Histological prevalence of Helicobacter pylori in patients undergoing upper gastrointestinal endoscopy at Cayenne Hospital and follow-up outcomes.

INTRODUCTION

Helicobacter pylori (H. pylori) infects approximately half of the world's population and is more prevalent in developing countries. It is a major risk factor for gastric cancer, which ranks fifth worldwide in both incidence and mortality. French Guiana is a French overseas territory located in the Amazon region and presents several characteristics that may favor H. pylori transmission compared with mainland France, including immigration from neighboring low-income countries, widespread socioeconomic vulnerability, a limited number of specialized healthcare professionals. In addition, the incidence of gastric cancer is high in this territory. However, the prevalence of H. pylori infection in this territory remains unknown. The aim of this study was to determine the histological prevalence of H. pylori infection in gastric biopsies, describe the clinical and histological characteristics of infected patients, and assess follow-up outcomes after diagnosis.

PATIENTS AND

METHODS

A retrospective study was conducted at Cayenne Hospital from January to December 2023 among patients with histologically confirmed H. pylori infection.

RESULTS

Helicobacter pylori was detected in 570 of 1,664 patients (34.3%). Among these, 545 infected patients were included in the analysis, of whom 57% were women. The mean age was 49.5 years. Two-thirds of the patients were foreign-born. The main indications for upper gastrointestinal endoscopy were epigastric pain (53%), gastroesophageal reflux disease (20%), and abdominal pain (19%). Histological examination revealed gastric adenocarcinoma in 1.65% of cases and gastric precancerous lesions in 28.4%, including 6.6% severe lesions requiring endoscopic surveillance. Regarding follow-up, only 52% (95% CI 47.8-56.3) of patients were aware of their diagnosis and 48% (95% CI 44.7-53.2) received eradication therapy, while 19% (95% CI 15.8-22.6) were lost to follow-up.

CONCLUSION

The histological prevalence of H. pylori infection was 34.3%. Despite the presence of gastric precancerous lesions in nearly one-third of patients, post-diagnosis follow-up remained inadequate.