title: Histopathological profile of gastritis in adult patients seen at a referral hospital in Kenya.
abstract: OBJECTIVE
  To conduct a detailed histological study of gastritis in adult patients attending an endoscopy clinic at a Kenyan teaching and referral hospital.
  
  
  METHODS
  Biopsy specimens from consecutive patients were examined and graded according to the Updated Sydney System for H pylori infection, chronic inflammation, neutrophil activity, glandular atrophy and intestinal metaplasia. Also documented were gastric tissue eosinophil counts and presence of lymphoid follicles.
  
  
  RESULTS
  The rate of the graded variables, in the antrum and corpus respectively, were as follows: H pylori infection (91%, 86%), chronic inflammation (98%, 93%), neutrophil activity (91%, 86%), glandular atrophy (57%, 15%) and intestinal metaplasia (11%, 2%). Lymphoid follicles were noted in 11% of cases. Duodenal and gastric ulcers were documented in 32% and 2% respectively. The mean eosinophil count was 5.9 +/- 0.74 eosinophils/HPF and 9.58 +/- 0.93 eosinophils/HPF in the corpus and antrum respectively. Significant association was found between the degree of H pylori colonisation with chronic inflammation, neutrophil activity and antral glandular atrophy. Biopsies from the antrum and corpus showed significant histopathological discordance for all the graded variables. H pylori negative cases were associated with recent antibiotic use.
  
  
  CONCLUSIONS
  The study reaffirms that H pylori is the chief cause of gastritis in this environment. The majority of patients show a moderate to high degree of inflammation but a low degree of glandular atrophy and intestinal metaplasia. The study shows that inter-relationships between the histological variables in this African population are similar to those found in other populations worldwide including non-African populations.
authors: Department of Pathology, University of Nairobi and Kenyatta National Hospital, Kenya. ahmedkalebi@yahoo.com
authors: Ahmed
authors: A
authors: Kalebi
authors: Farzana
authors: F
authors: Rana
authors: Walter
authors: W
authors: Mwanda
authors: Godfrey
authors: G
authors: Lule
authors: Martin
authors: M
authors: Hale
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003430:Cross-Sectional Studies; D005260:Female; D005756:Gastritis / Q000208:ethnology / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
references: Hum Pathol. 2001 Mar;32(3):247-9
references: 11274631
references: Trans R Soc Trop Med Hyg. 1994 Sep-Oct;88(5):569-71
references: 7992342
references: Curr Opin Gastroenterol. 2006 Nov;22(6):620-5
references: 17053439
references: QJM. 2001 Oct;94(10):561-5
references: 11588215
references: Am J Gastroenterol. 2002 Nov;97(11):2839-42
references: 12425557
references: Gut. 2006 Nov;55(11):1545-52
references: 16603635
references: East Afr Med J. 2002 Sep;79(9):454-6
references: 12625684
references: J Gastroenterol. 2004;39(4):324-8
references: 15168242
references: Gastroenterology. 2005 May;128(6):1567-78
references: 15887152
references: Helicobacter. 2001 Dec;6(4):263-7
references: 11843957
references: Helicobacter. 2005 Apr;10(2):107-13
references: 15810940
references: East Afr Med J. 1998 Feb;75(2):85-9
references: 9640829
references: J Gastroenterol Hepatol. 1999 Sep;14(9):851-8
references: 10535465
references: World J Gastroenterol. 2006 Jan 7;12(1):10-6
references: 16440410
references: Scand J Gastroenterol. 2005 May;40(5):523-9
references: 16036504
references: East Afr Med J. 2005 Dec;82(12):603-8
references: 16619703
references: Lancet. 1983 Jun 4;1(8336):1273-5
references: 6134060
references: J Pathol. 2006 Jan;208(2):233-48
references: 16362989
references: East Afr Med J. 2002 May;79(5):226-31
references: 12638804
references: Clin Exp Med. 2006 Oct;6(3):107-14
references: 17061058
references: Br J Cancer. 2001 Nov 2;85(9):1322-5
references: 11720468
references: Am J Clin Pathol. 1988 Oct;90(4):450-3
references: 2459956
references: Am J Surg Pathol. 1996 Oct;20(10):1161-81
references: 8827022
references: Eur J Gastroenterol Hepatol. 2000 Jun;12(6):617-21
references: 10912478