Current Trends in Gastroduodenal Ulcers in Dakar (Senegal): A Prospective Multicenter Study

Abstract

Background : Gastroduodenal ulcer disease (GDU) remains a significant global health concern despite considerable therapeutic advances over recent decades. In Senegal, several studies have reported a progressive decline in its prevalence. However, updated data reflecting current epidemiological and therapeutic patterns remain limited. This study aimed to reassess the epidemiological, clinical, endoscopic, and therapeutic characteristics of gastroduodenal ulcers in Dakar. Methods : We conducted a prospective multicenter study in the digestive endoscopy units of three tertiary hospitals in Dakar: Idrissa Pouye General Hospital, Dalal Jamm National Hospital Center, and Abass Ndao Hospital Center. The study period extended from August 1, 2023 to March 31, 2024. All patients with gastric and/or duodenal ulcers diagnosed during upper gastrointestinal endoscopy and who consented to participate were included. Sociodemographic, clinical, endoscopic, histological, therapeutic, and outcome data were collected using a standardized questionnaire. Statistical analyses were performed using Excel 2021 and R version 4.3. Results : During the study period, 1455 upper gastrointestinal endoscopies were performed. Among these, 83 cases of gastroduodenal ulcers were identified, corresponding to a frequency of 5.7%. The mean age of patients was 46 years (range: 12 - 80 years), with a predominance in the 40 - 60 year age group. A male predominance was observed (63.9%), with a sex ratio of 1.7. The most common clinical manifestation was epigastric pain (79.7%), while gastrointestinal bleeding occurred in 14.5% of cases. Duodenal ulcers were the most frequent (54.2%), followed by gastric ulcers (37.3%). Helicobacter pylori infection was detected in 92.6% of patients who underwent histological examination. Triple therapy combining a proton pump inhibitor, amoxicillin, and clarithromycin was the most frequently prescribed treatment (53.1%). Clinical improvement was observed in 80% of patients. Conclusion : This study highlights a continued decline in the prevalence of gastroduodenal ulcers in Dakar. However, Helicobacter pylori infection remains a key etiological factor in our context. Public health efforts should focus on improving access to eradication therapies, strengthening endoscopic follow-up, and enhancing patient awareness regarding treatment adherence in order to optimize the management of gastroduodenal ulcer disease.