scholarly journals Challenges of Accurate Diagnosis of Helicobacter pylori in Iran

2019 ◽  
Vol 7 (3) ◽  
pp. 88-92
Author(s):  
Farahnaz Fotoohi ◽  
Mohammad javad Kazemi ◽  
Hossein Ansariniya

Background: Helicobacter pylori-associated gastritis is regarded as the most prevalent gastrointestinal infection, as well as the major cause of several other diseases. Despite being discovered over 30 years ago, no golden diagnostic method has yet been suggested for this microorganism. Objective: The present study aimed to compare two common diagnostic methods of histology and serology. Materials and Methods: This cross-sectional study began in July, 2016, and was conducted at Imam Jafar Sadegh Hospital (a university hospital) in Maybod, Yazd, Iran, on 70 patients. All the patients underwent endoscopy, and biopsy samples were taken for histology, as well as blood samples for ELISA test. Finally, sensitivity, specificity, NPV (negative predictive values), and PPV (positive predictive values) were calculated and analyzed. Results: The sensitivity, specificity, accuracy, PPV, and NPV of the ELISA method with histology as the gold standard were 87.5%, 36.9%, 54.2%, 42%, and 85%, respectively. Still, the histology method appears to be the most reliable test for the diagnosis of H. pylori in Iran. Conclusion: Regarding the high prevalence of H. pylori in Iran, the present study recommends the use of histology as a diagnostic method in combination with other diagnostic methods for detecting H. pylori infection.

2018 ◽  
Vol 28 (2) ◽  
pp. 16
Author(s):  
Eman N. Naji

This Study was intended to diagnose H. pyiori the major causative pathogen in gastro duodenal irritation and ulceration. Differert techniques were used invasive tests (histopathological examina-tion, rapid urea CLO test and culture) , while noninvasive tests includes (serological tests and stool antigen) in addition to determination of some immune response factors (IgM , IgG , IgA) as well as (IL – 8 and IFN – y) in Ptients Sera. According to the results of invasive diagnostic method 30/113 (26.69%) patients were considered to be infected and 83/113(73.31%) patients were considered as noninfeted was contrasted with noninvasive diagnostic method 25/113 (22.14%) patients were considered to be infected and 88/133(77.83%) patients were considered as noninfeted. In order to get the overall percentage of the infected people included in this study, we merge the results of the two methods ,so we found out that the total infected patients with H. pylori diagnosed by invasive and noninvasive methods were 42 /113 (37.2%) while the noninfected 71/113 (62.8) disseminated as 27/68(39.71%) infect-ed male ,which was privileged than the infected female when it was 15/45(33.33%). The high prevalence of H. pylori infection in the age group ranging between (46-60) in male and female. Histology (invasive teq.) and ECO rapid test (noninvasive teq.) were considered as the ‘‘best techniques ’’ for H. pylori detection, in the outlook of its high specificity, sensitivity and because it detected the major number of H. pylori-positive patients along with the other techniques used in this work. The sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for histology were 100,100,100 and 94.5% , respectively, while for the ECO rapid test they were 96, 93, 91.5, and 97.14%. Culture (invasive teq.) and IgG anti H. pylori (noninvasive teq.) coming secondly in the diagnosis of H. pylori infection because they detected a little fewer number of infected patients than the first two teq. as noted above. The sensitivity, specificity, (PPV) (NPV) for Culture were 80%, 97% ,96.96% and87.5% and for IgG anti H. pylori were 85%, 91%,92.8% and 97.8%. Finally the smallest patient number was obtained from the rest of all the six teq. were used in the present work obtained from the urea CLO test and stool antigen, in-vasive and noninvasive teq. respectively. The present research found out that there were a relationship between the results of rapid anti H. pylori ECO test, antibody titer in ELFA, immunoglobulin (IgG and IgA) and (IFN-γ) , (IL-8) concentration. Also, all these data were related to the results of the histological changes and the results of the urea CLO test of patients when compared with the noninfected members. These results showed highly significant differences among patient groups in comparison with noninfect-ed group at (P. Value < 0.001). On the other hand, there were no relationship between IgM con-centration with any of the other results of diagnostic methods were used may such results consid-ered a first step for determining the susceptibility of infection and to confirame the diagnosis by use one more test in each time especialy Histology (invasive teq.) and ECO rapid test (noninva-sive teq.) correlated with estimation of (IgG and IgA) and (IFN-γ), (IL-8) concentration


