An Updated Systematic Review and Meta-Analysis to Determine the Association between Iron Deficiency Anemia and Helicobacter Pylori Infection in Low and Middle Income Countries

Abstract

Background: Studies focusing on the examination of the association between iron deficiency anemia (IDA) and Helicobacter Pylori (H. Pylori) infection is very important especially in developing countries. Therefore, the primary aim of the study was to assess if patients with H. Pylori infection were more prone to IDA than patients who were not suffering from H. Pylori. Methods: Databases used for this purpose include but not limited to Google Scholar, PubMed, Web of Science, MEDLINE, SCOPUS, EMBASE, and the Cochrane Library. As per our detailed search from last ten years data from above sources we found seventeen observational studies and four randomized controlled trials (RCTs) satisfy-ying our criteria for meta-analyses. By using random effects model we obtained Pooled odds ratio (OR), pooled sta-ndardized difference in means (SMD), and 95% confidence intervals (CIs). Forest plots were generated from these values. Results: Meta-analysis from our above study gave very remarkable results [Pooled OR: 1.649; 95% CI: 0.883-3.082; p-value = 0.117]. Results showed decreased likelihood of iron deficiency anemia (IDA) in participants having evidence of Helicobacter Pylori (H. Pylori) as compared to uninfected ones and a remarkable variation was found too in studies (I2 = 88.7%; p-value = 0.001). A significant increase in ferritin (Pooled SMD: 0.504; 95% CI: 0.135-0.873; p-value = 0.007) and hemoglobin (Pooled SMD: 0.476; 95% CI: 0.111-0.840; p-value = 0.011) levels was observed from meta-analyses of four RCTs by giving patient anti-H. Pylori treatment along with iron supplement as compared to using only iron supplement in iron deficiency anemia. Conclusion: Our study gave us conclusive results about decreased likelihood of prevalence of iron deficiency anemia as compared to Helicobacter Pylori (H. Pylori) infection in developing regions. Further to this effect we can say with certainty that combined H. Pylori eradication & iron supplement can be useful in improving values of ferritin and hemoglobin.