Prevalence of H. Pylori in Tonsillar Tissue of Patients with Chronic Recurrent Tonsillitis Using Rapid Urease Test in a Tertiary Referral Hospital in Sub Saharan Africa

Abstract Background Access to surgical care in Low- and Middle-Income Countries (LMICs) such as Tanzania is extremely limited. Northern Tanzania is served by a single tertiary referral hospital, Kilimanjaro Christian Medical Centre (KCMC). The surgical volumes, workflow, and payment mechanisms in this region have not been characterized. Understanding these factors is critical in expanding access to healthcare. The authors sought to evaluate the operations and financing of the main operating theaters at KCMC in Sub-Saharan Africa. Methods The 2018 case volume and specialty distribution (general, orthopaedic, and gynecology) in the main operating theaters at KCMC was retrieved through retrospective review of operating report books. Detailed workflow (i.e. planned and cancelled cases, lengths of procedures, lengths of operating days) and financing data (patient payment methods) from the five KCMC operating theater logs were retrospectively reviewed for the available five-month period of March 2018 to July 2018. Descriptive statistics and statistical analysis were performed. Results In 2018, the main operating theaters at KCMC performed 3817 total procedures, with elective procedures (2385) outnumbering emergency procedures (1432). General surgery (1927) was the most operated specialty, followed by orthopaedics (1371) and gynecology (519). In the five-month subset analysis period, just 54.6% of planned operating days were fully completed. There were 238 cancellations (20.8% of planned operations). Time constraints (31.1%, 74 cases) was the largest reason; lack of patient payment accounted for as many cancellations as unavailable equipment (6.3%, 15 cases each). Financing for elective theater cases included insurance 45.5% (418 patients), and cash 48.4% (445 patients). Conclusion While surgical volume is high, there are non-physical inefficiencies in the system that can be addressed to reduce cancellations and improve capacity. Improving physical resources is not enough to improve access to care in this region, and likely in many LMIC settings. Patient financing and workflow will be critical considerations to truly improve access to surgical care.

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Lower Extremity Injury at a Tertiary Referral Hospital in Sub-Saharan Africa: Injuries, Treatments and Outcomes

Journal of Surgical Research ◽

10.1016/j.jss.2011.11.958 ◽

2012 ◽

Vol 172 (2) ◽

pp. 347

Author(s):

J.A. Tomlinson ◽

T.E. Chilunjika ◽

A.G. Charles ◽

S. Young ◽

M.C. Hosseinipour ◽

...

Keyword(s):

Lower Extremity ◽

Referral Hospital ◽

Sub Saharan Africa ◽

Lower Extremity Injury ◽

Extremity Injury ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Sub Saharan

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Prevalence of Helicobacter pylori colonisation in tonsillar tissue in cases of chronic tonsillitis: a prospective study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181863 ◽

2018 ◽

Vol 4 (3) ◽

pp. 738

Author(s):

Vellamparambil Sreejaraj ◽

Paul Vazhapilly Sumam ◽

Verghese Nevil ◽

Karuthedath Sridevi ◽

Ariyamparampil Rajagopalan Vinayakumar

Keyword(s):

Helicobacter Pylori ◽

Tertiary Hospital ◽

Chronic Tonsillitis ◽

Rapid Urease Test ◽

Recurrent Tonsillitis ◽

Cross Sectional ◽

Female Ratio ◽

Tonsillar Tissue ◽

Urease Test ◽

H Pylori

Background: Human stomach is not the only reservoir of Helicobacter pylori but it has been detected in dental plaques, oral lesions and saliva. It could play role in the pathogenesis of various otorhinolaryngologic problems and remains debatable. This study was aimed to find out the prevalence of H. pylori in tonsillar tissue of patients with chronic tonsillitis by rapid urease test in a tertiary hospital in Kerala.Methods: Prospective cross sectional study was done in patients who attended the outpatient department of ENT with a history suggestive of chronic tonsillitis. The patient satisfied the criteria for chronic recurrent tonsillitis were subsequently posted for tonsillectomy. Each specimen was subjected to rapid urease test. Results: Total 228 patients were included in this study with age ranging between 3 and 31 years (10.0±7.1), with most common age being <10 years in 159 patients (69.7%). Male to female ratio was 1.4:1. Among these, the presence of H. pylori was seen in only 6/228 patients.Conclusions: The possibility of tonsillar tissue acting as a reservoir for H. pylori infection is very low.

