CHAPTER FOUR
RESULT AND ANALYSIS
4.1 Demographics characteristics of the participants
The social demographics information of the respondents was studied. A total of one hundred and
thirty eighty (138) participants who had consented and were recruited in this study and they
successfully produced blood samples for detection of H. pylori antigen.
4.1.1 Age of respondents
The participants in this study were between the ages of 15 and 60 years old and the age was
stratified into ten (10) age groups, namely; 15 – 19years, 20 – 24 years, 25 – 29 years, 30 – 34
years, 35 – 39 years, 40 – 44 years, 45 – 49 years 50–54 years and 55 – 59 years. The Mean age
was calculated to be 13.8 with Standard Deviation of 11.98. Out of the 138 participants in this
study, those who were in the age group between 50 to54 years had the lower numbers of
participants of two (2). Those participants who were in the age group between the ages of 20 to
24 years had the highest number of members who participated in the study at thirty-six (36), as
shown in Table 4.1; representation of ages of the participants.
Table 4.1: Demographic representation of ages of the participants
Age (years) Total participants
(N=138)
15– 19 22
20 – 24 36
25 – 29 29
30 – 34 20
35 – 39 5
40 – 44 7
45 – 49 5
50 –54 2
55 – 59 6
≥60 6
Total 138
Mean 13.8
SD 11.98
4.2 Prevalence of H. pylori infection among patients attending Modibbo Adama Health
Clinic.
A univariate analysis of H. pylori serum antigen test was done to establish the occurrence of the
bacteria among the participants. Prevalence refers to the percentage of the individuals found to
have the condition in a study population. This was achieved by dividing the number of people
found to be positive for the case by the total number of study population, and is usually
expressed as a fraction, as a percentage. The results showed that, out of the total 138 participants,
93 of them (67.4%) were reactive (positive) for H. pylori antigen serum test. Those participants
who were non-reactive (negative) for the H. pylori antigen stool test comprised 45, (32.6%). The
results showed that, the prevalence of H. pylori infection in patients attending Modibbo Adama
Health Clinic was 67.4% (P = 0.1). These were the patients who were positive for H. pylori stool
antigen test. As shown in the figure 4.1;
32.60%
Positive
Negative
67.40%
4.1 Figure; Showing the prevalence of H. pylori infection among the participants
4.3 H. pylori infection pattern among various age groups in the study population
The study results showed that, those participants who were between the ages of 25 –29 years had
the highest number of positive cases of H. pylori infection, which was twenty-six (26) cases,
translating to 28.0% (P = 0.1). Table 4.2 below shows the prevalence of H. pylori infection based
on various age groups of the participants.
Table 4.2 Occurrence of H. pylori in various age groups
Age groups (years) Positive Total Percentage
Male Female
15–19 06 06 12 12.9
20– 24 08 17 25 26.9
25– 29 11 15 26 28.0
30– 34 05 06 11 11.8
35–39 01 03 04 04.3
40– 44 03 02 05 05.4
45 – 49 01 01 02 02.2
50 – 54 00 01 01 01.1
55 – 59 02 02 04 04.3
≥60 01 02 03 03.2
Total 38 55 93 100.0
4.4.1 Gender of respondents and occurrence of H. pylori infection
Out of the total 138 study participants, 75 (54.3%) of the respondents were female while 63
(45.7%) participants were male. This represented a ratio of male to female participants of 1:1.2,
as shown in figure 4.2 below;
76 75
74
72
70
68
66
64 63
62
60
58
56
Male Female
Figure 4.2: Gender of participants and H. pylori infection
Out of the seventy-five (75) female participants, fifty-five (55) were positive for the H. pylori
serum antigen test, translating to 39.9%. The male participants were sixty three (63 ) and 27.5%
were positive for the H. pylori antigen test. A Pearson product-moment correlation coefficient
was computed to assess the relationship between the participant's gender and occurrence of H.
pylori antigen. Results show that there was a positive correlation between the study participants
gender and occurrence of H. pylori antigen (P = 0.1). Female had the higher number of infected
individual in the study population compared to the male counterparts, as shown in the table 4.3;
Table 4.3: Occurrence of H. pylori based on gender of participants (P = 0.1)
Positive Negative Total
Gender Female 55 (39.9%) 20 (14.5%) 75
Male 38(27.5%) 25(18.1%) 63
Total 93 (67.4%) 45 (32.6% 138(100%)
CHAPTER FIVE
DISCUSSION, CONCLUSIONS AND RECOMMENDATIONS
5.1 Discussion
The results of this study determined the prevalence of H. pylori infection in patients who were
attending Modibbo Adama University Health Clinic Yola, to be 67.4%, Mynepalli et al observed
a higher prevalence rate of 69.0% among secondary school students in Lagos state. Also the
same year, Senbanjo et al reported a higher prevalence of 77.6% among patients attending Lagos
State University Teaching Hospital while Holcombe et al in 2002 reported an age specific
prevalence rate of 91% in Maiduguri among subjects aged 10-50years. The reasons for the
higher prevalence in these studies may include the fact that, the serological method was used in
these studies to detect the infection, which does not discriminate between past and current
infections and thus higher prevalence were obtained.
