Comparison of the prevalence of Helicobacter pylori infection in dyspeptic patients between two institutional centers of different socio-economic strata during 2017-2018

Abstract

Helicobacter pylori (Hp) infection is associated with multiple digestive problems from gastroduodenal ulcers to gastric adenocarcinoma and/or MALT lymphoma. Peru is considered a place of high prevalence of Hp. In the world, significant differences have been described in the prevalence of Hp infection associated with the socioeconomic characteristics of the population. Objective: To compare the prevalence of Hp infection in dyspeptic patients between 2 institutional centers of different socio-economic strata during 2017-2018. Materials and methods: A sample of 633 patients with dyspepsia was collected retrospectively and randomly, without previous endoscopic study, or a history of Hp eradication therapy that came to the gastroenterology services of the Hospital Cayetano Heredia (HCH) in San Martin de Porres, and of the Anglo American Clinic (CAA) in San Isidro, during the period of June 2017 - July 2018 (CAA: 300 and HCH: 333). Proceeding then to review the clinical history, endoscopy report and pathological anatomy of each of them, for further statistical analysis using the SPSS program. Results: A prevalence of Hp was found in the HCH of 54.1%, while in the CAA it was only 29.3% (p<0.05), this relationship being maintained in the different age groups. Likewise, the prevalence of intestinal metaplasia (MI) in the total of patients with dyspepsia in the HCH was 33.9% (MI + in Hp + was 34.4%) and in the CAA the presence of MI without considering the Hp status was only 6.7% (MI + in HP + was 6.8%) (p<0.05). Finally, the presence of gastric atrophy in the HCH was 26.7% and in the CAA it was 1.3% (p<0.05). Conclusion: There is a clear relationship between the low socioeconomic stratum and the presence of Hp, gastric atrophy and intestinal metaplasia (the latter relationship remaining independent of Hp status).