This archive report was first published on 25 September 2019.
Kenya: A Stomach Bacteria Threatens Nairobi's Residents. What Can Be Done to Stop It ¶
Published on September 25, 2019, a study found that Helicobacter Pylori (H.pylori) is a public health concern in Nairobi due to poor urban sanitation and access to clean water.
According to Dr. Kimang'a Nyerere, H.pylori is a type of bacteria that interferes with the process controlling how much acid is in the stomach. It can cause a heavy acid load, leading to issues such as inflammation of the stomach lining (gastritis) and ulcers in the duodenum (the first part of the small intestine). If left untreated, it can even cause certain cancers.
People usually catch H.pylori from another person (through saliva) or if they eat food or drink water that's contaminated with faeces. In 2016, Dr. Nyerere and his colleagues investigated the presence of H.pylori in the water of the Nairobi River basin, which has three major rivers - Ngong, Nairobi, and Mathare. They found that 56% of the city's residents live in highly congested informal and middle-class settlements along the Nairobi River banks, and the river is very polluted by garbage, human waste, industrial waste, and overflowing sewers.
Dr. Nyerere's team detected H.pylori in two of the nine domestic wells sampled and one out of four rivers sampled. This finding is significant, considering H.pylori is a serious pathogen that's categorized as a 'definite' carcinogen by the World Health Organisation.
The presence of H.pylori can be attributed to a lack of sanitation. Dr. Nyerere's team found that 90% of the people who lived in the areas where H.pylori was detected didn't have toilets connected to the main sewerage system. They mostly used long-drops or defecated openly.
Studies in Kenya have put the prevalence of H.pylori at about 67.5% in all age groups. However, some African countries have shown higher infection rates: 91.7% in Egypt, 97% in The Gambia, and 75.4% in Ghana. This is almost twice as high as the average rates in developed countries of 34.7%.
Those infected can be treated with antibiotics. Treatment is quite intensive and usually involves more than one antibiotic and antacids over a period of up to 10 days. However, treatment failures are frequently reported, usually because people haven't taken the medication properly, or the bacteria has become resistant to some of the drugs.
Dr. Nyerere and his colleagues recently investigated the effectiveness of a 10-day sequential therapy compared with the standard 10-day triple therapy for treatment of H. pylori infection in children. They found that patients on the 10-day sequential therapy had a much higher H.pylori eradication rate than patients who received conventional treatment: 84.6% versus 48.8%, respectively.
Kenya should also consider using a test-and-treat strategy. In this approach, groups of people who are thought to be at high risk are tested and those who test positive are given treatment. In other countries, this strategy has had success in reducing the spread of H.pylori.
