Knowledge and approach towards Helicobacter pylori diagnosis and management among primary care physicians in Cameroon: a cross-sectional study.

BACKGROUND: Low- and middle-income countries have a high prevalence of Helicobacter pylori infection (HPI). In Cameroon, the majority of HPIs are diagnosed and treated by primary care physicians (PCPs). We sought to assess the knowledge and practices of PCPs in the diagnosis and management of HPI in Cameroon. METHODS: A hospital-based cross-sectional study was carried out in four randomly selected regions of Cameroon from November 2021 to June 2022. In each of the selected regions, PCPs were recruited by non-probability convenience sampling and interviewed using a pre-structured questionnaire. Chi-squared, Fisher's exact and Student's t-tests were performed for descriptive analyses. Multivariable logistic regression was used to examine associations between knowledge and practice, with the model adjusted by age of the PCP, geographic region, number of patients and years in practice. Analysis was performed in SAS version 9.4 (SAS Institute, Cary, NC, USA). RESULTS: A total of 382 PCPs were included in the analysis. The majority (60.0%) were males between the ages of 20-29 y (64.1%). Most PCPs (80.9%) reported that HPI is the cause of gastroesophageal reflux disease and 41.8% reported that HPI is the main cause of dyspeptic symptoms. The dominant diagnostic tests used for HPI were serology (52.8%) and stool antigen (30.9%). The most frequently used first-line therapies were amoxicillin (AMX), clarithromycin (CLA), metronidazole (MNZ) and proton pump inhibitor (PPI) concomitant therapy (32.2%), AMX-CLA-PPI triple therapy (18.6%) and AMX-MNZ-PPI triple therapy (13.1%). Half of the practitioners (48.6%) treat HPI empirically, without positive H. pylori testing. About half of the PCPs (48%) do not request laboratory confirmation of H. pylori eradication following treatment. CONCLUSIONS: There is inadequate knowledge and significant differences in the clinical approach towards HPI among PCPs in Cameroon. We recommend more teaching programs and continuous medical education on HPI.

Prevalence of hepatitis B and associated factors in the Buea Regional Hospital, Cameroon.

Introduction: Hepatitis B infection is a serious global health problem worldwide. In Cameroon, this infection shows a great variability in prevalence in the country and even within different population groups. However, the prevalence of HBV in the southwestern region is not yet known. Objectives: This study was conducted to determine the prevalence of hepatitis B, its associated factors, and the patient's knowledge about the infection at the Buea Regional Hospital. Method: We conducted a hospital-based cross-sectional study from March 29th to June 30th, 2021 involving participants of both sexes with ages ranging from 13 to 60+. A random sampling method was used to obtain a sample size of 113 participants as calculated using Lorentz's formula. The study questionnaires were administered to participants and their blood samples were collected by venous puncture. The blood samples were collected in non-hepainized test tube at the collection units of the Hospital. Diaspot one-step Hepatitis B Surface Antigen test strips with 99% sensitivity and 97% specificity were used to determine the status of the participants. The data were analysed using SPSS 25.0. Bivariate and multivariable analyses were used to obtain associated factors. The level of significance was set at p ≤ 0.05. Results: A total of 125 participants were recruited. However, only 119 provided complete data (questionnaire and blood samples). A proportion 61 (51.3%) of the participants were females in the 20-29-year age group. The prevalence of hepatitis was 8.4%. Fifty-three percent (64) of the participants had adequate knowledge of Hepatitis B. Having had more than one sexual partner in the last six months and having visited a dentist in the past was significantly associated with Hepatitis B positive status (p ≤ 0.05). Conclusion: The prevalence of Hepatitis B in the Buea Regional Hospital is 8.4% and 53.8% of the participants had adequate knowledge of the infection. Males were found to be 13.17 times more likely to be positive for Hepatitis B infection than females.