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Reasons for the high level of ulcer disease in Nigeria —Prof. Stella Smith

Reasons for the high level of ulcer disease in Nigeria—Prof. Stella Smith

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Reasons for the high level of ulcer disease in Nigeria—Prof. Stella Smith

Prof. Stella Smith, the founding president of the African Helicobacter and Microbiota Study Group (AHMSG), claims that the pathogen is persistent in infecting and causing a wide range of diseases and conditions in a significant number of people despite the long neglect of Helicobacter pylori (H. pylori) in Africa. Professor says

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The Helicobacter pylori bacterium infects and colonizes the human gut, according to Smith, who is also the Director of Research at the Nigerian Institute of Medical Research (NIMR). The pathogen, according to her, has been linked to a variety of gastric conditions, such as gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric adenocarcinoma.

Reeling out the challenges associated with the disease in her paper entitled “Helicobacter pylori: The Peptic Ulcer Bug: Neglected But Unrelenting” during the 2022 Health Writers Association of Nigeria’s Symposium, “HEWAN,” Smith said H. pylori has been reported to have infected 50 percent of the world’s population, with different races and regions having varying levels of severity and pathological outcomes.

Smith referred to a study that showed that in Nigeria, the prevalence of H. pylori infection varies, with northern Nigeria having more cases than other parts of the country. The study listed several challenges associated with H. pylori research, diagnosis, and treatment in Africa, including a lack of accurate prevalence data, an absence of consensus on diagnosis and treatment, inadequate health care infrastructure, a lack of funding, and a straggling number of professionals.

Smith regretted that while most other infectious diseases like HIV, malaria, tuberculosis, and COVID-19 have received more attention in terms of research funding and grants, Helicobacter pylori infection (HPI) is neglected in Africa.

“The burden of the infection in Africa is high, with a reported prevalence of 70.1 percent.” Although this number could be higher due to a lack of data in some regions of the continent, she further stated that 51 percent of the world’s population was infected, adding that the incidence is decreasing in developed nations but ubiquitous in developing ones.

“The possible causes of discrepancies in the prevalence rate across continents have been reported to be due to: urbanization with better access to health facilities and potable water; host genetic makeup, age, and gender; the immune response of the host; the pathogenicity of the H. pylori strains; and environmental factors,” the researchers observed. On the way forward, she called for prompt diagnosis of the infection in Africa.

Considering the high burden of Helicobacter pylori infection (HPI) in Africa and its associated pathological outcomes, accurate and prompt diagnosis is key to managing, treating, and eradicating the disease.

She said several diagnostic approaches, including invasive and non-invasive methods, have been deployed across Africa. Signs and symptoms of HPI include an ache or burning pain in your stomach (abdomen), stomach pain that may be worse when your stomach is empty, nausea, loss of appetite, frequent burping (belching), bloating, and unintentional weight loss.

She regretted that in Nigeria, most stomach aches are assumed to be ulcers due to a lack of awareness and misdiagnosis. “Misdiagnosis mixed with a lack of awareness remains a major problem in Africa, especially Nigeria. The need for accurate diagnosis and treatment led to the formation of the African Helicobacter and Microbiota Study Group (AHMSG).

“Due to misuse and overuse of antibiotics, several bacterial pathogens, including H. pylori, have developed resistance to antibiotics.

This is posing a big challenge to the effective treatment and eradication of H. pylori infection. “There is no treatment regimen that guarantees cure of H. pylori infection in 100 percent of patients; multiple antibiotic regimens have been evaluated for H. pylori therapy in Africa. However, few regimens have consistently achieved high eradication rates. There are also limited data on H. pylori antibiotic resistance rates to guide therapy.”

 

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