Burden of Helicobacter pylori Infections and Associated Risk Factors among Cases of Iron Deficiency Anaemia in Egypt

Abstract

Introduction: Iron deficiency anaemia (IDA) is a worldwide nutritional problem; it accounts for about half of the world’s anaemia burden. Globally, Helicobacter pylori (H. pylori) is becoming an increasingly troublesome economic and public health problem. The colonization of the organism in gastric mucosa may impair iron uptake and increase iron loss, potentially leading to iron deficiency anaemia. The mechanisms by which H. pylori is postulated to cause IDA are H. pylori -associated chronic gastritis resulting in hypo/or achlorhydria, reduced ascorbic acid secretion and reduced intestinal iron absorption, occult blood loss due to chronic erosive gastritis, and sequestration and utilization of iron by Helicobacter pylori. Aims: To detect H. pylori–related IDA prevalence among asymptomatic cases of anaemia and to address the possibility that such infection may play a detrimental role in their blood picture, serum iron and ferritin levels and total iron binding capacity (TIBC) Study Design & Methods: Facility based cross-sectional study was conducted in the period from December 2018 to May 2019. Screening was done for asymptomatic attendants of a   number of private laboratories in Beheira, Alexandria and Gharbiya governorates. Three hundreds of whom were proved to be cases of IDA and were further tested for H. pylori antigen in stool. Results: Helicobacter pylori Ag test in stool was positive in 180 out of 300 cases of iron deficiency anaemia. The infection significantly affected the haemoglobin level, MCV, MCH and RDW in studied cases (p<0.05). Infection with H. pylori also significantly affected the serum iron, serum ferritin and TIBC in the studied cases of IDA (p<0.05). Conclusion: A significant association between H. pylori infection and IDA. Screening for H. pylori among unexplained cases of IDA is recommended.