Background The effectiveness of Helicobacter pylori (H. pylori) eradication depends on the treatment protocol. This study investigates the H. pylori eradication rate in Africa using the best available evidence from databases. Methods Databases were searched and results were pooled together. Heterogeneity between studies was assessed using I2 test statistics. Stata version 13 software was employed to compute the pooled eradication rate. In the subgroup analysis comparison, the finding is considered significant when the confidence intervals did not overlap. Results Twenty-two studies from 9 African countries with a total population of 2,163 were included in this study. The pooled eradication rate of H. pylori was 79% (95% CI: 75%-82%), heterogeneity (I2 = 93.02%). In the subgroup analysis by study design, a higher eradication rate was reported from observational studies (85%, 95% CI: 79%-90%), compared to randomized control trials (77%, 95% CI: 73%-82%); by the duration of therapy, higher eradication rate was reported in 10-days regimen (88%, 95% CI: 84%-92%), compared to 7-days regimen (66%, 95% CI: 55%-77%); by country, the highest eradication rate was found in Ethiopia (90%; 95% CI: 87%-93%) and the lowest eradication rate was reported in Ivory Coast (22.3%; 95% CI:15%-29%); by type of H. pylori test, the highest eradication rate was reported when rapid urease test coupled with histology (88%, 95% CI: 77%-96%), and the lowest eradication rate was reported with histology alone (22.3%; 95% CI:15%-29%). Significant heterogeneity was observed with pooled prevalence (I2 = 93.02%, P < 0.000). Conclusions In Africa, the first-line therapy showed a variable eradication rate for H. pylori. This study demonstrates the necessity to optimize current H. pylori treatment regimens in each country, taking into account the antibiotic susceptibility. Future RCT studies with standardized regimens are warranted.
Background The effectiveness of Helicobacter pylori (H. pylori) eradication depends on the treatment protocol. This study aimed to investigate the H. pylori eradication effectiveness in Africa using the best available evidence from databases. Methods PubMed, Google Scholar, Hinari, Scopus, and the directory of Open Access Journals (DOAJ) were searched. The quality of each included study was assessed using Cochrane risk-of-bias tool for randomized trials (RoB2) and Risk of Bias in Non-Randomized Studies of Intervention (ROBINS-I) for observational studies. Heterogeneity between studies was assessed using I2 test statistics based on the random effect model. Stata version 13 (College Station, Texas 77845 USA) software was employed to compute the pooled eradication rate. Forest plots and tables were used to present the data. Results Twenty-two studies from 9 African countries with a total population of 2,163 met the inclusion criteria and were included in the analysis. The pooled eradication rate of H. pylori by standard therapy was 79% (95% CI: 75%, 82%), with heterogeneity (I2 = 93.02%). In the subgroup analysis by study design, a higher eradication rate was reported from observational studies (85%, 95% CI: 79%-90%), compared to randomized control trials (77%, 95% CI: 73%-82%); by the duration of therapy, higher eradication rate was reported in 10-days regimen (88%, 95% CI: 84–92), compared to 7-days regimen (66%, 95% CI: 55–77); by country, the highest eradication rate was found in Ethiopia (90%; 95% CI: 87%-93%) and the lowest eradication rate was reported in Ivory Coast (22.3%; 95% CI:15%-29%); by type of H. pylori test, the highest eradication rate was reported when rapid urease test coupled with histology (88%, 95% CI: 77–96), and the lowest eradication rate was reported using histology alone (22.3%; 95% CI:15%-29%). Conclusions Eradication therapy for H. pylori in Africa had eradication rates that could be considered effective even in the lowest reported cases. This study demonstrates the necessity to optimize current H. pylori treatment regimens in each country, taking into account the antibiotic susceptibility of the bacteria.
Background: The increase in antimicrobial resistance worldwide has necessitated the search for alternative therapeutic agents. The leaf extracts of Ritchiea albersii and Cynoglossum amplifolium have been used as traditional medicine for the management of eye, ear and wound infections in Ethiopia. Objective: The objective of the study was to evaluate the antibacterial activity of R. albersii and C. amplifolium against three common bacteria. Materials and Methods: In this experimental study, the antimicrobial properties of 80% methanol, chloroform and acetone extracts of R. albersii and C. amplifolium were evaluated against two Gram-positive bacteria ( Staphylococcus aureus ATCC 25923 and Streptococcus pneumoniae ATCC 49619) and one Gram-negative bacterium ( Escherichia coli ATCC 25922) using the agar-well diffusion method. Ciprofloxacin 0.05 mg/disc was used as a positive control. Furthermore, a preliminary phytochemical study was carried out. Results: The zones of inhibition shown by all extracts of the two plants against the tested bacteria were significantly lesser ( P < 0.05) than the standard drug. E. coli and S. aureus were the most susceptible strains for most extracts studied. The acetone extract of R. albersii exhibited a higher inhibitory effect ( P < 0.05) against S. pneumoniae (16 mm) and E. coli (19 mm) compared with its methanol extract. The chloroform extract of R. albersii was more effective than its methanol extract ( P < 0.05) against all tested bacteria. The acetone extract of C. amplifolium displayed a higher inhibitory effect (20 mm) against E. coli than its methanol and chloroform extracts. Conclusions: The leaf extracts of R. albersii and C. amplifolium exhibited broad-spectrum antimicrobial activity, highlighting their potential as phytotherapeutic drugs in preventing and treating infections caused by S. aureus , S. pneumoniae and E. coli . Further investigations for isolating specific compounds and elucidating mechanisms are required to address the need for novel antibacterial drugs.
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