Prevalence and factors associated with Helicobacter pylori Infection in adults attending medical outpatient unit at Aden Abdulle Hospital, Mogadishu, Somalia

Abstract

Background: H. pylori is known to be a highly prevalent infection among persons in developing countries. It is an established etiologic agent for acute and chronic gastritis and a predisposing factor in peptic ulcer disease, gastric carcinoma and B-cell mucosaassociated lymphoid tissue (MALT) lymphoma. Despite its significant morbidity and mortality, data on the burden of this infection in many developing countries is lacking. Data on prevalence in Somalia and particularly among patients attending Aden Abdulle Hospital (AAH) medical outpatient unit was also lacking. Objectives: To determine the prevalence and factors associated with H. pylori infection among patients attending AAH medical outpatient unit. Study Design: A cross sectional study conducted at the Aden Abdulle hospital among outpatient attenders. Setting: AAH medical outpatient unit, a private Hospital in Mogadishu, Somalia. Patients and Methods: The study enrolled patients 18 years an above attending AAH medical outpatient unit. Those who had taken proton pump inhibitors, H2 receptor blockers, bismuth salts or antibiotics, and those who were not willing to consent were excluded. Patients who met the inclusion criteria had their demographic and other information that could lead to transmission taken. Stool samples were then collected using and tested using H pylori test kit cassette (Pylori K-SeT cassette, Gembloux, Belgium). The data were entered into Epidata version 3.1 by EpiData Association, Denmark analysed using StataSE version 12.0 by StataCorp USA Results: A total of 323 patients were studied, 131 (40.5%) were male and 192 (59.5%) were female. The median age was 38years (IQR=27 - 53). There were 2 age group peaks, 18 to 29 and ≥ 50 years. Among all patients, 138 (42.7%) of them were H. pylori positive and 61.6% of these were female. None of the factors (age, gender, residence, smoking, chewing Khat and clinical presentations) were associated with H. pylori infection in this study. Conclusion: The prevalence H. pylori in this study was 42.7%. None of the factors (age, gender, residence, smoking, chewing Khat and previous or current dyspeptic symptoms) were associated with H. pylori infection. Recommendation: Given a high prevalence in this study, doctors should be aware that their patients could be infected. They can use this noninvasive test which is readily available in the country and treat their patients accordingly. A larger study recruiting from the community will be important to determine the actual prevalence of infection in the community.