Prevalence of Helicobacter pylori infection and the associated demographic and histopathological characteristics in patients diagnosed with chronic gastritis in three histopathology laboratories in Uganda

BACKGROUND: Helicobacter pylori is the principal infectious driver of chronic gastritis, a precursor to several gastric lesions. Data on tissue-based prevalence and associated histopathology in Uganda remain limited. H. pylori affect over half the global population, leading to chronic gastritis and subsequent complications with increased risk of gastric cancer in about 1-3% of patients. This study investigated H. pylori prevalence, its demographic and histopathological associations among chronic gastritis patients in three histopathology laboratories in Uganda. METHODS: A cross-sectional study analyzed 150 formalin-fixed paraffin-embedded tissue blocks of patients diagnosed with chronic gastritis between September 2018 to August 2021. The histopathology analysis was done using H&E and modified Giemsa stains. Data was analyzed with STATA version 17, determining prevalence through proportions, assessing associations using Chi-square tests and Fisher exact test. Significance was set at p ≤ 0.05 with 95% confidence intervals. RESULTS: The study included 150 patients (male-to-female ratio 1.5:1; mean age 48 years, SD = 17, range 12-89). H. pylori prevalence was 29.3%. Significant associations were observed with chronic inflammation (p < 0.001), neutrophil activity (p < 0.001), glandular atrophy (p < 0.001) and intestinal metaplasia (p < 0.001). CONCLUSION: H. pylori positivity was associated with more severe chronic inflammation and active neutrophilic infiltration, glandular atrophy and intestinal metaplasia.