2009 ◽  
Vol 46 (3) ◽  
pp. 209-213 ◽  
Author(s):  
Severino Marcos Borba de Arruda ◽  
Nora Manoukian Forones ◽  
Norma Thomé Jucá ◽  
Kátia Simone Cezário de Barros

CONTEXT: It still remains an open debate whether Helicobacter pylori eradication is beneficial or not for the improvement of symptoms in functional dyspepsia. Differences in geographic distribution, the worldwide H. pylori genetic variability and the fact that the outcome of infection is strongly related to the virulence of the infecting strain are factors that might be driving ongoing controversies. OBJECTIVE: To study the correlation between gastric histology and H. pylori serology status in patients with dyspepsia. METHODS: This is a cross-sectional study where 40 consecutive dyspeptic patients (28 women and 12 men, mean age 48.5 years) with endoscopically normal stomachs were selected from the endoscopy unit at a university hospital in Recife, PE, Northeast of Brazil, between March 1998 and July 1999. Patients underwent gastric mucosal biopsy and serological tests (anti-Hp and anti-CagA antibodies). Gastric biopsies were examined using H-E and Giemsa stains and gastritis was classified and graded (mild, moderate or severe) according to "the updated Sydney System - Houston, 1994". RESULTS: Among 40 patients with dyspepsia the gastric histology revealed that about ¼ had moderate (25%) or severe (2.5%) gastritis. This subgroup of patients also had a greater positive frequency of anti-Hp (100% vs 41%; P = 0.0005) and anti-CagA (91% vs 58%; P = 0.09) antibodies when compared with those with normal histology (27.5%) or mild gastritis (45%). CONCLUSION: Since upper gastrointestinal endoscopy is part of the functional dyspepsia investigation and serology for anti-CagA antibody is not available in daily clinical practice, by biopsying gastric mucosa we would only be able to selectively apply H. pylori eradication therapy for those with histology that best correlate with virulent infecting strains (moderate or severe gastritis) - around ¼ of our study patients with dyspepsia.


1970 ◽  
Vol 17 (2) ◽  
pp. 88-93
Author(s):  
K Ahsan ◽  
MZ Hossain ◽  
MR Uddin

Context: A cross-sectional study was carried out at the Department of Pathology, Dhaka Medical Collage, Dhaka and Immunology Laboratory, Laboratory Sciences Division of ICDDR,B, Dhaka during a period of 1 year from July, 2007 to June, 2008 to determine the efficacy of endoscopic crush cytology in the detection of Helicobacter pylori infection in gastroduodenal diseases. Clinically suspected cases of gastro-duodenal lesions and who had not taken antibiotics, omeprazole or bismuth salts for at least three weeks prior to endoscopy were selected. Patients who were clinically and endoscopically suspected of having malignancy were excluded from the study. A total of 110 such subjects were consecutively included in the study. The statistics used to analyze the data were descriptive statistics and components of accuracy test.Results: The sensitivity of crush cytology in correctly diagnosing H. pylori of those who had the disease was 89.3%, while the specificity of the test in correctly differentiating those who did not have H. pylori was 92.6% when compared against histopathological examination using Giemsa stain. However, a slightly low sensitivity (86.2%) without compromising with specificity (92.3%) was obtained when the crush cytology diagnosis was compared against histopathological examination using haematoxylin-eosin (H & E) stain.Conclusion: The study concludes that the diagnostic accuracy of crush smear cytology (sensitivity and specificity) for detection of Helicobacter pylori in gastric biopsy material is comparable to histopathology. Moreover, the technique is very simple, less expensive and less time consuming which gives clinicians added advantage in making a quicker decision.Key words: Cytology; Helicobacter pylori; Gastroduodenal disease. DOI: 10.3329/jdmc.v17i2.6589J Dhaka Med Coll. 2008; 17(2) : 88-93


2017 ◽  
Vol 3 (1) ◽  
pp. 29
Author(s):  
Willy Brodus Uwan ◽  
Ari Fahrial Syam ◽  
C Rinaldi A. Lesmana ◽  
Cleopas Martin Rumende

