Abstract
Background: Helicobacter pylori infection is a major cause of gastroduodenal diseases and is strongly associated with gastric carcinogenesis. Endoscopy plays a key role in identifying mucosal lesions related to this infection. However, data on the endoscopic aspects of H. pylori–associated lesions remain scarce in Cameroon. This study aimed to describe the endoscopic features of lesions associated with Helicobacter pylori infection in two hospitals in Douala over a three-year period.
Methods: This analytical cross-sectional study included 842 patients who underwent upper gastrointestinal endoscopy with gastric biopsies. The diagnosis of H. pylori infection was established using histology (reference method), rapid urease testing, and bacterial culture. Histological lesions, including mononuclear and polymorphonuclear infiltration, glandular atrophy, and intestinal metaplasia, were assessed according to the updated Sydney classification and compared according to H. pylori infection status.
Results: The prevalence of H. pylori infection was 73.2% by histology, 67.7% by rapid urease test, and 42.9% by bacterial culture. The most common endoscopic lesions were superficial gastritis (28.4%) and erosive gastritis (22.3%), followed by duodenal ulcers (16.8%) and gastric ulcers (10%). The prevalence of H. pylori infection was particularly high in duodenal ulcers (91.9%), gastric ulcers (82.1%), and gastric cancer (100%). High positivity rates were also observed in superficial gastritis (70.7%), erosive gastritis (64.9%), and patients with normal endoscopic findings (63.6%). H. pylori infection was significantly associated (p < 0.01) with severe mononuclear and polymorphonuclear infiltration, glandular atrophy, and intestinal metaplasia.
Conclusion: This study confirms the high prevalence of H. pylori infection and its significant association with inflammatory, ulcerative, and precancerous gastric lesions. These findings support the major role of H. pylori in the pathophysiological cascade leading to gastric cancer and highlight the importance of early detection and eradication strategies.
