Helicobacter pylori infection, a risk factors for pulmonary tuberculosis: prevalence, associated factors and clinical profile among treatment-naive tuberculosis patients in Yaounde-Cameroon

The persistence of gastric inflammation in Helicobacter pylori (H. pylori) infection profoundly alters gastric immune response and predispose to gastric hypochlorhydria that may be a risk factor for other infections. This study sought to determine potential risk factors and clinical profile associated with prevalence of H. pylori among newly diagnosed pulmonary tuberculosis (TB) patients in Cameroon. This was a cross–sectional study conducted from June 2024 to March 2025 at Jamot Hospital of Yaoundé-Cameroon. A total of 305 newly diagnosed pulmonary tuberculosis patients were enrolled. The study was approved by Ethical Committees. Each subject gave a written consent. For each patient, body mass index (BMI) and direct inquiry about respiratory diseases symptoms were done. Sputum samples were tested for the presence of Mycobacterium tuberculosis using TB LAMP assay. H. pylori antigen in human stool samples ( Evancare medical, China) was used for H. pylori detection. IBM SPSS Statistics 22 was used for data analysis. The overall prevalence of H. pylori infection and TB was of 65.90% (n = 201/305) and 58.36% (n = 178/305) respectively. Among TB-positive patients, the prevalence of H. pylori co-infection was 60.67% (n = 108/178). Furthermore, patients with H. pylori infected were 1.77 time more likely to be TB-positive (OR = 1.77; 95%IC = 1.081–2.908; p = 0.02). Among studied variables, being married (p = 0.0096), having low-income level (p = 0.0422), alcohol consumption (p ˂ 0.0001), and low BMI (p = 0.0068) were significantly associated to TB/H.pylori co-infection. The strength of the association between TB and nausea, TB and vomiting increases with co-infection. The OR between TB and night sweats in tuberculosis alone was 39.63-time lower in case of co-infection. Our data reveals a significant high prevalence of H. pylori infection among TB patients. Specific factor such as low-income level, being married, alcohol consumption, and underweight are risk factor for H. pylori-TB co-infection. Our data reveals changes of the classic clinical picture of tuberculosis in the presence of H. pylori.