SERODIAGNOSIS  AND  RISK FACTOR ANALYSIS FOR HELICOBACTER PYLORI AND SHIGELLA FLEXNERI INFECTION IN BANGLADESHI POPULATION 

                                     

 Abstract

The gastric barrier, an important host defense against small bowel infection, may be compromised by infection with Helicobacter pylori. Warren and Marshall, in 1983, successfully cultured a corkscrew-shaped, microaerophilic gram-negative bacterium from the human gastric mucosa, termed as Helicobacter pylori. H. pylori infection is causally associated with chronic antral gastritis, duodenal ulcer, gastric ulcer and gastric cancer. H. pylori seroprevalence is generally significant higher in adults in developing countries (70-90%) compared with developed countries (30-50%).

Bacillary dysentery caused by Shigella species is a public health problem in developing countries including Bangladesh. Among the four species, S. flexneri though less virulent but still frequently causes sever dysentery and its complication. Before 1971, S. flexneri was predominant species and after liberation war S. dysenteriae maintained its dominance till the comeback of S.  flexneri in 1978. Though four species of Shigella are endemic in Bangladesh, recent study revealed that Shigella flexneri infection accounts for the majority of Shigella related deaths.

The key aims of the present study were to evaluate the seroprevalance of H. pylori and S. flexneri infection among the Bangladeshi population and to assess whether there is association between various risk factors.

Serum samples (n=400) were collected from Dhaka University, Ad-Din Hospital and Dhaka Medical college hospital, and from this 376 serum samples were employed to detect the presence of H. pylori and S. flexneri specific antibody by non-invasive, low cost, rapid less laborious In-House ELISA method. Optical density (O.D.) values found ³1 were considered as seropositive and <1 were considered as seronegative. The background information obtained from the study population by questionnaire was analyzed statistically with computer program SPSS. Over all 79% of the total study population were seropositive for   H. pylori infection and 79.3% were positive for S. flexneri infection. A lack of association was found between the seroprevalence of H. pylori, S. flexneri and sex, blood group, diarrhea and abdominal pain (present symptom or past symptom within one year). Seroprevalence of       H. pylori has been found related significantly with age group (p= 0.023) which increase with increasing age, occupation (p=0.001), present acidity (p=0.014), long history of acidity (p=0.009) and pregnancy (p=0.035). Seroprevalence of S. flexneri has been found significant associated with occupation (p=0.004). Seroprevalence of S. flexneri infection not found significantly related with study population having acidity. No significant association was observed in H. pylori infection and the development of S. flexneri infection. By odds ratio (OR) analysis it was found that occupation (OR=2.208), present acidity (OR=1.203) and long history acidity (OR=2.364) and pregnancy (OR=2.228) be the potential risk factors of developing of H. pylori infection.

It may be concluded from the present study that H. pylori and S. flexneri infection is widespread among the Bangladeshi population and their prevalence may be associated with various socioeconomic and health related factors.

 

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