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Abstract:
The objective of this study was to examine demographic, clinical, and pathologic variables, including Helicobacter pylori infection and malignancy, associated with chronic abdominal pain in a rural Haitian population. One hundred four patients underwent esophagogastroduodenoscopy, with biopsy only in those with gross findings. Associations between demographic, clinical, and pathologic variables were examined using the chi-square test. Pvalues less than or equal to 0.05 were considered statistically significant. The majority (n = 66; 63%) required biopsy. Of these, 62% were positive for H. pylori. The associations between (1) chest complaints and esophageal disease, (2) female gender and benign esophageal disease, and (3) chronic active gastritis and presence of H. pylori-were, significant. There was one malignancy. H. pylori gastritis was common; malignancy was rare. Demographic and clinical variables poorly predicted pathologic diagnosis, which is consistent with previous studies. Further study is needed to assess the influence of other variables, including the African enigma, on disease progression in this population.
Key words: Helicobacter pylori, Haiti, chronic gastritis, abdominal pain, African enigma.
The Republic of Haiti is the second oldest democracy and the poorest country in the Western hemisphere. Ethnically 90% African, its population has been subject to extraordinary hardship, largely because of political turmoil and failed economic policies. The negative impact of this environment on the health of the Haitian people has been enormous, particularly in rural areas. The persistent lack of basic medical care, adequate nutrition, and public health standards have resulted in high infant mortality, malnutrition, and decreased life expectancy. International support in the form of supplies, medicines, and volunteers helps to ease the shortage of local healthcare resources, but never bridges the medical gulf between Haiti and other Western and Caribbean countries.
An extraordinary example of support is the H6pital Albert Schweitzer (HAS) in Deschapelles, Haiti, founded by Dr. and Mrs. Larimer Mellon in 1957. Established on the premise that the hospital would ultimately be turned over to the Haitian people, now more than 90% of the staff is Haitian. The hospital attracts volunteers, drawn to its mission, from all over the world. The hospital service area comprises a 610-square mile region in the Artibonite Valley of central Haiti. Inpatient services at HAS include pediatrics, obstetrics and gynecology, adult medicine, and surgery. Outpatient...