Background: Gastroduodenal ulcer disease (GDU) remains a significant global health concern despite considerable therapeutic advances over recent decades. In Senegal, several studies have reported a progressive decline in its prevalence. However, updated data reflecting current epidemiological and therapeutic patterns remain limited. This study aimed to reassess the epidemiological, clinical, endoscopic, and therapeutic characteristics of gastroduodenal ulcers in Dakar. Methods: We conducted a prospective multicenter study in the digestive endoscopy units of three tertiary hospitals in Dakar: Idrissa Pouye General Hospital, Dalal Jamm National Hospital Center, and Abass Ndao Hospital Center. The study period extended from August 1, 2023 to March 31, 2024. All patients with gastric and/or duodenal ulcers diagnosed during upper gastrointestinal endoscopy and who consented to participate were included. Sociodemographic, clinical, endoscopic, histological, therapeutic, and outcome data were collected using a standardized questionnaire. Statistical analyses were performed using Excel 2021 and R version 4.3. Results: During the study period, 1455 upper gastrointestinal endoscopies were performed. Among these, 83 cases of gastroduodenal ulcers were identified, corresponding to a frequency of 5.7%. The mean age of patients was 46 years (range: 12 - 80 years), with a predominance in the 40 - 60 year age group. A male predominance was observed (63.9%), with a sex ratio of 1.7. The most common clinical manifestation was epigastric pain (79.7%), while gastrointestinal bleeding occurred in 14.5% of cases. Duodenal ulcers were the most frequent (54.2%), followed by gastric ulcers (37.3%). Helicobacter pylori infection was detected in 92.6% of patients who underwent histological examination. Triple therapy combining a proton pump inhibitor, amoxicillin, and clarithromycin was the most frequently prescribed treatment (53.1%). Clinical improvement was observed in 80% of patients. Conclusion: This study highlights a continued decline in the prevalence of gastroduodenal ulcers in Dakar. However, Helicobacter pylori infection remains a key etiological factor in our context. Public health efforts should focus on improving access to eradication therapies, strengthening endoscopic follow-up, and enhancing patient awareness regarding treatment adherence in order to optimize the management of gastroduodenal ulcer disease.
References
[1]
Lanas, A. and Chan, F.K.L. (2017) Peptic Ulcer Disease. The Lancet, 390, 613-624. https://doi.org/10.1016/s0140-6736(16)32404-7
[2]
Valle, J.D. (2018) Peptic Ulcer Disease and Related Disorders. In: Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L. and Loscalzo, J., Eds., Harrison’s Principles of Internal Medicine, 20e. McGraw-Hill Education.
[3]
Mbengue, M., Diouf, M.L., Dangou, J.M., Ka, M.M., Ba-Seck, A., Ndiaye, M.F., Moreira-Diop, T., Ndiaye, P.D. and Bao, O. (1997) [Frequency of Helicobacter pylori Infection in Symptomatic Patients in Senegal]. Médecine Tropicale, 57, 256-258. https://pubmed.ncbi.nlm.nih.gov/9513152/
[4]
Diouf, M.-L., Ondélé-Ipongo, A.-P., Dia, D., Bassène, M.-L., Mbengue, M. and Seck, A. (2010) Trends in the Prevalence of Gastroduodenal Ulcers in the Digestive Endoscopy Center of Aristide Le Dantec Hospital in Dakar. Journal Africain d’Hépato-Gastroentérologie, 5, 23-27. https://doi.org/10.1007/s12157-010-0236-4
[5]
Li, Z., Zou, D., Ma, X., Chen, J., Shi, X., Gong, Y., et al. (2010) Epidemiology of Peptic Ulcer Disease: Endoscopic Results of the Systematic Investigation of Gastrointestinal Disease in China. American Journal of Gastroenterology, 105, 2570-2577. https://doi.org/10.1038/ajg.2010.324
[6]
Xie, L., Liu, G., Liu, Y., Li, P., Hu, X., He, X., et al. (2024) Prevalence of Helicobacter pylori Infection in China from 2014-2023: A Systematic Review and Meta-Analysis. World Journal of Gastroenterology, 30, 4636-4656. https://doi.org/10.3748/wjg.v30.i43.4636
[7]
Hooi, J.K.Y., Lai, W.Y., Ng, W.K., Suen, M.M.Y., Underwood, F.E., Tanyingoh, D., et al. (2017) Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology, 153, 420-429. https://doi.org/10.1053/j.gastro.2017.04.022
[8]
de Korwin, J.D. (2014) épidémiologie de l’infection à Helicobacter pylori et du cancer gastrique. La Revue du Praticien, 64, 189-193. https://eurekamag.com/research/053/008/053008507.php?utm_source=chatgpt.com
[9]
Millogo, T. (2010) Gastroduodenal Ulcer Disease in Hospitalized Patients at CHU/YO: Epidemiological, Clinical, and Therapeutic Aspects. Ph.D. Thesis, Centre Hospitalier Universitaire de Ouagadougou.
