Helicobacter pylori is the key causative agent of chronic gastritis, peptic ulcer disease, and gastric malignancies, affecting mostly the African population. Its infection influences more than half of the world’s inhabitants. However, the specific epidemiological landscape of this infection in Nakuru County remains under-documented. This study aimed to investigate the prevalence of H. pylori infection among peptic ulcer patients at Nakuru Level Five Hospital, Kenya focusing to identify associated risk factors and provide insights to improve awareness and prevention strategies. A cross-sectional research design was employed, involving 348 symptomatic participants recruited from a target population of 2,711 patients that presented at the hospital between the months of June to December 2025. Primary data on socio-demographic status and hygiene factors were collected using pre-tested structured questionnaires. Diagnostic identification of parasites from stool samples was achieved through direct wet mount microscopy for intestinal parasites and monoclonal antigen immunoassay for H. pylori. Data were analyzed using SPSS (Version 26), utilizing univarriate analysis and multivariate logistic regression to determine prevalence and identified risk factors. The results revealed an overall prevalence of 19.3%, with a significantly higher burden in males (24.3%) compared to females (16.9%). Key risk factors included the use of unsafe drinking water (AOR 3.21, p < 0.001), lack of water treatment (AOR 2.48, p = 0.005), and open defecation practices (AOR 3.06, p = 0.001). These findings underscore the critical role of environmental sanitation and personal hygiene in the persistence of gastrointestinal pathogens. The study recommends that the Ministry of Health integrate regular screening for both H. pylori and intestinal parasites in symptomatic patients and intensify community health education on water safety and sanitation to interrupt the fecal-oral transmission cycle of intestinal parasitic infections.

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