Only a few reports have established the importance of chronic gastritis and Helicobacter pylori infection in Africa. The aim of this study was to ascertain the prevalence of chronic gastritis and Helicobacter pylori infection in a symptomatic population in Abidjan, Côte-d'Ivoire. The study included 277 consecutive patients referred for gastroscopy. Two hundred nine patients complained of abdominal pain without gastroduodenal ulcer or cancer: 26 had a duodenal ulcer, 23 had a gastric ulcer, and 6 had gastric cancer. The remaining 14 patients underwent gastroscopy for various other reasons. Chronic gastritis was present in 89 percent of cases, of which 96 percent showed signs of activity. There were four cases of lymphocytic gastritis. Patients with antral chronic gastritis were older (39.43 +/- 14.3 years) than those with normal antral mucosa (33.7 +/- 12 years, P less than 0.05). Helicobacter pylori was present in 91.3 percent of cases, representing all patients with active chronic gastritis, and 60 percent of the patients with normal gastric mucosa. Chronic gastritis was present in 86 percent of patients with abdominal pain, in 100 percent of those with duodenal of gastric ulcer, and Helicobacter pylori were observed in 90, 100, and 91 percent of the same patient groups, respectively. This study demonstrates the high prevalence of chronic gastritis and the very high level of Helicobacter pylori infection in Ivorian patients complaining of various gastrointestinal symptoms. The usefulness and feasibility of therapeutic trials still have to be investigated.