Awareness, attitude, and practice of pediatricians in relation to helicobacter pylori infection, diagnosis, and management in Rwanda

Abstract

INTRODUCTION: Helicobacter pylori infection (HPI) is a global public health problem, believed to cause more than 300,000 deaths each year. This study explores pediatricians' awareness, attitudes, and practices regarding diagnosing and managing helicobacter pylori infection (HPI) in Rwanda.

METHODS: This descriptive cross-sectional study was conducted from May to June 2022 in Rwanda. Among eighty registered pediatricians, 66 were recruited based on a simple random sampling approach. The lead researcher distributed a self-administered questionnaire. Data were analyzed using SPSS software, and a p-value of ≤ 0.05 was considered significant.

RESULTS: Among sixty-six recruited participants, more than half (57.6%) initiated testing from 5-12 years of child’s age, 86.4% treated the infection after investigation, and the most requested investigations were: stool antigen (90.6%), serology test (46.9%), and endoscopic exam (31.3%). Participants from public institutions were more likely to utilize stool antigen (90.0% vs 50.0%, OR:1.800, p=0.006) and less likely to utilize serology tests (40.0% vs 83.3%, OR:0.480, p=0.041).Participants with the rank of consultant or beyond were more adherent to a 14-day antibiotic regimen than junior consultants (55.0% vs 26.9%, OR:1.624, p=0.025).

CONCLUSIONS: Rwandan pediatricians are aware of the current evidence on H. pylori and are willing to utilize evidence-based guidelines. The results express a need to institutionalize the existing evidence on HPI among the pediatric population and a need to promote continuous medical education for capacity building of the pediatricians. Where possible, hospitals should create and sustain the inter-facility agreement to utilize the existing minimum capacity to serve the maximum number of patients, as stated by Sustainable Development Goal 17.