Persistent High Burden of Helicobacter pylori Infection and Early Gastric Precancerous Lesions: A Five‑Year Retrospective Study (2021–2025) from Misurata Medical Center, Libya

• Wafaa Babh

  Department of Pathology, Misurata Medical Center (MMC), Misurata, Libya. Department of Pathology, Alrazi University, Libya

  Author

• Wesam Elsaghayer

  Department of Pathology, Misurata Medical Center (MMC), Misurata, Libya. Department of Pathology, Alrazi University, Libya

  Author

• Ritaj Elsalhi

  Department of Pathology, Misurata Medical Center (MMC), Misurata, Libya

  Author

Helicobacter pylori infection remains a major public health problem in low‑ and middle‑income countries and is a well‑established risk factor for gastric cancer. Contemporary longitudinal histopathological data from Libya are scarce. The objective of this study is to determine the five-year prevalence, evolving patterns, and histopathological consequences of H. pylori infection in central Libya and to compare these findings with regional and international epidemiologic data. A retrospective descriptive study was conducted on 201 gastric biopsy specimens diagnosed at the Department of Pathology, Misurata Medical Center, between January 2021 and December 2025. Histopathological evaluation was performed using hematoxylin and eosin staining, with modified Giemsa when indicated. Diagnoses were made according to the WHO Classification of Digestive System Tumours (5th edition). Demographic, endoscopic, and histological data were analyzed. Associations were assessed using chi‑square testing. H. pylori infection was identified in 162 cases (80.6%). Intestinal metaplasia and epithelial dysplasia were detected in 4.5% and 1.0% of cases, respectively. A statistically significant increase in H. pylori prevalence was observed over time, rising from 57.1% in 2022 to 85.3% in 2025 (p = 0.03). Premalignant lesions were significantly more frequent in patients aged ≥60 years (p = 0.01). Nodular gastric mucosa showed a strong association with H. pylori positivity (p < 0.001). H. pylori infection remains highly prevalent in central Libya, with evidence of early precancerous changes. These findings highlight the urgent need for structured national eradication programs, standardized biopsy protocols, and risk-stratified surveillance to reduce future gastric cancer burden.

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