Monoclonal Stool Antigen Test of Helicobacter pylori in Sub-Saharan Dyspeptic Patients

Helicobacter pylori (H. pylori) infection is a public health concern in sub-Saharan Africa (SSA). This study aimed to assess the monoclonal stool antigen test (SAT) in dyspeptic patients and the associated behavioral factors. It was cross-sectional from clinical records between January 2022 to February 2025. The eligible population was at least 18 years old with gastrointestinal disorder (GID) symptoms and a SAT result. Patients included were anonymized using a consecutive numeric identifier number increasing to the calculated size. The collected data were analyzed with STATA 16. A p-value < 0.05 was considered statistically significant. Prevalence of H. pylori infection was 55.69%. The sex ratio was 0.81. Mean age was 41.62 years and the oldest was 86 years. Comparing results according to the age group and results of monoclonal SAT, the p-value was 0.03. Residence was urban for 69.11%. Alcohol consumption was: beer (62.65%), wine (15.66%), liquor (4.82%) and multiple types (16.87%). All were symptomatic with various medical histories, chronic diseases and other associated symptoms. The GID symptoms were bloating (75.2%); EPS (56.91%); esophageal disorders (55.28%); constipation (41.06%); belching disorders (31.3%); nausea or vomiting disorders (17.89%); postprandial distress syndrome (12.6%); diarrhea (5.28%) and halitosis (2.44%). Endoscopy was performed in 49.19%. Tests for serum IgG antibodies against H. pylori had been done in 50% and 32.52% (1/3 patient) were positive. Compared with the presence of H. pylori in histology (88.24%), SAT had sensitivity at 76.47% and serum IgG antibodies sensitivity at 32.52% (p = 0.18 and 0.17). Histology was performed by 34 patients (13.82%): all had gastritis including 32 chronic; 26 with atrophy and one dysplasia. Prevalence remains high in symptomatic patients. This research was not in accordance with the “African enigma.” Findings highlight the need for a population-based H. pylori test-and-treat strategy.