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Gastro-duodenal disease in Africa: Literature review and clinical data from Accra, Ghana

World Journal of Gastroenterology 2019年第26期25卷 3344-3358页

作者： timothy n archampong Richard H Asmah Cathy J Richards Vicki J Martin Christopher D Bayliss Edília Botao Leonor David Sandra Beleza Carla Carrilho Department of Medicine and Therapeutics School of Medicine and DentistryUniversity of GhanaAccra Box 4236Ghana Department of Genetics and Genome Biology University of LeicesterLeicester LE1 7RHUnited Kingdom Department of Medical Laboratory Sciences School of Biomedical and Allied Health SciencesUniversity of GhanaAccra Box 4236Ghana Department of Histopathology Leicester Royal InfirmaryLeicester LE1 5WWUnited Kingdom Department of Pathology Maputo Central HospitalMaputo POBox 1164Mozambique Department of Pathology Medical Faculty of the University of PortoPorto 4200-465Portugal Institute of Molecular Pathology and Immunology at the University of Porto(Ipatimup) Porto 4200-465Portugal Instituto de Investigacao e Inovacao em Saude(i3S) University of PortoPorto 4200-465Portugal Department of Pathology Faculty of MedicineEduardo Mondlane UniversityMaputo POBox 257Mozambique

Gastroduodenal disease(GDD)was initially thought to be uncommon in *** others,lack of access to optimal health infrastructure and suspicion of conventional medicine resulted in the reported prevalence of GDD being significantly lower than that in other areas of the *** the increasing availability of flexible upper gastro-intestinal endoscopy,it has now become apparent that GDD,especially peptic ulcer disease(PUD),is prevalent across the continent of *** risk factors for gastric cancer(GCA)include Helicobater pylori(***),diet,Epstein-Barr virus infection and industrial chemical exposure,while those for PUD are ***,non-steroidal antiinflammatory drug(nSAID)-use,smoking and alcohol *** these,*** is generally accepted to be causally related to the development of atrophic gastritis(AG),intestinal metaplasia(IM),PUD and distal ***,we perform a systematic review of the patterns of GDD across Africa obtained with endoscopy,and complement the analysis with new data obtained on premalignant gastric his-topathological lesions in Accra,Ghana which was compared with previous data from Maputo,*** there is a general lack of structured cohort studies in Africa,we also considered endoscopy-based hospital or tertiary centre studies of symptomatic *** Africa,there is considerable heterogeneity in the prevalence of PUD with no clear geographical ***,there are differences in PUD within-country despite universally endemic *** *** is not uncommon in *** of the African tertiary-centre studies had higher prevalence of PUD when compared with similar studies in western *** additional intriguing observation is a recent,ongoing decline in PUD in some African countries where *** infection is still *** possible reason for the high,sustained prevalence of PUD may be the significant use of nSAIDs in local or over-the-counter *** prevalence

关键词： Gastroduodenal Peptic ulcer Gastric cancer Africa Pre-malignant Atrophy Intestinal metaplasia Duodenal ulcer Gastric ulcer

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