Helicobacter pylori infections in Ethiopia; prevalence and associated factors: a systematic review and meta-analysis

Abstract

BackgroundHelicobacter pylori (H.pylori) infections are prevalent and recognized as major cause of gastrointestinal diseases in Ethiopia. However, Studies conducted on the prevalence, risk factors and other clinical forms of H.pylori on different population and geographical areas are reporting conflicting results. Therefore, this review was conducted to estimate the pooled prevalence of H.pylori infections and associated factors in Ethiopia.MethodsPubMed, Embase, Google scholar, and Ethiopian Universities’ repositories were searched following the Preferred Items for Systematic review and Meta-analysis (PRISMA) guideline. The quality of included studies was assessed using the Newcastle-Ottawa Scale in meta-analysis. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics based on the random effects model. Comprehensive meta-analysis (CMA 2.0) and Review Manager (RevMan 5.3) were employed to compute the pooled prevalence and summary odds ratios of factors associated with of H.pylori infection.ResultsThirty seven studies with a total of 18,890 participants were eligible and included in the analysis. The overall pooled prevalence of H.pylori infection was 52.2% (95% CI: 45.8–58.6). In the subgroup analysis by region, the highest prevalence was found in Somalia (71%; 95% CI: 32.5–92.6) and the lowest prevalence was reported in Oromia (39.9%; 95% CI: 17.3–67.7). Absence of hand washing after toilet (OR = 1.8, 95% CI; 1.19–2.72), alcohol consumption (OR = 1.34, 95% CI; 1.03–1.74) and gastrointestinal (GI) symptoms (OR = 2.23, 95% CI; 1.59–3.14) were associated with H.pylori infection. The trend of H.pylori infection showed a decreasing pattern overtime from 1990 to 2017 in the meta-regression analysis.ConclusionThe prevalence of H.pylori infection remains high; more than half of Ethiopians were infected. Although the trend of infection showed a decreasing pattern; appropriate use of eradication therapy, health education primarily to improve knowledge and awareness on the transmission dynamics of the bacteria, behavioral changes, adequate sanitation, population screening and diagnosis using multiple tests are required to reduce H.pylori infections. Recognizing the bacteria as a priority issue and designing gastric cancer screening policies are also recommended.Electronic supplementary materialThe online version of this article (10.1186/s12876-018-0927-3) contains supplementary material, which is available to authorized users.

Review: Epidemiology of Helicobacter pylori infection

“…6 A high overall pooled H pylori prevalence was identified (52.2%), although a trend of decreasing incidence was observed over time . 6 A high overall pooled H pylori prevalence was identified (52.2%), although a trend of decreasing incidence was observed over time .…”

“…A systemic review with meta-analysis of 37 studies, with a total of 18 890 participants, addressed H pylori prevalence and risk factors for infection in Ethiopia. 6 A high overall pooled H pylori prevalence was identified (52.2%), although a trend of decreasing incidence was observed over time . Low hygienic standards, alcohol consumption, and the presence of gastrointestinal symptoms were associated with a higher risk of infection.…”

“…19 In Ethiopia, subjects who did not wash their hands after using the toilet were more likely to be infected (OR 1.8; 95% CI: 1.19-2.72; P = .005). 6 In United Arab Emirates, the prevalence of H pylori was significantly different (P = .001) in tap water drinking individuals compared to bottled water drinkers (58.6% and 36.7%, respectively). 7 A long-term sampling analysis of raw and drinking water for fecal indicator bacteria (FIB) and H pylori DNA was conducted in Bogota, Colombia.…”

Feco-prevalence of Helicobacter Pylori Infection and Associated Risk Factors Among Patients Living with HIV/AIDS on ART at Tefera Hailu Memorial General Hospital Sekota, Northeast Ethiopia

“…Its global estimate was reported at 48.5% while continental reports were 69.4% in South America, 37.1% in North America, 24.4% in Oceania, 54.6% in Asia, 47.0% in Europe and 79.1% in Africa (7)(8)(9). In addition, the overall pooled prevalence of H.pylori infection in a systematic review and meta analysis study was 52.2%, and a sub-group analysis indicated that the highest prevalence was recorded from the Amhara National Regional State (54.6%) (10).…”

“…The trend of H.pylori infection showed a decreasing pattern in the last three decades from 1990 to 2017; 64.4% in the rst decade (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000), 62.2% in the second decade (2001-2011) and 42.9% in the third decade (2012-2017). This decrement might be related with relative improvements in sanitation, water access, life style and behavioral changes, quality of life and socioeconomic status, and increased awareness on the transmission, diagnosis, eradication therapy, prevention and control of H.pylori infection (10).…”