Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2019 Mar-Apr;25(2):126-131.
doi: 10.4103/sjg.SJG_288_18.

Accuracy of invasive and noninvasive methods of Helicobacter pylori infection diagnosis in Saudi children

Mohammed Hasosah  1
Affiliations
Comparative Study

Accuracy of invasive and noninvasive methods of Helicobacter pylori infection diagnosis in Saudi children

Mohammed Hasosah. Saudi J Gastroenterol. 2019 Mar-Apr.

Abstract

Background/aim: Helicobacter pylori (H. pylori) infection is one of the most common chronic infections in the world. The prevalence of H. pylori is high in Saudi Arabia, but there are no studies in children on the accuracy of invasive and noninvasive methods to diagnose H. pylori infection. The aim of this study was to evaluate the accuracy of six methods for diagnosis of H. pylori infection; four invasive [rapid urease test (RUT), histology, antral nodularity (AD), and biopsy culture (BC)] and two noninvasive methods [serologic test and stool antigen test (SAT)].

Patients and methods: A prospective cross-sectional study was performed among symptomatic children in National Guard hospitals who underwent esophagogastroduodenoscopy from 2010 to 2013. The gold standard diagnosis of H. pylori was positive tissue culture. If the culture was unsuccessful or not done, concordant-positive results for histology and RUT were considered to indicate a positive H. pylori. The variables analyzed as diagnostic methods included RUT, BC, histology, AD, serologic test, and SAT.

Results: A total of 303 children were included in the study. The overall prevalence of H. pylori infection was 49.8%. Most diagnostic tests showed high specificity and moderate-to-low sensitivity when compared to the gold standard test. Sensitivity of AD, SAT, and RUT to detect H. pylori were 62% (95% CI: 0.51-0.74), 69% (95% CI: 0.58-0.79), and 87% (95% CI: 0.79-0.95), respectively (P value 0.040, 0.0023, and <0.0001, respectively). RUT showed the lowest specificity, 65% (95% CI: 0.58-0.71) in contrast to BC and histology which showed moderate-to-high specificities of 88% (95% CI: 0.82-0.95) and 89% (95% CI: 0.82-0.95), respectively (P <0.0001).

Conclusion: RUT is a valuable diagnostic method for identifying H. pylori with the highest sensitivity compared to AD and SAT. All diagnostic tests showed moderate-to-high specificities but BC and histology showed the highest specificity.

Keywords: Children; Helicobacter pylori; diagnostic methods.

PubMed Disclaimer

Conflict of interest statement

None

Figures

Figure 1
Figure 1
Flowchart of the outcome of six methods
See this image and copyright information in PMC

References

    1. Malaty HM. Epidemiology of Helicobacter pylori infection. Best Pract Res Clin Gastroenterol. 2007;21:205–14. - PubMed
    1. Malaty HM, El-Kasabany A, Graham DY, Miller CC, Reddy SG, Srinivasan SR, et al. Age at acquisition of Helicobacter pylori infection: A follow-up study from infancy to adulthood. Lancet. 2002;359:931–5. - PubMed
    1. Calvet X, Sanchez-Delgado J, Montserrat A, Lario S, Ramirez-Lazaro MJ, Quesada M, et al. Accuracy of diagnostic tests for Helicobacter pylori: A reappraisal. Clin Infect Dis. 2009;48:1385–91. - PubMed
    1. Feldman RA, Evans SJW. Accuracy of diagnostic methods used for epidemiological studies of Helicobacter pylori. Aliment Pharmacol Ther. 1995;9:21–31. - PubMed
    1. Hunt RH, Xiao SD, Megraud F, Leon-Barua R, Bazzoli F, van der Merwe S, et al. World Gastroenterology Organization. J Gastrointestin Liver Dis. 2011;20:299–304. - PubMed

Publication types

MeSH terms