Helicobacter Pylori Infection at the Regional Hospital of Agadir: First Evaluation of Prevalence in Endoscopy

Introduction: Helicobacter pylori (HP) is a Gram-negative bacterium that colonizes the gastric mucosa and is implicated in various gastrointestinal pathologies. Globally, the prevalence of HP infection is approximately 50%. This study aimed to evaluate the prevalence of HP infection among patients undergoing esophagogastroduodenoscopy (EGD) at the Regional Hospital Center of Agadir and to analyze its clinical, endoscopic, and histopathological associations. Materials and Methods: This retrospective cross-sectional study was conducted over 76 months (January 2016 - May 2022). The cohort consisted of 407 patients presenting with upper gastrointestinal symptoms who underwent EGD with biopsies for histological assessment of HP infection. Data included demographic characteristics, clinical presentations, endoscopic findings, and histopathological results. Results: The prevalence of Helicobacter pylori (HP) infection in the study population was 91.5% (n = 372), with no significant differences observed based on age (mean: 47.8 ± 16 years) or sex (p = 1). Clinically, epigastric pain was the most common indication for esophagogastroduodenoscopy (EGD) in HP-positive patients (43.8%). Endoscopic findings revealed that erythematous pangastritis was the predominant lesion, occurring in 38.4% of HP-positive patients, with a statistically significant association between HP infection and macroscopic endoscopic lesions (p ＜ 0.001). Histopathological examination confirmed chronic gastritis in all cases, with active gastritis present in 93%. The bacterial load was categorized as low in 10.8% of cases, moderate in 35.4%, and high in 53.5%, with a significant correlation between bacterial load and HP infection (p ＜ 0.001). Although precancerous lesions, including intestinal metaplasia (7.1%) and dysplasia (1.2%), were identified, they were not significantly associated with HP infection. Conclusion: This study highlights the high prevalence of HP infection in the Agadir region. While neither age nor sex influenced infection rates, HP was strongly associated with the presence and activity of inflammatory gastric lesions.