Prevalence of Helicobacter pylori infection and gastric preneoplastic lesions in patients admitted for upper gastro-intestinal endoscopy in Cotonou (Benin Republic)

Abstract

Infection with Helicobacter pylori (H. pylori) is common in developing countries such as Benin. This germ can cause several gastroduodenal diseases such as gastritis, ulcer, adenocarcinoma or gastric MALT lymphoma. This study aimed to determine the prevalence of H. pylori infection and gastric pre-neoplastic histological lesions in patients admitted for upper gastrointestinal endoscopy (UGE) and to identify factors associated with this infection.Methods: This was a cross-sectional descriptive and analytical study, with prospective data collection, conducted from October 2014 to December 2015. We included all patients admitted to Menontin Hospital for UGE in whom a gastric biopsy has been done. H. pylori research was conducted in anatomy-pathology, either in a medical laboratory in Cotonou or at the CERBA laboratory in Paris, France, depending on the patient's choice. The microscopic study was carried out after staining with Haematoxyline-Eosine-Safran (HES) and the search for H. pylori using Giemsa staining.Results: H. pylori was investigated in 137 patients, 67 men (48.9%) and 70 women (51.1%). The mean age was 48.3±14.6years with extremes of 10 and 83years. Some patients had had at least one previous H. pylori eradication treatment (63 cases or 46%). For the general population, the test was positive in 98 cases, i.e. a prevalence of 71.5%. Depending on whether or not patients had been pre-treated for H. pylori, the test was positive in 40 out of 63 (63.5%) pre-treated patients, versus 58 out of 74 (78.4%) patients who were naïve to any eradication treatment (p=0.057). The pre-neoplastic lesions noted were gastric atrophy in 35 patients (including 25 H. pylori positive), intestinal metaplasia in 13 patients (including 10 H. pylori positive) and low grade dysplasia in 14 patients (including 12 H. pylori positive); high grade dysplasia was found in one patient who was H. pylori negative. Only the type of prior eradicant treatment appeared to be associated with H. pylori infection (p=0.182). Conclusion:H. pylori infection is common in our patients admitted for upper gastrointestinal endoscopy. Gastric atrophy was the most common pre-neoplastic lesion.

<b><i>Helicobacter pylori</i></b> Infection in Africa: Update of the Current Situation and Challenges

“…Furthermore, a prevalence of 64.6% in children with risk factors of overcrowding, patronizing of food vendors, and illiteracy was reported in Egypt [36]. In the Republic of Benin, a 71.5% prevalence rate was reported but was not associated with age, sex, marital status, religion, occupation, or education [37]; 73.2% in Cameroon with a significant association with age, socioeconomic status, alcohol, family history, and nonsteroidal anti-inflammatory drugs and similarly anemia, duodenal ulcer, and chronic gastritis have been reported as common in patients with H. pylori infection [38]; and 71.43% prevalence rate was published in Algeria [39]. In a research conducted in Ethiopia, 88.9% H. pylori prevalence was reported in male individuals, while 82.8% was in female individuals [40].…”

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“…20,24 Meanwhile, the study of Agbor et al and Kpossou et al found a similar HPI prevalence in both gender. 21,23 These differences observed could be explain by the sample size and the study population. Furthermore, these differences may be due to improvement in the socioeconomic and hygiene conditions of the population over time according to.…”

“…22 Despite the small sample size, several studies conducted in SSA show the large representation of the females than the males. 21,23 The rate of antibodies anti-H. pilory (IgG) was 66.90% (95/142). In comparaison to other studies conducted in Cameroon, this result is higher than that found by Agbor et al 21 and similar to that found by Laure Brigitte et al 24 who reported a HPI seroprevalence of 43.4% (217/500) and 64.39% (132/205) respectively.…”

<i>Helicobacter pylori</i> Diagnosis and Treatment in Africa: The First Lagos Consensus Statement of the African Helicobacter and Microbiota Study Group

“…Prevalence data published between 2014 and 2020 in Burundi, Rwanda, Congo-Brazzaville, and Cameroon have been reported to be 70.8%, 75%, 93.1%, and 73.2%, respectively [22][23][24][25]. Regions in West Africa, including Nigeria, Ghana, Togo, and the Republic of Benin, have reported prevalence of 87.8%, 88%, 70.41%, and 71.5%, respectively [26][27][28][29]. Prevalence as high as 71.43% has been reported in Algeria, 63.8% in Morocco, and 64.6% in Egypt, all located in the northern part of Africa [30][31][32].…”