The gastro-oesophageal reflux disease complex in sub-Saharan Africa

Epidemiological and clinical studies that have reported on gastro-oesophage al reflux disease (GERD), Barrett's oesophagus, oesophageal adenocarcinoma and Helicobacter pylori infection in sub-Saharan Africa were reviewed. The data indicate that Barrett's oesophagus is rare and oesophageal adenocarcin oma uncommon in all regions of sub-Saharan Africa studied (South Africa, Et hiopia, Nigeria, Zimbabwe, Kenya and Uganda), Hiatus hernia is also uncommo n. There are too few reports of GERD to allow comment. The overwhelming maj ority of oesophageal cancers are squamous cell type. H. pylori infection is ubiquitous with an overall prevalence of 61-100%, It is concluded that alt hough urbanization has resulted in an increase of risk factors associated w ith GERD, which would be expected to lead to an increase in this disease am ong Africans, this increase has not happened. It is believed that the criti cal factor preventing GERD in black Africans is H. pylori infection, which is usually acquired in childhood, is lifelong and is probably protective fo r the oesophagus, (C) 2001 Lippincott Williams & Wilkins.