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Abstract
ABSTRACT
Background and aim. Helicobacter pylori (Hp) chronic gastritis (CG) promotes gastroduodenal ulcers (GDU) and precancerous lesions (gastric intestinal atrophy and metaplasia). The aim of our study was to evaluate the prevalence of GDU and precancerous gastric lesions in patients with CG at Hp in Abidjan. Patients and Methods. This was a prospective study conducted from 9 February to 9 August 2002 at the Yopougon University Hospital Center. Ninety patients who came to perform a gastroscopy had gastric biopsies. Only those with CG were included in the study The prevalence of GDU and precancerous gastric lesions were determined. Results. HP CG was observed in 57.8% of cases (n = 52). The sex ratio and mean age of the patients were 0.79 and 37.5 ± 14.2 years, respectively. Epigastralgia was the main reason for endoscopy (82.7% of cases, n = 43). An ulcer was seen in the duodenum in 11 patients (21.1%) and in the stomach for 3 patients (5.8%). The mucosa of the antrum was normal at endoscopy in 73.1% (n = 38) of cases, while the fundal mucosa was normal for 76.9% (n = 40) of cases. Chronic atrophic gastritis was present in 84.6% of cases (n = 44) at the antrum and in 61.8% (n = 8) of cases for the fundus. Gastric intestinal metaplasia was present in 3.8% of cases (n = 32) and was limited to the antrum. Conclusion. GDU and gastric pre-cancerous lesions are common in black African during endoscopy. Gastric biopsies should be the rule for any gastroscopy even in the absence of endoscopic lesions.
RÉSUMÉ
Contexte et objectif. La gastrite chronique (GC) à Helicobacter pylori (Hp) favorise les ulcères gastroduodénaux (UGD) et les lésions précancéreuses (atrophie et métaplasie intestinale gastriques). L’objectif de notre étude était d’évaluer la prévalence des (UGD) et des lésions précancéreuses gastriques chez les malades porteurs de GC à Hp à Abidjan. Patients et Méthodes. Il s’est agit d’une étude prospective réalisée du 9 février au 9 Aout 2002 au centre hospitalier universitaire de Yopougon. Quatre-vingt-dix patients venus réaliser une gastroscopie ont été tiré au sort. Tous ont eu des biopsies gastriques. Ceux ayant une GC à Hp à l’histologie ont été inclus dans l’étude. Chez tous, la prévalence des UGD et des lésions précancéreuses gastriques a été déterminée. Résultats. Une GC à Hp a été observé dans 57,8% des cas (n = 52). Le sex ratio et la moyenne d’âge des patients était respectivement de 0,79 et de 37,5± 14,2 ans. Les épigastralgies constituaient le principal motif de l’examen endoscopique (82,7% des cas ; n=43). Un ulcère a été visualisé au niveau duodénal chez 11 patients (21,1%) et gastrique chez 3 patients (5,8%). La muqueuse gastrique était endoscopiquement normale dans 73,1% (n=38) des cas au niveau de l’antre et 76,9% (n=40) des cas au niveau du fundus. La gastrite chronique atrophique était présente dans 84,6% des cas (n= 44) au niveau antral et fundique dans 61,8% (n = 8) des cas. La métaplasie intestinale gastrique était présente dans 3,8% des cas (n = 32) et uniquement au niveau antral. Conclusion. Les UGD et les lésions pré cancéreuses gastriques sont fréquents en milieu endoscopique africain noir. Les biopsies gastriques devraient y être la règle lors de toute gastroscopie même en l’absence de lésion endoscopique.
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References
- Marshall BJ, Warren JR: Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet,1984;1;1311-1315.
- Hooi JKY, Lai WY, Ng WK, Suen MMY et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017 Aug;153(2):420-429.
- Smith SI, Seriki A, Ndip R, Pellicano R. Helicobacter pylori infection in Africa: 2018 literature update. Minerva Gastroenterol Dietol. 2018 Sep;64(3):222-234.
- Tytgat GN. Review article: practical management issues for the Helicobacter pylori-infected patients at risk of gastric cancer. .Aliment Pharmacol Ther 1998; 12 (suppl1):123-128.
- Timothy N Archampong, Richard H Asmah, Cathy J Richards et al. Gastro-duodenal disease in Africa: Literature review and clinical data from Accra, Ghana. World J. Gastroenterol. 2019 Jul 14; 25(26): 3344–3358.
- Smith S, Fowora M, Pellicano R. Infections with Helicobacter pylori and challenges encountered in Africa. World J Gastroenterol. 2019 Jul 7;25(25):3183-3195.
- Correa P. A human model of gastric carcinogenesis. Cancer Res. 1988; 48:3554–3560.
- M. Dinis-Ribeiro, M. Areia, A. C. de Vries et al. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Socieda de Portuguesa de Endoscopia Digestiva (SPED). Endoscopy. 2012 Jan; 44(1): 74–94.
