Evaluation of the Knowledge and Practical Attitudes of General Practitioners Regarding Helicobacter pylori Infection in the Bamako District, Mali

Abstract

Background: Helicobacter pylori (H. pylori) infection is one of the most widespread bacterial infections worldwide and a major public health problem in developing countries. It is implicated in the development of numerous digestive disorders, including chronic gastritis, peptic ulcers, and certain gastric cancers. In Mali, the high prevalence of the infection and the heterogeneity of medical practices justify an assessment of general practitioners' knowledge and attitudes toward this disease. Objective: The study aims to evaluate the knowledge and practical attitudes of general practitioners working in the Reference Health Centres (CSREF) of the Bamako district. Methodology: This was a descriptive cross-sectional study conducted from March 20, 2024, to March 31, 2025, among general practitioners at community health centres (CSREFs) in the six communes of the Bamako district. Data were collected using a structured questionnaire assessing knowledge, diagnostic attitudes, and therapeutic practices. Statistical analysis was performed using SPSS software, employing the chi-square and Fisher's exact tests with a significance threshold set at p < 0.05. Results: The study included 109 general practitioners, predominantly male (65.1%), with a predominance of practitioners under 30 years of age (40.4%). Almost all (92.7%) had already diagnosed with a case of H. pylori infection. Epigastric pain was the most frequently reported symptom (86.2%). The most commonly mentioned routes of transmission were oral-oral (63.3%) and faecal-oral (55.9%). Gastroduodenal ulcer (98.2%), gastric cancer (70.6%), and chronic gastritis (64.2%) were the most frequently associated pathologies. Regarding indications for screening, a gastroduodenal ulcer was the most frequently cited (97.2%). Serology was the most commonly used first-line diagnostic test (68.8%), while only 19.3% used the breath test. Therapeutic practices were variable, and the use of recommended protocols remained uneven. Conclusion: This study highlights significant disparities in the knowledge and practices of general practitioners regarding H. pylori infection in the Bamako district and international guidelines. Improved continuing education and the dissemination of updated recommendations are necessary to optimise the management of this infection.