Detection of helicobacter pylori infection and upper gastrointestinal disorders among Zagazig university hospitals waste collectors: a comparative cross- sectional study

ABSTRACT

Hospital work, involving direct patient contact and poor sanitary conditions, constitutes a major risk factor for acquisition of H. pylori infection. 1] determining the prevalence and occupational risk of, pylori infection among hospital waste collectors, 2] identifying some of its associated risk factors, 3] investigating the validity of some non-invasive tests for the diagnosis of H. pylori infection in comparison with the gold-standard invasive test, esophagogastroduodenoscopy with biopsy, 4] comparing the diagnostic performance of salivary H. pylori IgG with that of serum H. pylori IgG, and 5] determining the percentages of upper gastrointestinal [GIT] symptoms and the endoscopic findings among hospital waste collectors and assessing their relation to H. pylori infection. This comparative cross-sectional study was conducted on 78 hospital waste collectors and 78 security and administrative workers from Zagazig University Hospitals as a control group. All participants filled pre-constructed questionnaires and were subjected to H. pylori stool antigen and serum and salivary anti-H. pylori IgG tests; while only 110 workers underwent esophagogastroduodenoscopy with biopsy and rapid urease test. The results revealed absence of significant occupational risk of H. pylori infection acquisition among hospital waste collectors compared to the controls. Moreover, Male sex, smoking habit, low socioeconomic status, poor personal hygiene, and family history of upper GIT complaints were the risk factors significantly associated with active H. pylori infection. Fecal antigen test had the highest sensitivity, specificity, positive, and negative predictive values for the diagnosis of H, pylori infection compared to the other non-invasive tests. Moreover, there was a fair degree of agreement between salivary and serum H. pylori IgG tests regarding their diagnostic performance [0.34]. Also, absence of statistical significant differences between both studied groups regarding the percentages of upper gastrointestinal symptoms and different endoscopic findings was revealed. Finally, current H. pylori infection was found to be significantly associated with different types of gastritis; however, normal mucosa by endoscopy didn't exclude the presence of H, pylori infection. So, improving the overall standard of living in our country, environmental sanitation, introducing effective anti-infective sanitary regulations at work, mass screening through either stool antigen or serum IgG or salivary IgG tests to detect infected persons, and proper treatment of infected persons are mandatory