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Neck dissection: Clinicosurgical appraisal of 21 cases in a sub-Saharan African tertiary referral hospital

Journal of Clinical Sciences ◽

10.4103/jcls.jcls_32_18 ◽

2018 ◽

Vol 15 (4) ◽

pp. 176

Author(s):

RamatOyebunmi Braimah ◽

AbdurrazaqOlanrewaju Taiwo ◽

AdebayoAremu Ibikunle ◽

OlalekanMicah Gbotolorun ◽

TerryGodwin Ndubuizu

Keyword(s):

Neck Dissection ◽

Referral Hospital ◽

Tertiary Referral ◽

Tertiary Referral Hospital ◽

Sub Saharan

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Overview of Helicobacter pylori Detection Using Rapid Urease Test and Giemsa Modification Staining in Chronic Tonsillitis Patients

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5244 ◽

2020 ◽

Vol 8 (B) ◽

pp. 1105-1109

Author(s):

Ade Asyari ◽

Ferdy Azman ◽

Novialdi Novialdi ◽

Aziz Djamal ◽

Hafni Bachtiar ◽

...

Keyword(s):

Helicobacter Pylori ◽

Descriptive Study ◽

Chronic Tonsillitis ◽

Rapid Urease Test ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Tonsillar Tissue ◽

Urease Test ◽

Tonsil Tissue ◽

H Pylori

BACKGROUND: Helicobacter pylori (H. pylori) is a Gram-negative bacteria and has been known for its role in causing gastric infection aused diseases such as gastric ulcer. H. pylori also implied to play a role in chronic tonsillitis, but this theory remains controversial. Many researches have different and contradictory results due to difficulty to accurately detect H. pylori in tonsillar tissue. There is still no appropriate method that able to detect H. pylori in tonsil tissue. AIM: The aim of the study was to detect H. pylori colonization in chronic tonsillitis and understand some of the methods of examination that can be done to detect H. pylori in tonsillar tissue. METHODS: This study is a descriptive study conducted on 25 respondents. Each sample was taken from patients with chronic tonsillitis who underwent tonsillectomy. Then, the rapid urease test (RUT) and the Giemsa modification staining were carried out to determine the presence of H. pylori. RESULTS: There were 19 people (76%) positive and 6 people (24%) negative for H. pylori using RUT. On examination with Giemsa modification staining obtained 19 people (76%) positive and 6 people (24%) negative for H. pylori. CONCLUSION: H. pylori can be found in most of chronic tonsillitis. Combination RUT and Giemsa modification staining examination can be a good option in detecting H. pylori in chronic tonsillitis.

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A Correlative Study between Chronic Tonsillitis and Helicobacter Pylori

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2019.v27i1.227 ◽

2019 ◽

Vol 27 (1) ◽

pp. 60-64

Author(s):

Abhishek Singh ◽

Santosh Uttarkar Pandurangarao ◽

Aravind Darga Ramchandra ◽

Sridurga Janarthanan

Keyword(s):

Helicobacter Pylori ◽

Acute Infection ◽

Chronic Tonsillitis ◽

Common Finding ◽

Rapid Urease Test ◽

Palatine Tonsils ◽

Regular Treatment ◽

Tonsillar Tissue ◽

Urease Test ◽

H Pylori

Introduction : Chronic tonsillitis is characterized by persistent inflammation of the palatine tonsils and seen commonly in patients attending ENT OPD. Bacterial infection is usually the cause but anaerobes and viruses may also be implicated. The possibility that tonsillar tissue possesses Helicobacter pylori or that H. pylori can colonize the palatine tonsils is explored. Materials and Methods : Hundred patients aged between 5-50 years of either sex diagnosed with chronic tonsillitis undergoing elective tonsillectomy and willing to participate in the study were selected. Informed and written consent was taken from all the patients (in case of minor patients, consent was taken from parents). Specimen (tonsillar tissue) was harvested from the surgically removed tonsils and put through Rapid urease test. The results were analysed statistically using Chi square test and Unpaired t test and inference was drawn. Results : Amongst 100 patients, 61 (61%) patients were females and 39 (39%) patients were males. Helicobacter pylori could be detected in Chronic Tonsillitis in 64 (64%) patients. Conclusion : According to our study, Helicobacter pylori was found to be a common finding in cases of chronic tonsillitis. Even after regular treatment with antibiotics, the chances of getting acute infection in chronic tonsillitis still persist. We can try treatment for H. pylori and look for changes in recurrence of tonsillitis and also it can be tried in patients who are not willing/fit to undergo tonsillectomy.

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