[10]
Coulibaly, A., Sermé, A.K., Godonou, H., Somda, K.S., Cissé, K., Romond, S., et al. (2016) Peptic Ulcer Disease in Chuyo. Open Journal of Gastroenterology, 6, 353-361. https://doi.org/10.4236/ojgas.2016.611038
[11]
Ndam, E.C.N., Tzeuton, C., Mbakop, A., Pouepene, J., Guemne, T.A., Njoya, O., et al. (1990) Upper Gastrointestinal Endoscopy in Cameroon. Médecine d’Afrique Noire, 37, 453-456.
[12]
Ankouane, F., Ngatcha, G., Kowo, M., Ndam, A., Tagni-Sartre, M., Dang, I., et al. (2016) Demographic and Endoscopic Analysis of Patients with Gastroduodenal Ulcer in Yaoundé, Cameroon: What Has Changed Since the 1990s? Médecine d’Afrique Noire, 14, 409-415.
[13]
Groenen, M.J., Kuipers, E.J., Hansen, B.E. and Ouwendijk, R.J.T. (2009) Incidence of Duodenal Ulcers and Gastric Ulcers in a Western Population: Back to Where It Started. Canadian Journal of Gastroenterology, 23, 604-608. https://doi.org/10.1155/2009/181059
[14]
Aro, P., Storskrubb, T., Ronkainen, J., Bolling-Sternevald, E., Engstrand, L., Vieth, M., et al. (2006) Peptic Ulcer Disease in a General Adult Population. American Journal of Epidemiology, 163, 1025-1034. https://doi.org/10.1093/aje/kwj129
[15]
Diallo, A., Cointet, F. and Mbaye, P.S. (1995) Epidemiological Aspects of Gastroduodenal Ulcer Disease in Senegal (About 858 New Cases Observed in One Year at the Principal Hospital of Dakar). Dakar Médical, 3, 101-104.
[16]
Seck, A., Mbengue, M., Gassama-Sow, A., Diouf, L., Ka, M.M. and Boye, C.S. (2009) Antibiotic Susceptibility of Helicobacter pylori Isolates in Dakar, Senegal. The Journal of Infection in Developing Countries, 3, 137-140. https://doi.org/10.3855/jidc.512
[17]
Lawson-Ananissoh, L.M., Bouglouga, O., Bagny, A., El-Hadj Yakoubou, R., Kaaga, L. and Redah, D. (2015) Epidemiological Profile of Gastroduodenal Ulcers at the Campus University Hospital of Lomé (Togo). Journal Africain d’Hépato-Gastroentérologie, 9, 99-103. https://doi.org/10.1007/s12157-015-0597-5
[18]
Diarra, M., Konate, A., Traoré, C., Soukho, A., Kamate, B., Diallo, A.B., et al. (2009) Gastroduodenal Ulcers in Rural Settings in Mali. Mali Médical, 2, 1-3.
[19]
Okon, J.B., Diakité, M., Aké, F., Koné, A., Koffi, O.K. and Kouamé, D.K. (2020) Management of Gastroduodenal Ulcer in an Ivorian University Hospital in the Era of Quadruple Therapy. Médecine d’Afrique Noire, 67, 673-682.
[20]
Sanogo, D.S., Doumbia, K., Sow, H., Diarra, A. and Youssoufou, O. (2024) Concomitant Quadruple Therapy in the Eradication Treatment of Helicobacter pylori in Gastroduodenal Ulcer Disease. Mali Médical, 39, 45-48.
[21]
Bamba, C.C.A., Ngone, G.M., Salamata, D., Polèle, F.M., Aissé, T.M. and Gnagna, D. (2021) Gastritis: Sociodemographic, Clinical, Endoscopic and Histological Aspects, about 593 Cases at the Digestive Endoscopy Unit of the General Hospital Idrissa Pouye. Open Journal of Gastroenterology, 11, 184？193. https://doi.org/10.4236/ojgas.2021.1110019
[22]
Diallo, S., Bassène, M.L., Fall, M.P. and Issa, A. (2021) Evaluation of Three Helicobacter pylori Eradication Protocols in a Digestive Endoscopy Center in Dakar. Open Journal of Gastroenterology, 11, 244？254. https://doi.org/10.4236/ojgas.2021.1111025
