Email updates

Keep up to date with the latest news and content from BMC Gastroenterology and BioMed Central.

Open Access Highly Accessed Research article

Helicobacter pylori infection: approach of primary care physicians in a developing country

Shahid Ahmed*, Mohammad Salih, Wasim Jafri, Hasnain Ali Shah and Saeed Hamid

Author Affiliations

Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan

For all author emails, please log on.

BMC Gastroenterology 2009, 9:23  doi:10.1186/1471-230X-9-23

Published: 9 April 2009

Abstract

Background

The aim of the study was to assess the knowledge and practices of primary care physicians in diagnosis and management of Helicobacter pylori (H. pylori) infection in developing country.

Methods

This convenient sample based, cross sectional study was conducted in primary care physicians of Karachi, Pakistan from March 2008 to August 2008 through a pretested self-designed questionnaire, which contained 11 items pertaining to H. pylori route of transmission, diagnosis, indication for testing, treatment options, follow up and source of information.

Results

Out of 509 primary care physicians, 451 consented to participate with the response rate of 88.6%. Responses of 426 primary care physicians were analyzed after excluding 19 physicians. 78% of the physicians thought that contaminated water was the source of spread of infection, dyspepsia was the most frequent indication for investigating H. pylori infection (67% of the physicians), while 43% physicians were of the view that serology was the most appropriate test to diagnose active H. pylori infection. 77% of physicians thought that gastric ulcer was the most compelling indication for treatment, 61% physicians preferred Clarithromycin based triple therapy for 7–14 days. 57% of the physicians would confirm H. pylori eradication after treatment in selected patients and 47% physicians preferred serological testing for follow-up. In case of treatment failure, only 36% of the physicians were in favor of gastroenterologist referral.

Conclusion

The primary care physicians in this study lacked in knowledge regarding management of H. pylori infection. Internationally published guidelines and World gastroenterology organization (WGO) practice guideline on H. pylori for developing countries have little impact on current practices of primary care physicians. We recommend more teaching programs, continuous medical education activities regarding H. pylori infection.