Helicobacter pyrlori in Malawi, central Africa.
A total of 160 adult Malawians with epigastric pain for longer than 2 weeks was investigated by endoscopy and serologically for evidence of infection with Helicobacter pylori. The organism was demonstrated histologically and/or by culture in 141 (88%) patients. With histological means and/or culture as the 'gold standard', the histological technique was 100% sensitive while culture was only 81% sensitive. All isolates tested were sensitive to amoxycillin and tetracycline; 74% were resistant to metronidazole. Endoscopic findings were normal in 104 (65%) patients (86.5% H. pylori positive). Evidence of duodenal ulcer was found in 41 (25%) patients (95% H. pylori positive). Histologically, gastritis was common, severe gastritis being associated with increased colonisation by H. pylori. Two kinds of urease test were found to be 100% specific for the presence of H. pylori. The sensitivity of the serological test (Helico-G test) was 98% but its specificity was only 27%. These results provide important background information for planned therapeutic studies in patients with upper gastro-intestinal disease in Malawi.
Harries
A D
AD
Liverpool School of Tropical Medicine, UK.
Stewart
M
M
Deegan
K M
KM
Mughogho
G K
GK
Wirima
J J
JJ
Hommel
M
M
Hart
C A
CA
D000293:Adolescent; D000328:Adult; D000368:Aged; D004384:Duodenoscopy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008295:Malawi; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011795:Surveys and Questionnaires