- Obayo S, Muzoora C, Ocama P, Cooney MM, Wilson T, Probert CS. Upper gastrointestinal diseases in patients for endoscopy in South-Western Uganda. Afr Health Sci. 2015 Sep;15 (3):959-66.
- Jaka H, Mushi MF, Mirambo MM et al. Sero-prevalence and associated factors of Helicobacter pylori infection among adult patients with dyspepsia attending the gastroenterology unit in a tertiary hospital in Mwanza, Tanzania. Afr Health Sci. 2016 Sep;16 (3):684-689.
- Attia KA, N'dri Yoman T, Diomandé MI et al. Clinical, endoscopic and histologic aspects of chronic Helicobacter pylori gastritis in Côte d'Ivoire: study of 102 patients. Bull Soc Pathol Exot. 2001 Mar; 94 (1):5-7.
- Eloumou Bagnaka SA, Luma Namme H, Noah Noah D, et al.. Risk factors associated with gastroduodenal lesions in a Douala referral hospital (Cameroon)]. Med Sante Trop. 2016 Jan-Mar; 26 (1):104-9.
- Kamdem J, Palmer D, Barrier C, Bardin R, Brown JA, Topazian M. Diagnostic yield of gastrointestinal endoscopy in North West Region Cameroon and trends in diagnosis over time. Pan Afr Med J. 2018:27; 29:178.
- Ijarotimi O1, Soyoye DO, Adekanle O, Ndububa DA, Umoru BI, Alatise OI. Declining prevalence of duodenal ulcer at endoscopy in Ile-Ife, Nigeria. S Afr Med J. 2017 Aug 25;107(9):750-753.
- Diomande MI1, Fléjou JF, Potet F et al. Chronic gastritis and Helicobacter pylori infection on the Ivory Coast. A series of 277 symptomatic patients. Gastroenterol Clin Biol. 1991; 15 (10):711-6.
- Aduful HK, Naaeder SB, Darko R, Baa et al. Upper gastrointestinal endoscopy at the Korle Bu Teaching Hospital Accra, Ghana. Ghana Med J. 2007; 41(1):12–16.
- Jaka H, Mushi MF, Mirambo MM, Wilson L, Seni J, Mtebe M, Mshana SE. Sero-prevalence and associated factors of Helicobacter pylori infection among adult patients with dyspepsia attending the gastroenterology unit in a tertiary hospital in Mwanza, Tanzania. Afr Health Sci. 2016 Sep;16(3):684-689.
- Doh K, Thiam I, Halim A, Takin R.C, Woto-Gaye G. Panorama histopathologique des gastrites chroniques en cas d'endoscopie normale au Sénégal Me´decine et Sante´ Tropicales 2017 ; 27 : 439-442.
- Nwokediuko SC, Ijoma U, Obienu O, Picardo N. Time trends of upper gastrointestinal diseases in Nigeria. Ann Gastroenterol 2012 ; 25 : 1-9.
- Diouf M, Ondele-ipogo A, Dia D. Evolution de la pre´valence des ulce`res gastroduode´naux dans le centre d’endoscopie digestive de l’Hoˆpital Aristide-le-Dantec de Dakar. J Afr Gastroenterol 2011 ; 5 : 23-7. 10.
- Ankouane F, Noah Noah D, Ntoné Enyime F et al. Helicobacter pylori and precancerous conditions of the stomach: the frequency of infection in a cross-sectional study of 79 consecutive patients with chronic antral gastritis in Yaoundé, Cameroon. Pan Afr Med J. 2015 ; 20 : 52.
- Papatheodoridis GV, Sougioultzis S, Archimandritis AJ. Effects of Helicobacter pylori and nonsteroidal anti-inflammatory drugs on peptic ulcer disease: a systematic review. Clin Gastroenterol Hepatol. 2006;4(2):130.
- Lahner E, Esposito G, Zullo A, Hassan C, Carabotti M, Galli G, Annibale B. Gastric precancerous conditions and Helicobacter pylori infection in dyspeptic patients with or without endoscopic lesions. Scand J Gastroenterol. 2016 Nov;51(11):1294-8.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Personal habits and indoor combustions. Volume 100 E. A review of human carcinogens. IARC Monogr Eval Carcinog Risks Hum. 2012;100:1–538
References
Marshall BJ, Warren JR: Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet,1984;1;1311-1315.
Hooi JKY, Lai WY, Ng WK, Suen MMY et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017 Aug;153(2):420-429.
Smith SI, Seriki A, Ndip R, Pellicano R. Helicobacter pylori infection in Africa: 2018 literature update. Minerva Gastroenterol Dietol. 2018 Sep;64(3):222-234.
Tytgat GN. Review article: practical management issues for the Helicobacter pylori-infected patients at risk of gastric cancer. .Aliment Pharmacol Ther 1998; 12 (suppl1):123-128.
