DETERMINANTS OF HELICOBACTER PYLORI INFECTION AMONG ADULTS ATTENDING THE GENERAL OUTPATIENT CLINICS, FEDERAL MEDICAL CENTRE, ASABA, DELTA STATE, NIGERIA

Abstract

Helicobacter pylori (H. pylori) is the major aetiologic agent for Gastritis, Peptic Ulcer Disease (PUD), Gastric Cancer and Primary Gastric B-cell Lymphoma. Eradication of H.pylori has been shown to significantly improve the clinical conditions of patients with Gastritis and Peptic Ulcer Disease and lower the risk of recurrent peptic ulcer bleeding as well as Gastric Cancer. A review of the records at the Medical Records Unit at the Federal Medical Centre (FMC), Asaba, in January 2017 revealed that many patients attending the General Outpatient Clinic (GOPC) present with one or more symptoms suggestive of Gastritis or PUD but their H.pylori status is not known. This study was conducted to determine the sero-prevalence of H.pylori infection among patient attending the GOPC, FMC Asaba, identify the risk factors associated with H.pylori infection and the proportion of H. pylori seropositive patients who were symptomatic. This was a cross sectional study conducted among 232 patients presenting at the GOPC of the FMC, Asaba, Delta State. A structured interviewer administered questionnaire was used to obtain information on socio demographics, medical history, risk factors such as overcrowding, source of drinking water and personal hygiene, and results of H.pylori test. A one step serological method was used to test for H pylori status. Data were summarized using frequency tables and charts. Chi square test was used to determine risk factors that are significantly associated with the infection while logistic regression analysis was employed to obtain independent risk factors. All analysis was carried out at 5% level of significance. The mean age of respondents was of 36.8 (± 9.7) with range between 18 and 56 years. One hundred and fifty-six (67.2%) were married and 163 (70.3%) had university education. The symptom distribution among the respondents include epigastric pain (53%), bloating (29.7%), easy satiety (34.5%) and heart bum (32.7%). One hundred and thirty-two (56.9%) tested positive to H.pylori. The risk factors independently associated with H pylori infection include overcrowding - (AOR 3.3; 95% CI: 1.3 - 8.4), drinking water considered dirty or untreated in the past (AOR 35.3; 95% CI: 8.1 - 151), living in an overcrowded house after attaining 10 years of age (AOR 3.9; 95% CI: 1.6 - 9.6), sharing of cutlery with sibling as a child (AOR 17.5; 95% CI: 2.1 - 141) and a positive family history of Gastric Cancers (AOR 2.5; 95% CI: 1.9 - 7.0). More than half of the participants were H pylori positive and this is of public health concern. The risk factors are modifiable; hence intensified efforts should be given to health education of the populace. Opportunistic health education at the health facilities emphasising good hygiene, better living condition and provision of potable water as well as screening for Gastric Cancer are recommended.