Declining eradication rates of with standard triple therapy in Addis Ababa, Ethiopia.

Background: Standard triple therapy is an effective treatment for eradicating infection, but it is encountered with drug resistance. The stool antigen test is a cost-effective and easy-to-perform test to confirm the eradication of , 4-8 weeks post-therapy, with 86% sensitivity and 92% specificity.

Aim: To assess the eradication rate of standard triple therapy and factors affecting the eradication rate.

Methods: We conducted a prospective, multicenter follow-up study in Addis Ababa, Ethiopia, at selected healthcare facilities among dyspeptic patients with positive stool antigen tests from June 1, 2023 to October 30, 2023 to assess the eradication rate. After completing the standard triple therapy, the eradication was confirmed using a stool antigen test 4 weeks later. The data were analyzed using bivariate and multivariate logistic regression methods.

Results: The eradication rate was 85.4%. Patients with a previous diagnosis of infection, smokers, and local alcohol consumption were associated with a lower eradication rate, with adjusted odds ratio (AORs) of 0.159 [95% confidence interval (CI): 0.050-0.511], 0.206 (95%CI: 0.052-0.822), and 0.228 (95%CI: 0.052-0.997), respectively. Patients with complete symptom resolution were 5.383 times more likely to achieve eradication than patients without symptom improvement, AOR = 5.383, 95%CI: 1.74-21.089.

Conclusion: eradication rate was lower than expected. Post-treatment testing is crucial to confirm eradication and guide further management, such as susceptibility testing.