Timothy N Archampong, Richard H Asmah, Cathy J Richards et al. Gastro-duodenal disease in Africa: Literature review and clinical data from Accra, Ghana. World J. Gastroenterol. 2019 Jul 14; 25(26): 3344–3358.
Smith S, Fowora M, Pellicano R. Infections with Helicobacter pylori and challenges encountered in Africa. World J Gastroenterol. 2019 Jul 7;25(25):3183-3195.
Correa P. A human model of gastric carcinogenesis. Cancer Res. 1988; 48:3554–3560.
M. Dinis-Ribeiro, M. Areia, A. C. de Vries et al. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Socieda de Portuguesa de Endoscopia Digestiva (SPED). Endoscopy. 2012 Jan; 44(1): 74–94.
Obayo S, Muzoora C, Ocama P, Cooney MM, Wilson T, Probert CS. Upper gastrointestinal diseases in patients for endoscopy in South-Western Uganda. Afr Health Sci. 2015 Sep;15 (3):959-66.
Jaka H, Mushi MF, Mirambo MM et al. Sero-prevalence and associated factors of Helicobacter pylori infection among adult patients with dyspepsia attending the gastroenterology unit in a tertiary hospital in Mwanza, Tanzania. Afr Health Sci. 2016 Sep;16 (3):684-689.
Attia KA, N'dri Yoman T, Diomandé MI et al. Clinical, endoscopic and histologic aspects of chronic Helicobacter pylori gastritis in Côte d'Ivoire: study of 102 patients. Bull Soc Pathol Exot. 2001 Mar; 94 (1):5-7.
Eloumou Bagnaka SA, Luma Namme H, Noah Noah D, et al.. Risk factors associated with gastroduodenal lesions in a Douala referral hospital (Cameroon)]. Med Sante Trop. 2016 Jan-Mar; 26 (1):104-9.
Kamdem J, Palmer D, Barrier C, Bardin R, Brown JA, Topazian M. Diagnostic yield of gastrointestinal endoscopy in North West Region Cameroon and trends in diagnosis over time. Pan Afr Med J. 2018:27; 29:178.
Ijarotimi O1, Soyoye DO, Adekanle O, Ndububa DA, Umoru BI, Alatise OI. Declining prevalence of duodenal ulcer at endoscopy in Ile-Ife, Nigeria. S Afr Med J. 2017 Aug 25;107(9):750-753.
Diomande MI1, Fléjou JF, Potet F et al. Chronic gastritis and Helicobacter pylori infection on the Ivory Coast. A series of 277 symptomatic patients. Gastroenterol Clin Biol. 1991; 15 (10):711-6.
Aduful HK, Naaeder SB, Darko R, Baa et al. Upper gastrointestinal endoscopy at the Korle Bu Teaching Hospital Accra, Ghana. Ghana Med J. 2007; 41(1):12–16.
Jaka H, Mushi MF, Mirambo MM, Wilson L, Seni J, Mtebe M, Mshana SE. Sero-prevalence and associated factors of Helicobacter pylori infection among adult patients with dyspepsia attending the gastroenterology unit in a tertiary hospital in Mwanza, Tanzania. Afr Health Sci. 2016 Sep;16(3):684-689.
Doh K, Thiam I, Halim A, Takin R.C, Woto-Gaye G. Panorama histopathologique des gastrites chroniques en cas d'endoscopie normale au Sénégal Me´decine et Sante´ Tropicales 2017 ; 27 : 439-442.
Nwokediuko SC, Ijoma U, Obienu O, Picardo N. Time trends of upper gastrointestinal diseases in Nigeria. Ann Gastroenterol 2012 ; 25 : 1-9.
Diouf M, Ondele-ipogo A, Dia D. Evolution de la pre´valence des ulce`res gastroduode´naux dans le centre d’endoscopie digestive de l’Hoˆpital Aristide-le-Dantec de Dakar. J Afr Gastroenterol 2011 ; 5 : 23-7. 10.
Ankouane F, Noah Noah D, Ntoné Enyime F et al. Helicobacter pylori and precancerous conditions of the stomach: the frequency of infection in a cross-sectional study of 79 consecutive patients with chronic antral gastritis in Yaoundé, Cameroon. Pan Afr Med J. 2015 ; 20 : 52.
Papatheodoridis GV, Sougioultzis S, Archimandritis AJ. Effects of Helicobacter pylori and nonsteroidal anti-inflammatory drugs on peptic ulcer disease: a systematic review. Clin Gastroenterol Hepatol. 2006;4(2):130.
Lahner E, Esposito G, Zullo A, Hassan C, Carabotti M, Galli G, Annibale B. Gastric precancerous conditions and Helicobacter pylori infection in dyspeptic patients with or without endoscopic lesions. Scand J Gastroenterol. 2016 Nov;51(11):1294-8.
IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Personal habits and indoor combustions. Volume 100 E. A review of human carcinogens. IARC Monogr Eval Carcinog Risks Hum. 2012;100:1–538