Pendahuluan. Risiko infeksi Helicobacter pylori (H. pylori) dikaitkan dengan banyak faktor yang terkait dengan pejamuagen-lingkungan. Etnis adalah salah satu faktor dari pejamu yang banyak diteliti di luar negeri. Prevalensi infeksi H. pylori didapatkan lebih tinggi pada etnis tertentu seperti misalnya di Cina. Berdasarkan teori migrasi dan teori transmisi, diduga infeksi H. pylori akan dibawa oleh penduduk yang bermigrasi dari daerah dengan prevalensi tinggi ke tempat tujuan migrasi. Etnis Tionghoa di Kalimantan Barat berasal dari daerah Cina Selatan dengan prevalensi infeksi H.pylori tinggi. Diperkirakan ada perbedaan angka prevalensi infeksi H. pylori pada etnis Tionghoa dibandingkan pada etnis asli Kalimantan Barat, yaitu etnis Dayak. Penelitian ini dilakukan untuk mengetahui perbedaan angka prevalensi, karakteristik epidemiologis dan gambaran hasil pemeriksaan endoskopi pada subjek etnis Tionghoa dan Dayak dengan sindrom dispepsia.Metode. Penelitian ini menggunakan studi potong lintang untuk mengetahui perbedaan angka prevalensi infeksi H.pylori. Penelitian dilakukan di RSU Santo Antonius Pontianak dari bulan Desember 2014 sampai Juni 2015 dengan metode pengambilan sampel secara consecutive sampling. Angka prevalensi infeksi H. pylori disajikan dalam angka persentase, sedangkan perbedaan karakteristik epidemiologis dan perbedaan gambaran hasil pemeriksaan endoskopi pada etnis Tionghoa dan Dayak dianalisis dengan analisis bivariat menggunakan chi-square dengan tingkat kemaknaan (p)=0,05.Hasil. Dari 203 subjek yang diteliti, terdiri dari 102 subjek etnis Tionghoa dan 101 subjek etnis Dayak, didapatkan angkaprevalensi H. pylori sebesar 40,8%. Prevalensi pada etnis Tionghoa didapatkan lebih tinggi dibanding etnis Dayak,berturut-turut sebesar 48,0% dan 33,7%. Tidak ditemukan adanya perbedaan karakteristik epidemiologis dan temuan hasil pemeriksaan endoskopi yang bermakna pada kedua kelompok etnis.Simpulan. Terdapat perbedaan angka prevalensi infeksi H. pylori pada etnis Tionghoa (48,0%) dibanding etnis Dayak (33,7%). Namun, tidak ada perbedaan karakteristik epidemiologis dan gambaran hasil pemeriksaan endoskopi pada kedua kelompok etnis tersebut.Kata kunci: Dayak, etnis, Helicobacter pylori, sindrom dispepsia, Tionghoa The Difference in Prevalence of Helicobacter pylori Infection between Chinese and Dayak Ethnics with Dyspepsia SyndromeIntroduction. Helicobacter pylori (H. pylori) infection risk is associated with many factors related to host-agent-environment. Ethnicity is one of the host factors which was the most studied factor overseas. The prevalence of H. pylori infection was found higher in certain ethnic such among Chinese. Based on migration and transmission theory, it was suspected that H. pylori infection was transmitted by people migrating from areas with a high prevalence of infection to the destination area. Chinese in West Borneo are originated from South China region where the prevalence of H. pylori infection is high. It is estimated that there are differences in the prevalence of H. pylori infection among Chinese compared to the native people of West Borneo, the Dayaknese. Methods. This was a cross-sectional study to determine the differences in the prevalence of H. pylori infection. The study was conducted at St. Antonius General Hospital Pontianak from December 2014 to June 2015 with consecutive samplingmethod. H. pylori infection prevalence is presented in percentage numbers, while the epidemiological characteristics and endoscopic finding differences among Chinese and Dayaknese were analyzed by bivariate analysis using the chi-square with significance value (p) = 0.05.Results. From a total of 203 subjects in this study, consisted of 102 Chinese subjects and 101 Dayaknese subjects, the prevalence of H. pylori infection was 40.8%. The prevalence among Chinese is higher than Dayaknese, which is 48.0% and 33.7%, respectively. There is no difference in the epidemiological characteristics and endoscopic findings in both ethnic groups.Conclusions. The prevalence of H. pylori infection among the Chinese (48.0%) is higher than among Dayaknese (33.7%). There is no difference in the epidemiological characteristics and endoscopic findings among both ethnic groups.Keywords: Chinese, Dayak, Dyspeptic syndrome, Ethnic, Helicobacter pylori


