Survey on the prevalence of dyspepsia and practices of dyspepsia management in rural Eastern Uganda

Abstract

Aim To investigate the current prevalence and management of dyspepsia in rural Eastern Uganda. Methods Residents older than 18 years of age across 95 study sites in Namutumba District, Eastern Uganda were surveyed. Each respondent was administered a questionnaire about dyspepsia and pertinent health-seeking behaviors. Health workers at 12 different clinics were also assessed on their competence in managing dyspepsia. Proportion-based analysis was used to determine self-reported outcome variables reported in this study, including: prevalence of dyspepsia; breakdown of symptoms; initial diagnosis location; management strategies; and appropriate medication usage. Results 397 residents (average age of 41.2 years) participated in this study (54.4% males, 45.6% females). 57.9% self-reported currently having dyspepsia, of average duration 4.5 years. Of this subset, 87% reported experiencing epigastric pain, and 42.2% believed that ulcers were “wounds in the stomach.” Only 3% of respondents had heard of Helicobacter pylori (Hp) . Respondents varied in their management of dyspepsia, with frequent eating (39.1%), doing nothing (23.9%), and taking Western medicine (20%) being the most common strategies. The diagnosis of “peptic ulcer disease” was made by a health worker in 64.3% of cases, and 27% of cases were self-diagnosed. Notably, 70.3% of diagnoses at formal health centers were based on clinical symptoms alone and only 22.7% of respondents received treatment according to Ugandan Ministry of Health guidelines. Among the 12 health care workers surveyed, 10 cited epigastric pain as a common symptom of “ulcer,” although only two reported having heard of Hp. Only two out of 12 clinics had the capability to prescribe the triple therapy as treatment for presumed Hp. Conclusion There is a high incidence of dyspepsia in Eastern Uganda, and current management strategies are poor and inconsistent, and may contribute to antibiotic resistance. Further studies are needed to investigate the causes of dyspepsia to guide appropriate management.

The Burden of Gastrointestinal, Hepatobiliary and Pancreas Related Diseases and Their Causes at Tertiary Care Hospital in Karachi

“…This study also exhibited dyspeptic symptoms often found among females similar to an existing acquaintance. 17 Cholangitis of variable intensity includes mild, moderate or severe, need fluid and antibiotics administration along with biliary drainage endoscopically followed by cholecystectomy in patients with gallstone accordingly, Ahmed et al, 18 Metastatic disease adopted diverse notions for liver disease, including NAFLD, viral infection, cirrhosis, HCC and/or any combination. Wang et al higher incidence of simultaneous Liver metastasis in patients with HBsAg.…”

Evaluasi pola penggunaan obat dispepsia berdasarkan indikator WHO (World Health Organization) pada pasien rawat jalan Puskesmas Karang Taliwang tahun 2019

“…Penggunaan obat yang tidak tepat masih sering ditemukan di pusat-pusat kesehatan seperti rumah sakit dan puskesmas. Berdasarkan penelitian Lee et al (2019) menyatakan bahwa lebih dari sepertiga tripel terapi yang diberikan di pusat-pusat kesehatan tidak memadai meliputi durasi pengobatan yang tidak tepat atau dosis yang tidak mencukupi dari satu atau lebih komponen tripel terapi (Lee et al, 2019). Ketidaksesuaian terapi berdasarkan pedoman Formularium Nasional juga terjadi, berdasarkan hasil studi Musnelina dan Dewa (2019) menyatakan bahwa ketidaksesuaian indikasi terapi dispepsia di RS.Tk.IV Cijantung tahun 2016 sebesar 14,1% dengan pemberian jenis terapi berupa omeprazol.…”

High rates of gastroesophageal cancers in patients with dyspepsia undergoing upper gastrointestinal endoscopy in Uganda

“…Dyspepsia, which by definition is the presence of one or more of the symptoms of epigastric pain, bloating, post-prandial fullness, early satiation, and retrosternal pain 1 , is estimated to affect up to 50 % of individuals globally 2 with an estimated higher prevalence in low and middle income countries, particularly Africa with the highest prevalence of uninvestigated dyspepsia 3 . In one community study conducted in rural Uganda, more than 50 % of the respondents reported having had symptoms of dyspepsia 4 . The majority of dyspepsia in Africa is uninvestigated with patients often treated symptomatically.…”