Knowledge and approach towards Helicobacter pylori diagnosis and management among primary care physicians in Cameroon: a cross-sectional study

Author:

Tazinkeng Nkengeh123ORCID,Monteiro Joao Filipe4,Mbianyor Bill-Erich3,Nowbuth Avis Anya2,Ntonifor Monela35,Evenge Claudia5,Nkhoma Alick6,Moss Steven F4,Asombang Akwi W12

Affiliation:

1. Division of Gastroenterology, Massachusetts General Hospital , Boston, MA , USA

2. Department of Research, Pan-African Organization for Health, Education and Research , Lusaka , Zambia

3. Department of Population Health Research, Health Education and Research Organization , Buea , Cameroon

4. Warren Alpert Medical School of Brown University , Rhode Island , USA

5. Faculty of Health Sciences, University of Buea , Buea , Cameroon

6. Royal Stoke Hospital, NHS Trust , Stoke-on-Trent , UK

Abstract

Abstract Background Low- and middle-income countries have a high prevalence of Helicobacter pylori infection (HPI). In Cameroon, the majority of HPIs are diagnosed and treated by primary care physicians (PCPs). We sought to assess the knowledge and practices of PCPs in the diagnosis and management of HPI in Cameroon. Methods A hospital-based cross-sectional study was carried out in four randomly selected regions of Cameroon from November 2021 to June 2022. In each of the selected regions, PCPs were recruited by non-probability convenience sampling and interviewed using a pre-structured questionnaire. Chi-squared, Fisher’s exact and Student's t-tests were performed for descriptive analyses. Multivariable logistic regression was used to examine associations between knowledge and practice, with the model adjusted by age of the PCP, geographic region, number of patients and years in practice. Analysis was performed in SAS version 9.4 (SAS Institute, Cary, NC, USA). Results A total of 382 PCPs were included in the analysis. The majority (60.0%) were males between the ages of 20–29 y (64.1%). Most PCPs (80.9%) reported that HPI is the cause of gastroesophageal reflux disease and 41.8% reported that HPI is the main cause of dyspeptic symptoms. The dominant diagnostic tests used for HPI were serology (52.8%) and stool antigen (30.9%). The most frequently used first-line therapies were amoxicillin (AMX), clarithromycin (CLA), metronidazole (MNZ) and proton pump inhibitor (PPI) concomitant therapy (32.2%), AMX–CLA–PPI triple therapy (18.6%) and AMX–MNZ–PPI triple therapy (13.1%). Half of the practitioners (48.6%) treat HPI empirically, without positive H. pylori testing. About half of the PCPs (48%) do not request laboratory confirmation of H. pylori eradication following treatment. Conclusions There is inadequate knowledge and significant differences in the clinical approach towards HPI among PCPs in Cameroon. We recommend more teaching programs and continuous medical education on HPI.

Funder

Royal Society of Tropical Medicine and Hygiene

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,General Medicine,Parasitology

Reference20 articles.

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