title: 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.
abstract: BACKGROUND
  The study aimed at determining the different types of precancerous conditions of the stomach and searches the frequency of Helicobacter pylori in these lesions in patients with chronic antral gastritis in Yaounde, Cameroon.
  
  
  METHODS
  Five gastric biopsies were performed during upper gastrointestinal endoscopy for pathology and fixed in formol 10% before being coated in paraffin. Both the modified Giemsa and Periodic acid of Shift - Alkaline blue stains were used for the histological diagnosis of Helicobacter pylori infection. Hematoxylyn and eosin stain was used to determine the activity of gastritis, atrophic gastritis and intestinal metaplasia in accordance to the Sydney's classification of gastritis. Data were analysed using both the Epi info 6.04 and Excel 2007 softwares. Means and their standard deviations, medians and their interquartiles (IQR) were calculated. Proportions were established for qualitative variables and chi square analysis done in this study with a p value set at 0.05.
  
  
  RESULTS
  Seventy-nine patients with chronic antral gastritis were enrolled, of which 43 (54.4%) were male, median age: 43 years (range from 21 to 70 years). The rate of atrophic gastritis was 74.7% (59/79). The activity of atrophic gastritis was mild in 47.5% (28/59) of cases, moderate in 47.5% (28/59) and severe in 5% (5/59). Intestinal metaplasia and follicular gastritis were present in 6.3% (5/79), and 10.1% (8/79), respectively. Concerning Helicobacter pylori infection, 71.2% (42/59) of patients with atrophic gastritis tested positive against 28.8% (17/59) who tested negative (p=0.00003). Helicobacter pylori infection was related to the severity of gastric atrophy (p=0.0001). Among patients with intestinal metaplasia and follicular gastritis, the proportion of those who tested positive for Helicobacter pylori infection was 80% (4/5), and 75% (6/8), respectively. There were no significant differences in the occurrence of atrophic gastritis according to age groups (p=0.908).
  
  
  CONCLUSIONS
  This study concludes that atrophic gastritis, which is most often caused by Helicobacter pylori, is the most frequent precancerous condition of stomach in Cameroon. Routine gastric sampling for pathologic analysis is mandatory for effective diagnosis and surveillance of Helicobacter pylori infection and precancerous conditions of the stomach.
authors.affiliation: Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde 1, Cameroon.
authors.forename: Firmin
authors.initials: F
authors.lastname: Ankouane
authors.affiliation: Department of clinical sciences, Faculty of medicine and pharmaceutical sciences, University of Douala, Cameroon.
authors.forename: Dominique Noah
authors.initials: DN
authors.lastname: Noah
authors.affiliation: Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde 1, Cameroon.
authors.forename: Félicien Ntoné
authors.initials: FN
authors.lastname: Enyime
authors.affiliation: Department of morphological sciences, anatomy and pathology, Faculty of medicine and biomedical sciences, University of Yaounde 1, Cameroon.
authors.forename: Carole Menzy
authors.initials: CM
authors.lastname: Ndjollé
authors.affiliation: Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde 1, Cameroon.
authors.forename: Roger Nsenga
authors.initials: RN
authors.lastname: Djapa
authors.affiliation: Department of surgery and specialties, Faculty of medicine and biomedical sciences, University of Yaounde 1, Cameroon.
authors.forename: Bernadette Ngo
authors.initials: BN
authors.lastname: Nonga
authors.affiliation: Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde 1, Cameroon.
authors.forename: Oudou
authors.initials: O
authors.lastname: Njoya
authors.affiliation: Department of internal medicine and specialties, Faculty of medicine and biomedical sciences, University of Yaounde 1, Cameroon.
authors.forename: Elie Claude Ndjitoyap
authors.initials: EC
authors.lastname: Ndam
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005756:Gastritis / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D005757:Gastritis, Atrophic / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D055815:Young Adult
keywords: Cameroon; Helicobacter pylori; gastritis; intestinal metaplasia; precancerous conditions of the stomach