Helicobacter pylori Infection in Nigeria: Epidemiology, Risk Factors, Diagnostic Challenges, and Public Health Implications

Abstract

Background: Helicobacter pylori infection remains a major global public health concern, with disproportionately high prevalence in developing countries such as Nigeria. Aims: This study presents a narrative review of the epidemiology, transmission dynamics, risk factors, diagnostic approaches, and public health implications of Helicobacter pylori infection in Nigeria. Study Design: This study is a narrative review with elements of systematic literature search. Place and Duration of Study: The study was conducted as a desk-based literature review using electronic databases, with the review process carried out between 2010 and 2025. Methodology: A narrative review with a structured literature search was performed using PubMed and Google Scholar, where relevant studies were screened and analyzed based on predefined inclusion criteria. Results: Findings indicate that the prevalence of Helicobacter pylori infection in Nigeria varies widely, ranging from 5.5% among university students to as high as 96% among symptomatic patients, with an overall national estimate between 30% and 87.7%. Higher prevalence rates were consistently reported in Northern Nigeria compared to Southern regions. Infection is commonly acquired during childhood and is strongly associated with low socioeconomic status, poor sanitation, overcrowding, unsafe drinking water, alcohol consumption, and smoking. Diagnostic practices rely on both invasive and non-invasive methods; however, access to reliable diagnostic tools such as urea breath tests and molecular techniques remains limited in many settings. Additionally, increasing antimicrobial resistance, particularly to commonly used antibiotics, poses a significant challenge to effective treatment. Conclusion: Helicobacter pylori infection remains highly endemic in Nigeria, with marked regional and demographic disparities. Strengthening healthcare infrastructure, improving sanitation, promoting health education, and implementing antimicrobial stewardship programmes are essential strategies for reducing infection burden and preventing long-term complications.