Antral biopsies obtained by gastro-intestinal endoscopy from 200 Ethio
pian patients with dyspepsia were studied histologically and bacteriol
ogically for the presence of Helicobacter pylori. Helicobacter pylori
was identified by culture, urease-screening, and Gram, Giemsa and Gime
nez staining of the antral mucosa. There were 87 patients with duodena
l ulcer, 80 (92%) of whom had antral gastritis and 7 normal histology;
and 113 patients with non-ulcer dyspepsia, 88 (78%) with antral gastr
itis and 25 with normal mucosa. Helicobacter pylori was present in 83
(94%) patients with duodenal ulcer (76 associated with gastritis and 7
with normal histology), and in 82 (73%) patients with nun-ulcer dyspe
psia (73 associated with gastritis and 9 with normal mucosa) (p < 0.00
02). When the prevalence of Helicobacter pylori infection in the duode
nal ulcer group (95%) and non-ulcer dyspepsia group (83%) with antral
gastritis was compared, the difference was significant (p = 0.0265). T
he finding of Helicobacter pylori in 50% of normal antral mucosa (9 of
25 patients with non-ulcer dyspepsia and all 7 duodenal ulcer cases)
was unusual. The total absence of gastric ulcer in the presence of gas
tritis and Helicobacter pylori infection may be due to strain differen
ce in the organism involved or due to unknown factor(s) which may be p
rotective to the gastric mucosa of Ethiopians.