Prevalence and associated risk factors of Helicobacter pyloriinfection in East Africa: a systematic review and meta-analysis

Background: Helicobacter pyloriis the main cause of chronic gastritis, peptic ulcer, lymphoma, and gastric cancer in humans. The prevalence and factors associated with H. pyloriinfection are varied across countries.Thus, a comprehensive review has not been done on prevalence and associated factors in East Africa. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and identify factors associated with H. pyloriinfection in East Africa. Methods: Articles written in English language were retrieved from PubMed, Scopus, and Science Direct. Relevant articles were selected and screened using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Publication bias was assessed qualitatively and qualitatively using funnel plot symmetry and Egger’s test, respectively. Heterogeneity was assessed using the I²measure. Data were analyzed using Stata software, version 14, and the “metan” command. Results: A total of 231 articles were retrieved from nineteen countries in East Africa. Of these, 70 articles were eligible for the review. The pooled prevalence of H. pyloriin East Africa was 50.98% (95% CI: 45.05–56.90). The prevalence of H. pyloriinfection ranged from 7.7 to 94.5% in East African countries. The highest pooled prevalence was from Sudan (61.3%, 95% CI: 52.6–69.9), and the lowest prevalence was reported from Uganda (40.7%, 95% CI: 33–48.3). Persons with no formal education (OR: 2.03; 95% CI: 1.22–2.83), lack of hand washing habit after toilet (OR: 2.24; 95% CI: 1.45–3.02), having a history of dyspepsia (OR: 2.25; 95% CI: 1.31–3.18), living in rural areas (OR = 1.80; 95% CI: 0.38–3.23), and having unclean water source (OR = 1.5; 95% CI:0.45–3.45) were all associated with higher risk for H. pyloriinfection. Conclusion: More than half of the populations of East African countries were positive for H. pyloriinfection. Rural residence, source of water, and alcohol consumption were significantly associated with H. pyloriinfection. Therefore, healthcare workers could provide health education on the aforementioned risk factors, and the government and other stakeholders could improve the source of drinking water in East Africa.