Prevalence of Helicobacter pylori and Histopathological Features of Gastric Biopsies from Patients with Dyspeptic Symptoms in Cameroon: A Contraindication of African Enigma

Background: There is a contradictory observation referring as the “African enigma” illustrating that in sub-Saharan Africa where H. pylori infection prevalence is high, gastric cancer incidence is lower. The aim of this study was to establish the relationship between this infection and histopathological condition in gastric mucosa. Methods: This cross sectional study was conducted among dyspeptic patients attending Gastroenterology Unit in hospitals in Cameroon from October 2020 to October 2022. The study was approved by the Cameroon Ethical Committee of Medical Sciences. Gastric biopsies were collected from patient for H. pylori detection using both the rapid urease test and histological examination, and for the assessment of the different histological features of the gastric mucosa. Result: The prevalence of H. pylori was 57.89% among the 532 patients enrolled. Chronic gastritis, atrophic gastritis, intestinal metaplasia, dysplasia, and gastric cancer was found in 46.11, 18.74, 5.89, 14.95, and 4.00% of cases respectively. The rate of H. pylori infection was 55.25, 51.69, 60.71, 73.24, and 68.42% in patients with chronic gastritis, atrophic gastritis, intestinal metaplasia, dysplasia, and gastric cancer respectively (p= 0.0434). Infected participant were 1.223(0.8484-1.762), 1.363(0.8583-2.166), 1.132(0.5182-2.473), 2.221(1.268-3.893) and 1.604(0.5990-4.297) more time in risk to develop chronic gastritis, atrophic gastritis, metaplasia, dysplasia and gastric cancer respectively. Neutrophil activity were present in 57.89% of infected patients, of which 52.91, 61.35, and 59.38% cases were with mild, moderate, and severe activity respectively. Conclusion: Our findings showed that the prevalence of precancerous and cancerous lesions are slightly higher to those found in low risk groups for gastric cancer area, and that H. pylori infection is a risk factor in the development of these affections in our milieu.