Helicobacter pylori infection prevalence and associated factors among adults presenting with spontaneous gastroduodenal perforation: A cross-sectional study at a tertiary hospital in Lusaka, Zambia
Abstract
Background: Helicobacter pylori infection affects more than 50% of the global population and is a known causal factors for gastroduodenal ulcers. Gastroduodenal perforation is associated with high mortality. There is no published data on the association of H. pylori infection with gastroduodenal perforation in Zambia. We, therefore, set out to explore the prevalence of and risk factors for H. pylori infection among adults presenting with spontaneous gastroduodenal perforation at the University Teaching Hospital in Lusaka, Zambia.
Methods: This was a hospital-based, prospective, cross-sectional study carried out at the University Teaching Hospital in Lusaka, Zambia, from June 2018 through March 2019. Sixty adult patients were enrolled who had identifiable gastroduodenal perforation at emergency laparotomy for generalized acute peritonitis. H. pylori infection detection was carried out by histopathological examination of gastroduodenal specimens. Data were collected using a questionnaire. H. pylori prevalence and risk factors were analysed by predictive margins and multiple logistic regression analysis using Stata, version 15.
Results: There were 48 males and 12 females with a median age of 40 (interquartile range, 31-52) years. The prevalence of H. pylori infection in association with spontaneous gastroduodenal perforation was 11.7% (95% confidence interval, 8.5% to 14.9%). Predictive margins showed that patients with HIV and a history of nonsteroidal anti-inflammatory drug (NSAID) use had a 21.2% probability of H. pylori infection, while those with HIV and a history of peptic ulcer disease (PUD) had a probability of 46.1%.
Conclusions: The prevalence of H. pylori infection was 11.7% among patients with gastroduodenal perforation. The probability of H. pylori infection appeared to increase in association with HIV and NSAID use and further doubled among patients with both HIV and PUD. Further larger-scale multicentre studies in the region are warranted.
