•Don says chronic bacterial infection with germ is the strongest risk factor for stomach cancer, advocates mass education

Medical scientists have alerted to a rise in cases of gastric cancer deaths associated with Helicobacter pylori (an organism that causes stomach ulcers) in Nigeria.

They said chronic bacterial infection with Helicobacter pylori is the strongest risk factor for stomach cancer.

Founding President, African Helicobacter and Microtobiota Study Group (AHMSG), Prof. Stella Smith, has canvased more awareness of Helicobacter pylori to reduce the rate of gastric cancer-related deaths in the country.

Speaking on Monday during the historic launch of AHMSG in Lagos, she explained that Helicobacter pylori are a type of bacteria that infects the stomach and causes gastric cancer.

With the theme: “Helicobacter pylori, A Neglected Bacteria Pathogen in Need of Attention,” she said many people are familiar with diseases like malaria, Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS), tuberculosis, COVID-19 and Ebola because “they have been given so much focus. So Helicobacter pylori are worth noticing and must be given urgent attention.”

She further disclosed that Helicobacter pylori are a neglected pathogen, adding that about 50 per cent of the world’s population is infected.

She recalled, “I was working on Campylobacter jejuni and C. coli, when some months into my programme, I think early 1994, my host and supervisor announced to us all that he had ‘caught the bug’. While wondering in my mind, if he was referring to an insect, he photocopied two pages on H. pylori, which I had never heard about until that moment and after reading through I thought it was meant for the Caucasians, but to my surprise on getting home that evening my landlady’s (Nigerian) sister announced to us that she did a test in her pregnant state and she was informed she had H. pylori.

“There and then she asked me if I knew anything about H. pylori and that was when it dawned on me it wasn’t meant for only a set of people but it was a disease that affected all. This was the scenario that informed my decision to work on H. pylori after my PhD. I got home and started the process of getting my first PhD student to co-supervise his work on H. pylori. We used to travel to Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) and come back the same day at night around 11 pm. I was able with this to obtain three post-doctoral fellowships, two in Germany and one in France.”

Continuing, she said after her post-doctoral in Germany and France, she started nursing the idea of the West African Helicobacter Study Group in 2001 and “I muted the idea to Prof. Arigbabu. We established the West African Helicobacter Study group with Prof. Arigbabu as President and my humble self as Vice, but this group didn’t last long due to paucity of funds and it naturally fizzled out, but I still held on to that idea due to the inappropriate diagnosis, treatment and management of H. pylori. Let me state here that Prof. Arigbabu gave me an opportunity by listening to me and he supported me to date. I also want to appreciate Profs. Ndububa, Otegbayo, Onyekwere and recently Dr Ugiagbe were with me on this journey of H. pylori research in Nigeria.

“I met my other board members during some of my meetings with DFG and quest to look for members for the group. The Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) is the central, independent research-funding organisation in Germany. It was in 2010, that the idea of African Helicobacter Study Group came back to me, and I discussed it with my then collaborator, who was very busy and so was not keen. It wasn’t until I met Dr. Christian Schulz, in late 2020 whom I called my younger brother and again muted the idea to him, he then discussed this with Prof. Peter Malfertheiner, The Big Masquerade of European Helicobacter and whom I call my professional daddy, that the establishment of the Group began to see the light of the day. Christian asked me if I was ready to steer the Group and I excitedly said yes and then I started communicating for the purposes of getting partners with the same dream as I and the rest is history.”

Speaking further, she said in countries where there is gastric cancer, there is a high rate of death.

“We need to look at the culture so that we can know the exact treatment to give the organism.

Whatever research we do is not Nigeria alone, we are conducting in-depth research on Helicobacter pylori, its treatment and its management in Africa.

Speaking on AHMSG, she said: “We decided to fill the gap because Helicobacter pylori are real.” She added that the Group is multidisciplinary, comprising representatives from several African countries with a vision to advance Helicobacter pylori research.

Director-General, Nigerian Institute of Medical Research (NIMR), Prof. Babatunde Lawal Salako, stated that the Group is long overdue because the area they have chosen is the gastrointestinal system.

He noted that it is an opportunity to bring a group of Africans together that have shared experience and common problems and would be able to use that platform to research into the occurrence of the bacteria, how prevalent it is, and how to treat and prevent it.

Most of the time, he observed that Africans are often left out but now there is a group that has its focuses in new ways of diagnosis, treatment or prevention, peculiar to Africa.

“My charge to them is to ensure that what they started today is not allowed to die. They should water it and make it grow beyond what it is today because we have a very large population in Africa and Nigeria in particular that will continue to require young hands that need this kind of platform to launch themselves. So if this group continues to grow, they can absorb more of our future scientists.”

Secretary, AHMSG, Muhammed Alboraie, said: “We are following the guidelines released by European and Asian Scientists but we didn’t have such a group in Africa so this group is very important because we will develop our own strategy to manage this bacteria.”

Helicobacter pylori, previously known as Campylobacter pylori, is a gram-negative, microaerophilic, spiral (helical) bacterium usually found in the stomach. Its helical shape (from which the genus name, helicobacter, derives) is thought to have evolved in order to penetrate the mucoid lining of the stomach and thereby establish infection. The Australian doctors Barry Marshall and Robin Warren first identified the bacterium in 1982. H. pylori has been associated with cancer of the mucosa-associated lymphoid tissue in the stomach, oesophagus, colon, rectum, or tissues around the eye (termed extranodal marginal zone B-cell lymphoma of the cited organ), and of lymphoid tissue in the stomach (termed diffuse large B-cell lymphoma).

H. pylori infection usually has no symptoms but sometimes causes gastritis (stomach inflammation) or ulcers of the stomach or first part of the small intestine. The infection is also associated with the development of certain cancers. Many investigators have suggested that H. pylori causes or prevents a wide range of other diseases, but many of these relationships remain controversial.

Some studies suggest that H. pylori play an important role in the natural stomach ecology, e.g. by influencing the type of bacteria that colonize the gastrointestinal tract. Other studies suggest that non-pathogenic strains of H. pylori may beneficially normalize stomach acid secretion, and regulate appetite.

In 2015, it was estimated that over 50 per cent of the world’s population had H. pylori in their upper gastrointestinal tracts with this infection (or colonization) being more common in developing countries. In recent decades, however, the prevalence of H. pylori colonization of the gastrointestinal tract has declined in many countries.