Establishing a Consensus Algorithm for H. Pylori Screening, Diagnosis, Initial Management, and Referral Protocols for Primary Care Physicians

Helicobacter pylori infection remains a major contributor to peptic ulcer disease and gastric cancer in Africa, yet diagnosis and treatment in primary care settings remain inconsistent. In a consensus-based Nigerian study, published in the Nigerian Medical Journal, involving 245 symptomatic patients, 55% tested positive for H. pylori, with epigastric pain, nausea/vomiting, and bloating identified as the most common presenting symptoms. 
The study also found that treatment-naïve patients were significantly more likely to test positive compared to previously treated patients, reinforcing the importance of early screening and standardized management.
Using findings from physician-led patient assessments, rapid antibody testing, and expert consensus through a modified Delphi process, the researchers developed a practical algorithm for H. pylori screening, diagnosis, treatment, and referral in resource-limited healthcare settings. The stepwise, evidence-based approach detailed in the algorithm could improve early diagnosis, optimize eradication rates, and strengthen H. pylori management across primary and secondary care in Africa.