ABSTRACT
BACKGROUND: The effectiveness of Helicobacter pylori (H. pylori) eradication depends on the treatment protocol. This study investigates the H. pylori eradication rate in Africa using the best available evidence from databases. METHODS: Databases were searched and results were pooled together. Heterogeneity between studies was assessed using I2 test statistics. Stata version 13 software was employed to compute the pooled eradication rate. In the subgroup analysis comparison, the finding is considered significant when the confidence intervals did not overlap. RESULTS: Twenty-two studies from 9 African countries with a total population of 2,163 were included in this study. The pooled eradication rate of H. pylori was 79% (95% CI: 75%-82%), heterogeneity (I2 = 93.02%). In the subgroup analysis by study design, a higher eradication rate was reported from observational studies (85%, 95% CI: 79%-90%), compared to randomized control trials (77%, 95% CI: 73%-82%); by the duration of therapy, higher eradication rate was reported in 10-days regimen (88%, 95% CI: 84%-92%), compared to 7-days regimen (66%, 95% CI: 55%-77%); by country, the highest eradication rate was found in Ethiopia (90%; 95% CI: 87%-93%) and the lowest eradication rate was reported in Ivory Coast (22.3%; 95% CI:15%-29%); by type of H. pylori test, the highest eradication rate was reported when rapid urease test coupled with histology (88%, 95% CI: 77%-96%), and the lowest eradication rate was reported with histology alone (22.3%; 95% CI:15%-29%). Significant heterogeneity was observed with pooled prevalence (I2 = 93.02%, P < 0.000). CONCLUSIONS: In Africa, the first-line therapy showed a variable eradication rate for H. pylori. This study demonstrates the necessity to optimize current H. pylori treatment regimens in each country, taking into account the antibiotic susceptibility. Future RCT studies with standardized regimens are warranted.
Subject(s)
Helicobacter Infections , Helicobacter pylori , Humans , Helicobacter Infections/drug therapy , Ethiopia , Databases, Factual , Prothrombin Time , Randomized Controlled Trials as TopicABSTRACT
Aphanomyces euteiches is a soilborne plant pathogen. It causes severe root rot in leguminous crop species. We report the complete genome sequence of a biocontrol strain, Pseudomonas simiae K-Hf-L9. The strain inhibited Aphanomyces euteiches mycelia and zoospores and suppressed root rot in field peas grown under controlled growth chamber conditions.
ABSTRACT
The increasing incidence and prevalence of the pathogen Aphanomyces euteiches in various pulse-growing regions worldwide necessitates the development of effective management strategies, including biological control agents. Numerous labs have undertaken research examining biological control methods to evaluate aphanomyces root rot suppression in multistep processes that include isolation of inhibitory organisms, lab assays, growth chamber assays, and field trials. Given the emergence of various biocontrol agents and the need to mitigate aphanomyces yield losses, we have undertaken a meta-analysis approach to analyze the effectiveness of biocontrol agents in relation to application method, biocontrol agent richness, biocontrol agent type, the type of study, and reporting system-oriented moderator variables. An effect size, calculated as a natural log response ratio, resulted in a summary weighted mean of -0.411, suggesting the overall effectiveness of biocontrol agents (p < .001). Aphanomyces root rot suppression using biological treatments showed significant heterogeneity for all moderator variables, confirming that the studies do not share a common effect size and the use of a random effect model was appropriate. Across studies, meta-analyses revealed that soil amendments, biocontrol agent application as a seed coating and suspension, bacterial and fungal biocontrol agents, mixed applications, growth chamber and field studies, and qualitative and quantitative reporting systems were all associated with significantly positive outcomes for aphanomyces root rot suppression. Our findings suggest that there is potential promise for biological control of aphanomyces root rot, and more field trials need to be conducted to demonstrate the efficacy level observed under growth chamber conditions. Moreover, we identified a lack of detailed understanding of the mechanism(s) of biological control of aphanomyces root rot as a research priority.