In the study, H. pylori serum antigen test was used as the diagnostic test of choice. According to
Kenneth (2012), prevalence refers to the percentage of the individuals found to have the
condition in a study population. It may be achieved by dividing the number of people found to be
positive for the case with the total number of study population, and is usually expressed as a
fraction, as a percentage ( Gerstman, 2013).
This study has also established that, the occurrences of H. pylori infection among the various age
groups was high, at twenty eight point zero per cent (28.0%) in the age bracket between 25 to29
years and it was lower at one point one per cent (1.1%) in the age group between 50to 54 years
old.
A study in Kenyan school going children from the age of 3 to 15 years in various hospitals
within Nairobi, by Nabwera et al., in 2000, found a prevalence rate of H. pylori infection to be
80.7%. Another study still done in Kenya by Kimang‘a et al, in 2010, also found the prevalence
of H. pylori to be 73.3% in children and 54.8% in adults, similar to the findings by Shmuely et
al., in 2013 in India, who documented prevalence rate of 60 to 73% in all age groups in patients
with gastritis and dyspepsia. In contrast, a study done in the United States, which is among the
developed countries, found that the occurrence of H. pylori infection was much lower with the
prevalence of 5% (Everhart et al., 2000). Most of the studies on the prevalence of H. pylori
infections in African countries including Nigeria, Tanzania, Egypt and Gambia, were done on
children at the school going age, at the age group of between 1 to 15 years and the results
showed a prevalence of an average percentage.
Even though previous studies have shown that H. pylori infection is linked with age, sex, and the
state of the social economy (Aguemonet al., 2005), the main risk factors for the infection vary
from population to population by countries (Allakeret al., 2002). From this study, majority of the
participants found positive for H. pylori were between the age group between 25 to 29 years.
They had the highest prevalence of twenty-eight point zero (28.0%) (P = 0.1), and the group
which was found to have the lowest prevalence was the age between 50 to 59 years, which was
found to be one point one (1.1%). This was in similar to the study by Everhart et al, in 2000,
where the study showed prevalence in various age groups varying from 16.7% for person 20
years and increasing to 56.9% for persons less than 70 years. This could have been attributed to
fact that, H. pylori is acquired during young age as normal flora but in absence of treatment, the
infection would persist throughout life time and manifest later in life (Naficy et al 2000). The
outcome of the study was similar to the results of other studies done in most other developing
countries. Moreover, results of 40% Seroprevalence in children less than 6 years of age from a
low income population were reported (Braga et al, 2007).
5.2 Conclusions
i. This study established that the prevalence of H. pylori among the patients attending
Modibbo Adama University Health Clinic was at 67.4%.
ii. The participants with the age group between 25 – 29 years had the highest prevalence
of H. pylori infection at 28.0% and the lowest prevalence was found in the age group
between 50 years and 54 years (1.1%). The occurrence of the H. pylori infection in
various age groups was also found to be high in the ages between 20 years to 24 years
old.
iii. From the results, it also concludes that the major predisposing factors for the
establishment of H. pylori infection among the patients attending Modibbo Adama
University Health Clinic may be due to water for consumption and other domestic
usages and female gender.
5.3 Recommendations
i. This study recommends that the governments should improve on the supply of clean,
treated water among the individuals in their residential areas and also look up on other
environmental sanitation which would generally help in the reduction of H. pylori
infection among the community. Similarly, those diagnosed and found positive for the
infection, should be treated on time and be followed up so as to curb the disease
transmission.
ii. There should be frequent testing for H. Pylori of individuals which should be done
routinely. This will allow for better and promptly management of those found positive so
as to avoid transmission of the infection from one person to another.
5.4 Suggestions for further studies
i. This study also recommends that more research studies on H. pylori should be done and
they should incorporate the aspects of drug resistance. This is because very minimal
research studies on drug resistance of H. pylori have been done in Nigeria, while there is
an emergent of the diseases associated with the bacterial infection even after treatment.
ii. This study also recommends that more research studies on Helicobacter species should
be done which should involve molecular characterization of the bacterial genome. This
will enable complete understanding of the gene involved in various mutations.