Review

Helicobacter pylori infection and transmission in Africa: Household hygiene and water sources are plausible factors exacerbating spread

C. Dube¹, N. F. Tanih¹, A. M. Clarke¹, N. Mkwetshana¹, E. Green¹ and R. N. Ndip^1,2*

¹Microbial Pathogenicity and Molecular Epidemiology Research Group, Department of Biochemistry and Microbiology, Faculty of Science and Agriculture, University of Fort Hare, Private Bag X1314, Alice 5700, South Africa.

²Department of Biochemistry and Microbiology, Faculty of Science, University of Buea, Cameroon.

*Corresponding author. E-mail: rndip@ufh.ac.za or ndip3@yahoo.com. 

Tel: +27 782696191. Fax: +27 86624759.

Accepted 21 September, 2009

   Abstract

Helicobacter pylori (H. pylori) is a microaerophilic motile curve rod that inhabits the gastric mucosa of the human stomach. The organism chronically infects billions of people worldwide and is one of the most genetically diverse of bacterial species. Infection with the bacterium which leads to chronic gastritis, peptic ulceration, gastric cancers and gastric malt lymphoma has been reported to follow a pattern linked to geographic and socio-demographic factors. Studies have documented a higher prevalence in Africa than elsewhere although the pathological outcomes do not correlate with infection. H. pylori transmission pathways are still vague, but the risks of transmission include precarious hygiene standards, over-crowding and contaminated environment and water sources amongst others. The possible routes of transmission include oral-oral, faecal-oral and person- to -person, either with or without transitional transmission steps during episodes of diarrhoea or gastro-oral contact in the event of vomiting. Use of contaminated water including municipal tap water has also been suspected to have a high impact in the transmission of the organism. To generate the data presented in this paper, we conducted an internet based search on relevant literature pertaining to H. pylori epidemiology in general and Africa in particular. Sites such as Pubmed, AJOL, Scopus and Goggle scholar were mainly used. This paper therefore attempts to appraise the role of household hygiene and water sources in the transmission of this organism in the developing world context.

Key words: H. pylori, Africa, prevalence, transmission, socio-economic factors, environmental factors, hygiene.