Health Survey of a Potential H. pylori Outbreak in a Girls School in Rwanda

Background:    A survey was conducted at a girls’ secondary boarding school in the Bugesera District of Rwanda to gather information regarding the type and prevalence of gastric distress symptoms students were experiencing.  Symptoms investigated were indicative of Heliobacter pylori (H. pylori) colonization. 

Methods:         Identifying information was initially collected for case finding and follow-up.  Additional information collected included students’ home district and the primary school attended to identify a potential source of exposure.  Two students were engaged in the development and collection of the health surveys.  Data was de-identified and entered into an Excel™ spreadsheet and verified.  Descriptive statistics, including frequency rates, were calculated to identify trends.

Results:            A total of 122 surveys were returned for a response rate of 46%.  A significant number of students, 67% of respondents (82 of the 122 respondents), at the school reported at least one complaint of gastric distress consistent with H. pylori.  Of the 82 students who reported symptoms, the majority (n=44/54%) reported one to two symptoms with 17 (21%) reporting 3 symptoms and 21 (26%) reporting 4 or more symptoms.  District or primary school rates were similar to the rates for the entire study population, so no single source of exposure could be identified.

Conclusion:      A significant number of students had symptoms consistent with H. pylori.  Prevention methods were recommended to reduce potential transmission in a group living situation.  It was also found that engaging students in the process enhanced the effectiveness of the project.