“…In addition, a review of the literature reveals that the several assumptions regarding peptic ulcer incidence in sub‐Saharan Africa have been based on clinical findings, X‐ray evidence, surgical experience and necroscopy examinations reported 20–30 years ago. 4,5 In spite of these difficulties, a review of the prospective, endoscopically based studies in the H. pylori era, albeit in subjects who have been selected by varying criteria which may represent a selection bias, is somewhat at odds with current perceptions. Indeed, it would appear that the organism’s association with gastritis in Africa is as strong as in the rest of the world and the available data generated in the endoscopy era suggest that the infection is strongly associated with PUD, while PUD itself may not be as rare as is commonly perceived.…”