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Background: Although Helicobacter pylori infection (H. pylori) prevalence in Africa has declined in the last decade, it remains concerningly high. H. pylori is asymptomatic in the majority of patients but is associated with significant morbidity and mortality in 10%-20%., Materials and Methods: We conducted an online survey of 21 African countries, with the link distributed to members of the African Helicobacter Microbiota Study Group. The survey was completed by 562 respondents; the majority were from Nigeria (27.2%), South Africa (18.1%), Tanzania (17.6%), Egypt (16.9%), and Cameroon (14.2%)., Results: The most common reason for H. pylori testing was dyspepsia in 83.9% of the cases. Abnormal findings at gastroscopy (62.3%) and heartburn (61.7%) were also common indications. Stool antigen testing and histological examination of gastric biopsies using Giemsa were the two most used methods for H. pylori testing at 62.3% and 50.3%, respectively. Most respondents reported the use of standard clarithromycin-based triple therapy as first-line treatment for H. pylori infection., Conclusion: This survey has demonstrated the diversity of practice and resource availability within the African continent. Several international guidelines exist on the management of H. pylori, but little data is available in Africa on how this condition is managed in every day clinical practice. There is an urgent need to formulate evidence-based and locally relevant practice guidelines on the African continent. In this context, the African Helicobacter and Microbiota study group was formed to coordinate efforts across the continent on H. pylori research to provide guidance on its management. This paper, therefore, aimed to evaluate the practice of H. pylori diagnostics and management, as well as related resources in representative countries in Africa, to facilitate the development of such guidelines., (© 2024 John Wiley & Sons Ltd.)

Background: Helicobacter pylori (H. pylori) infection is the most prevalent type of bacterial infection. Current guidelines from different regions of the world neglect specific African conditions and requirements. The African Helicobacter and Microbiota Study Group (AHMSG), founded in 2022, aimed to create an Africa-specific consensus report reflecting Africa-specific issues., Summary: Eighteen experts from nine African countries and two European delegates supported by nine African collaborators from eight other countries prepared statements on the most important African issues in four working groups: (1) epidemiology, (2) diagnosis, (3) indications and prevention, and (4) treatment. Limited resources, restricted access to medical systems, and underdeveloped diagnostic facilities differ from those of other regions. The results of the individual working groups were presented for the final consensus voting, which included all board members., Key Messages: There is a need for further studies on H. pylori prevalence in Africa, with diagnosis hinged on specific African situation. Treatment of H. pylori in the African setting should be based on accessibility and reimbursement, while indication and prevention should be defined in specific African countries., (© 2024 S. Karger AG, Basel.)

Background: Worldwide Helicobacter pylori (H.pylori) treatment is of great challenge due to increased antibiotic resistance. The burden of H. pylori antibiotic resistance in Africa is high with unclear information regarding the real magnitude. This systematic review and meta-analysis was conducted to investigate the magnitude of H.pylori antibiotic resistance in Africa to gain insight of the extent of the problem among H.pylori naïve treatment patients., Method: The search was performed in the academic databases, Embase, PubMed, Web of Science and Africa Wide Information. ProQuest Dissertation and Theses, Scopus, Ethos, Africa Index Medicus (WHO), BioMed Central Proceedings, BASE, British Library, Open grey, Library of Congress and the New York Academy of Grey Literature Report were additionally searched for grey literature. Published articles from Africa on H.pylori antibiotic resistance between 1986 and June 2017 were systematically reviewed to estimate the H. pylori extent of resistance to macrolides, quinolones, amoxicillin, tetracycline and metronidazole., Results: In 26 articles a total of 2085 isolates were tested for metronidazole, 1530 for amoxicillin, 1277 for tetracycline, 1752 for clarithromycin and 823 for quinolones.The overall pooled proportion of H.pylori resistance to quinolones, clarithromycin, tetracycline, metronidazole and amoxicillin were: (17.4%, 95%CI 12.8 - 21.9), (29.2%, 95%CI:26.7-31.8), (48.7%, 95%CI: 44.5-52.9), (75.8%, 95% CI: 74.1-.77.4) and (72.6%, 95% CI: 68.6-76.6), respectively. The commonest mutation detected were A2143G (49/97) for clarithromycin, RdxA (41/56) for metronidazole and D87I (16/40) for quinolones., Conclusion: Prevalence of metronidazole, clarithromycin, and amoxicillin resistance is high in developing world including Africa. This could impair the first line triple therapy of the H.pylori infection. There is a need of conducting surveillance of H.pylori susceptibility pattern in Africa for dual and triple resistance which can be used for the empirical treatment.