests performed for H. pylori detection in different studies. Some patients who were already on PPI or antibiotics may give false negative reports.…”

Noninvasive diagnosis of Helicobacter pylori among patients with dyspepsia

“…[11] The prevalence is lower compared to a similar study from low socioeconomic country Ethiopia (81%). [12] H. pylori was positive in 67% of chronic gastritis patients, significantly lower than that described by Shakya RP (90%) 10 and much higher than the other Nepalese study by Shrestha UK (41%) [11] and Shrestha S (44%). [8] Diagnostic accuracy of stool antigen test in our study showed lower sensitivity and specificity compared with histopathological examination than described by Gisbert JP et al, which showed a mean sensitivity, specificity, positive predictive value and negative predictive value of 91%, 93%, 92% and 87%, respectively.…”

“…However, this incidence is much higher than that in Lumbini region study from western Nepal. [10] Another study from Pokhara showed the overall prevalence of H. pylori to be only 29.4%. However, the prevalence was higher in symptomatic patients with gastritis, duodenitis, gastric and/or duodenal ulcers.…”