Magnitude of Helicobacter Pylori infection among patients with Esophageal cancer and apparently healthy individuals, at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia; a comparative cross-sectional study.
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Date
2023-06
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Addis Ababa University
Abstract
Background: Helicobacter pylori are Gram-negative bacterium that can cause diverse types of
gastrointestinal tract malignancies including esophageal cancer (EC), though evidences regarding
EC are conflicting. This study aimed to determine the magnitude of H. pylori among EC as
compared to Healthy individuals.
Objective: To investigate the magnitude of Helicobacter Pylori infection among patients with
esophageal cancer as compared to apparently healthy individuals.
Methods: a health facility-based comparative investigation was done from May 2021 to August
2022 cross-sectionally at Tikur Anbesa Specialized Hospital. Convenient sampling was used to
recruit 302 (112 cases and 190 (healthy individuals) participants. Cases of EC were clinically
confirmed as well as by Histological Examination. Apparently healthy individuals (staff and
attendant) were taken as a comparative group. H. pylori stool antigen as well as serum antibody
were measured following standard methods. Data analysis was done using SPSS Version 22.
Odds ratio was calculated with 95% confidence interval to describe the association between H.
pylori and esophageal cancer with level of significance set at p<0.05.
Results: Out of 302 study participants, 52% (157/302) were males and 91.1% (102) were
residing outside Addis Ababa. Majority, 74.1 % of EC cases had squamous type tumor and
37.4% were in stage II. The magnitude of H. pylori among Esophageal Cancer Patient were
40.2% (45/112) and 4.2% (8/190) in Healthy individuals. H. pylori infection is more infecting
the esophageal adenocarcinoma (EAC) type 48.3% (14/29) compared to ESCC which is 37.4%
(31/83); highest prevalence was noted in Stage IV patients (57.1 %). In the multivariable logistic
regression analysis, being in the age group 40 years and above (AOR=12.23, 95%CI=4.09-
36.53), living outside Addis Ababa (AOR=18.57, 95%CI=5.76-59.8), attaining primary level
education and below (AOR=17.24, 95%CI=5.31-55.96), and being positive for H. pylori stool
antigen (AOR=20.13, 95%CI=4.79- 84.62) were significantly associated with EC after
controlling for throat illness, taking alcohol, family history of throat illness and consuming hot
food. Conclusion; Magnitude of Helicobacter pylori was remarkably high among Esophageal
Cancer patients compared to Healthy individuals. Further study is needed and moreover,
advocacy of patients on the beneficiary effect of identified factors is one strategy to prevent EC.
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Keywords
H. pylori, EC, Adenocarcinoma, SCC, Magnitude, Addis Ababa, Ethiopia.