Assessment and Management of Chronic Dyspepsia in Eastern Uganda
Status:
Completed
Trial end date:
2020-06-30
Target enrollment:
Participant gender:
Summary
Chronic dyspepsia, or a sensation of indigestion, remains an underdiagnosed and often
inappropriately managed cause of morbidity in countries with limited medical resources. A
recent questionnaire of Eastern Ugandan residents identified chronic dyspepsia as the most
bothersome symptom in nearly 60% of respondents, resulting in significant morbidity and work
days missed. One of the most common causes for chronic dyspepsia worldwide is infection with
the stomach-adapted bacterium Helicobacter pylori (Hp), the most significant risk factor for
the development of stomach cancer. In developing countries, particularly in sub-Saharan
Africa, the prevalence of Hp has not been accurately determined, often owing to a lack of
adequate diagnostic methods. More importantly, proper diagnosis and treatment of chronic
dyspepsia would limit morbidity and mortality and help decrease the likelihood of progressing
to stomach cancer.
The purposes of this study are to identify the prevalence of chronic dyspepsia among
residents of eastern Uganda using a questionnaire, to assess how common Hp infection is using
fecal Hp antigen test kits, and to evaluate the efficacy of Hp eradication using standard
Ugandan treatment guidelines. Participants who test positive for Hp infection by fecal Hp
antigen testing will be offered Hp eradication treatment in the form of two antibiotics
(clarithromycin, amoxicillin) and an acid-suppression medication (omeprazole), according to
the current Ugandan guidelines. Patients with chronic dyspepsia who are negative for Hp (by
fecal antigen testing) will be given a one-month trial of omeprazole alone, according to
current American College of Gastroenterology guidelines, and their symptoms will be
reassessed. At the end of the treatment regimens, participants will have the option to
complete a follow-up questionnaire and provide stool samples for fecal antigen testing (if
they were Hp-positive).