title: Epidemiology of Helicobacter pylori infection in dyspeptic Ghanaian patients.
abstract: BACKGROUND
  Helicobacter pylori is a gram-negative urease-producing bacterium causally linked with gastritis, peptic ulcer disease and gastric adenocarcinoma. Infection is more frequent and acquired at an earlier age in developing countries compared to European populations. The incidence of Helicobacter pylori infection in dyspeptic Ghanaian patients was 75.4%. However, epidemiological factors associated with infection vary across populations.
  
  
  METHODS
  This study used a cross-sectional design to consecutively sample dyspeptic patients at the Endoscopy Unit of the Korle-Bu Teaching Hospital, Accra between 2010 and 2012. The study questionnaire elicited their epidemiological clinical characteristics. Helicobacter pylori infection was confirmed by rapid-urease examination of antral biopsies at upper Gastro-intestinal endoscopy.
  
  
  RESULTS
  The sample population of dyspeptic patients attending the Endoscopy Unit for upper GI endoscopy yielded 242 patients of which 47.5% were females. The age distribution of H. pylori-infection was even across most age - groups, ranging from 69.2% (61 - 70) years to 80% (21 - 30) years. Helicobacter pylori prevalence decreased across areas mapping to the three residential classes in accordance with increasing affluence with rural areas having the highest prevalence. The unemployed and patients in farming had relatively high Helicobacter pylori infection rates of 92.3% and 91.7% respectively.
  
  
  CONCLUSIONS
  Helicobacter pylori is endemic in Ghana but the persistently high prevalence across age groups despite significant community anti-microbial use suggests likely recrudescence or re-infection from multiple sources in a developing country. Socio-cultural factors such as residential class and farming may be facilitating factors for its continued prevalence.
authors.affiliation: Department of Medicine, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon Boundary, Accra, Ghana.
authors.forename: Timothy Nii Akushe
authors.initials: TN
authors.lastname: Archampong
authors.affiliation: Department of Medical Laboratory Sciences, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Legon Boundary, Accra, Ghana.
authors.forename: Richard Harry
authors.initials: RH
authors.lastname: Asmah
authors.affiliation: Department of Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon Boundary, Accra, Ghana.
authors.forename: Edwin Kwame
authors.initials: EK
authors.lastname: Wiredu
authors.affiliation: Department of Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon Boundary, Accra, Ghana.
authors.forename: Richard Kwasi
authors.initials: RK
authors.lastname: Gyasi
authors.affiliation: Department of Medicine, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon Boundary, Accra, Ghana.
authors.forename: Kofi Nyaako
authors.initials: KN
authors.lastname: Nkrumah
authors.affiliation: Department of Infection, Immunity and Inflammation, University of Leicester Medical School, Leicester LE1 9HN, United Kingdom ; Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, United Kingdom.
authors.forename: Kumar
authors.initials: K
authors.lastname: Rajakumar
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001706:Biopsy; D003430:Cross-Sectional Studies; D004415:Dyspepsia / Q000453:epidemiology* / Q000382:microbiology; D004651:Employment / Q000706:statistics & numerical data; D016099:Endoscopy, Gastrointestinal; D000067565:Farmers / Q000706:statistics & numerical data; D005260:Female; D005869:Ghana; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
keywords: Ghana; Helicobacter; dyspepsia; endoscopy; epidemiology; farming; social class