Background Low- and middle-income countries have a high prevalence of Helicobacter pylori infection (HPI). In Cameroon, the majority of HPIs are diagnosed and treated by primary care physicians (PCPs). We sought to assess the knowledge and practices of PCPs in the diagnosis and management of HPI in Cameroon. Methods A hospital-based cross-sectional study was carried out in four randomly selected regions of Cameroon from November 2021 to June 2022. In each of the selected regions, PCPs were recruited by non-probability convenience sampling and interviewed using a pre-structured questionnaire. Chi-squared, Fisher’s exact and Student's t-tests were performed for descriptive analyses. Multivariable logistic regression was used to examine associations between knowledge and practice, with the model adjusted by age of the PCP, geographic region, number of patients and years in practice. Analysis was performed in SAS version 9.4 (SAS Institute, Cary, NC, USA). Results A total of 382 PCPs were included in the analysis. The majority (60.0%) were males between the ages of 20–29 y (64.1%). Most PCPs (80.9%) reported that HPI is the cause of gastroesophageal reflux disease and 41.8% reported that HPI is the main cause of dyspeptic symptoms. The dominant diagnostic tests used for HPI were serology (52.8%) and stool antigen (30.9%). The most frequently used first-line therapies were amoxicillin (AMX), clarithromycin (CLA), metronidazole (MNZ) and proton pump inhibitor (PPI) concomitant therapy (32.2%), AMX–CLA–PPI triple therapy (18.6%) and AMX–MNZ–PPI triple therapy (13.1%). Half of the practitioners (48.6%) treat HPI empirically, without positive H. pylori testing. About half of the PCPs (48%) do not request laboratory confirmation of H. pylori eradication following treatment. Conclusions There is inadequate knowledge and significant differences in the clinical approach towards HPI among PCPs in Cameroon. We recommend more teaching programs and continuous medical education on HPI.

中文翻译：

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喀麦隆初级保健医生对幽门螺杆菌诊断和管理的知识和方法：一项横断面研究

背景 低收入和中等收入国家幽门螺杆菌感染（HPI）的患病率很高。在喀麦隆，大多数 HPI 由初级保健医生 (PCP) 诊断和治疗。我们试图评估喀麦隆 PCP 在 HPI 诊断和管理方面的知识和实践。方法 2021 年 11 月至 2022 年 6 月在喀麦隆随机选择的四个地区进行了一项以医院为基础的横断面研究。在每个选定地区，通过非概率方便抽样招募 PCP，并使用预先设计的问卷进行访谈。进行卡方检验、Fisher 精确检验和学生 t 检验以进行描述性分析。使用多变量逻辑回归来检查知识与实践之间的关联，并根据 PCP 的年龄、地理区域、患者数量和实践年限对模型进行调整。分析在 SAS 9.4 版（SAS Institute，Cary，NC，USA）中进行。结果 共有 382 名 PCP 纳入分析。大多数 (60.0%) 是 20-29 岁之间的男性 (64.1%)。大多数 PCP (80.9%) 报告 HPI 是胃食管反流病的病因，41.8% 报告 HPI 是消化不良症状的主要原因。HPI 的主要诊断测试是血清学（52.8%）和粪便抗原（30.9%）。最常用的一线疗法是阿莫西林 (AMX)、克拉霉素 (CLA)、甲硝唑 (MNZ) 和质子泵抑制剂 (PPI) 联合疗法 (32.2%)、AMX-CLA-PPI 三联疗法 (18.6%) 和 AMX –MNZ–PPI 三联疗法 (13.1%)。一半的从业者 (48.6%) 凭经验治疗 HPI，没有幽门螺杆菌检测呈阳性。大约一半的 PCP (48%) 不要求实验室确认治疗后幽门螺杆菌根除。结论 喀麦隆 PCP 对 HPI 的临床方法认识不足且存在显着差异。我们推荐更多关于 HPI 的教学项目和继续医学教育。