Helicobacter pylori eradication rate of standard triple therapy and factors affecting eradication rate at Bahir Dar city administration, Northwest Ethiopia: A prospective follow up study

Endalew Gebeyehu; Desalegn Nigatu; Ephrem Engidawork

doi:10.1371/journal.pone.0217645

Helicobacter pylori eradication rate of standard triple therapy and factors affecting eradication rate at Bahir Dar city administration, Northwest Ethiopia: A prospective follow up study

PLoS One. 2019 Jun 4;14(6):e0217645. doi: 10.1371/journal.pone.0217645. eCollection 2019.

Authors

Endalew Gebeyehu^{1

2}, Desalegn Nigatu³, Ephrem Engidawork^{1

2}

Affiliations

¹ Department of Pharmacology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
² Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
³ Department of Internal Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Abstract

Background: Eradication of Helicobacter pylori infection with standard triple therapy has been accepted to curb associated risks of chronic gastritis andpeptic ulcer disease.

Objective: To assess H. pylori eradication rate of standard triple therapy and patient related factors affecting eradication rate.

Methods: A facility based prospective follow up study was conducted in Bahir Dar City Administration, Ethiopia, on consented outpatients presented with gastritis and peptic ulcer disease and positive for H. pylori stool antigen test from May 2016 to April 2018. Eradication was confirmed with stool antigen test made after 4-6 weeks of standard triple therapy, comprising of proton pump inhibitor, clarithromycin and amoxicillin. Pre-developed questionnaire and data collection formats were used to collect variables before and after therapy. Bivariate and backward stepwise multivariate logistic regression was used to analyze data. P-value < 0.05 at 95%CI was considered as significant.

Results: The overall H. pylori eradication rate was 90.3% (379/421). Almost 80% of the patients were urban residents. Mean (±SD) age and body weight of patients were 30.63 (± 10.74) years and 56.79 (± 10.17) kg, respectively. Self-reported adverse drug effects and area of residence of patients were factors affecting eradication rate significantly. Patients with no self-reported adverse drug effect were 3.85 (AOR: 3.85; 95%CI (1.41-5.26)) times more likely to eradicate H. pylori infection compared to those reported adverse effects. Patients living in rural area were 2.7 (AOR: 2.7; 95%CI (1.19-20.0)) times more likely to achieve eradication compared to urban residents.

Conclusion: H. pylori eradication rate is within the recommended level for clinical practice, indicating that modifications of the standard triple therapy observed in the different healthcare institutions are not evidence-based. Emphasis should be given to adverse drug effects of medications and tailored counseling based on area of residence could have a contribution in improving eradication rate.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Disease Eradication*
Drug Therapy, Combination
Ethiopia
Female
Follow-Up Studies
Helicobacter Infections / drug therapy*
Helicobacter Infections / prevention & control*
Helicobacter pylori / physiology*
Humans
Logistic Models
Male
Middle Aged
Prospective Studies
Risk Factors
Young Adult

Grants and funding

The authors would like to acknowledge Addis Ababa University and Bahir Dar University for funding this research project. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.