Factors associated with gastro-duodenal disease in patients undergoing upper  GI endoscopy at the Korle-Bu Teaching Hospital, Accra, Ghana.

Timothy N. A. Archampong, Richard H. Asmah, Edwin K. Wiredu, Richard K. Gyasi, Kofi N. Nkrumah
1. Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences,
University of Ghana
2. Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of
Health Sciences, University of Ghana
3. Department of Pathology, School of Biomedical and Allied Health Sciences, College of Health Sciences,
University of Ghana

Abstract
Background: There is a high prevalence of gastro-duodenal disease in sub-Saharan Africa. Peptic ulcer disease in dyspeptic  patients, 24.5%, was comparable to prevalence of gastro-duodenal disease among symptomatic individuals in developed countries (12 – 25%). Limited data exists regarding its associated risk factors despite accumulating evidence indicating that gastroduodenal disease is common in Ghana.

Objectives: This study investigates risk factors associated with gastro-duodenal disease at the Korle-Bu Teaching Hospital, Accra, Ghana.

Methods: This study utilized a cross-sectional design to consecutively recruit patients referred with upper gastro-intestinal  symptoms for endoscopy. The study questionnaire was administered to study participants. Helicobacter pyloriinfection was confirmed by rapid-urease examination at endoscopy.

Results: Of 242 patients sampled; 64 had duodenal ulcer, 66 gastric ulcer, 27gastric cancer and 64 non-ulcer dyspepsia. Nineteen (19) had duodenal and gastric ulcer while 2 had gastric ulcer and cancer. A third (32.6%) of patients had history of NSAIDuse. H. pyloriwas associated with gastric ulcer (p=0.033) and duodenal ulcer (p=0.001). There was an increased prevalence of  duodenal ulcer in H. pylori-infected patients taking NSAIDs, P=0.003.

Conclusion: H. pyloriwas a major risk factor for peptic ulcer disease. However, NSAID-related gastro-duodenal injury has been
shown to be common in H. pylori infected patients. It highlights the need for awareness of the adverse gastro-intestinal effects  in a H. pylori endemic area.

Keywords: Peptic ulcer, Helicobacter, NSAIDs, endoscopy, Ghana.