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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2023

Open Access 01-12-2023 | Helicobacter Pylori | Research

Effectiveness of eradication therapy for Helicobacter pylori infection in Africa: a systematic review and meta-analysis

Authors: Sintayehu Fekadu, Hizkel Engiso, Sisay Seyfe, Hisashi Iizasa, Ashebir Godebo, Serawit Deyno, Hironori Yoshiyama

Published in: BMC Gastroenterology | Issue 1/2023

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Abstract

Background

The effectiveness of Helicobacter pylori (H. pylori) eradication depends on the treatment protocol. This study investigates the H. pylori eradication rate in Africa using the best available evidence from databases.

Methods

Databases were searched and results were pooled together. Heterogeneity between studies was assessed using I2 test statistics. Stata version 13 software was employed to compute the pooled eradication rate. In the subgroup analysis comparison, the finding is considered significant when the confidence intervals did not overlap.

Results

Twenty-two studies from 9 African countries with a total population of 2,163 were included in this study. The pooled eradication rate of H. pylori was 79% (95% CI: 75%-82%), heterogeneity (I2 = 93.02%). In the subgroup analysis by study design, a higher eradication rate was reported from observational studies (85%, 95% CI: 79%-90%), compared to randomized control trials (77%, 95% CI: 73%-82%); by the duration of therapy, higher eradication rate was reported in 10-days regimen (88%, 95% CI: 84%-92%), compared to 7-days regimen (66%, 95% CI: 55%-77%); by country, the highest eradication rate was found in Ethiopia (90%; 95% CI: 87%-93%) and the lowest eradication rate was reported in Ivory Coast (22.3%; 95% CI:15%-29%); by type of H. pylori test, the highest eradication rate was reported when rapid urease test coupled with histology (88%, 95% CI: 77%-96%), and the lowest eradication rate was reported with histology alone (22.3%; 95% CI:15%-29%). Significant heterogeneity was observed with pooled prevalence (I2 = 93.02%, P < 0.000).

Conclusions

In Africa, the first-line therapy showed a variable eradication rate for H. pylori. This study demonstrates the necessity to optimize current H. pylori treatment regimens in each country, taking into account the antibiotic susceptibility. Future RCT studies with standardized regimens are warranted.
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Metadata
Title
Effectiveness of eradication therapy for Helicobacter pylori infection in Africa: a systematic review and meta-analysis
Authors
Sintayehu Fekadu
Hizkel Engiso
Sisay Seyfe
Hisashi Iizasa
Ashebir Godebo
Serawit Deyno
Hironori Yoshiyama
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2023
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-023-02707-5

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