2010 ◽  
Vol 128 (4) ◽  
pp. 187-191 ◽  
Author(s):  
Aurea Cristina Portorreal Miranda ◽  
Rodrigo Strehl Machado ◽  
Edina Mariko Koga da Silva ◽  
Elisabete Kawakami

CONTEXT AND OBJECTIVE: Helicobacter pylori infection is mainly acquired during childhood, and is associated with significant morbidity in adults. The aim here was to evaluate the seroprevalence and risk factors of H. pylori infection among children of low socioeconomic level attended at a public hospital in São Paulo, Brazil. DESIGN AND SETTING: Cross-sectional study, among patients attended at an outpatient clinic. METHODS: 326 children were evaluated (150 boys and 176 girls; mean age 6.82 ± 4.07 years) in a cross-sectional study. Patients with chronic diseases or previous H. pylori treatment, and those whose participation was not permitted by the adult responsible for the child, were excluded. The adults answered a demographic questionnaire and blood samples were collected. The serological test used was Cobas Core II, a second-generation test. Titers > 5 U/ml were considered positive. RESULTS: H. pylori infection was diagnosed in 116 children (35.6%). Infected children were older than uninfected children (7.77 ± 4.08 years versus 5.59 ± 3.86 years; p < 0.0001). The seroprevalence increased from 20.8% among children aged two to four years, to 58.3% among those older than 12 years. There were no significant relationships between seropositivity and gender, color, breastfeeding, number of people in the home, number of rooms, bed sharing, living in a shantytown, maternal educational level, family income or nutritional status. In multivariate analysis, the only variable significantly associated with H. pylori seropositivity was age. CONCLUSION: Infection had intermediate prevalence in the study population, and age was associated with higher prevalence.


2016 ◽  
Vol 64 (2) ◽  
pp. 388-391 ◽  
Author(s):  
María José Ramírez-Lázaro ◽  
Josep Lite ◽  
Sergio Lario ◽  
Pepa Pérez-Jové ◽  
Antònia Montserrat ◽  
...  

Laboratory-based chemiluminescence immunoassays (CLIA) are widely used in clinical laboratories. Some years ago, a CLIA test was developed for the detection of Helicobacter pylori in stool samples, known as LIAISON H. pylori SA, but little information on its use has been reported. To evaluate the accuracy of the LIAISON H. pylori SA assay for diagnosing H. pylori infection prior to eradication treatment. Diagnostic reliability was evaluated in 252 untreated consecutive patients with dyspepsia. The gold standard for diagnosing H. pylori infection was defined as the concordance of the rapid urease test (RUT), histopathology and urea breath test (UBT). The CLIA assay was performed according to the manufacturer's instructions. Sensitivity, specificity, positive and negative predictive values, and 95% CIs were calculated. According to the gold standard selected, 121 patients were positive for H. pylori infection and 131 negative. LIAISON H. pylori SA had a sensitivity of 90.1% and a specificity of 92.4%, with positive and negative predictive values of 91.6% and 90.1%, respectively. The accuracy of the LIAISON H. pylori SA chemiluminescent diagnostic assay seems comparable to that of ELISA or the best-performing LFIAs. Its sensitivity and specificity, however, seem slightly lower than those of histology, RUT or UBT. The advantages of the assay are that it is cheap, automated, and minimally labor-intensive.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Raja Kannan ◽  
Suchetha S. Rao ◽  
Prasanna Mithra ◽  
B. Dhanashree ◽  
Shantharam Baliga ◽  
...  

Introduction. To evaluate Proadrenomedullin (Pro-ADM) as the diagnostic and prognostic marker in neonatal sepsis. Materials and Methods. In this cross-sectional study, Pro-ADM levels were estimated in 54 neonates with clinical sepsis and positive sepsis screen (cases) and 54 controls without clinical sepsis. Repeat Pro-ADM levels were estimated after 72 hours in cases. Pro-ADM levels were compared with the clinical outcome. Results and Discussion. Median Pro-ADM levels in cases were 31.8 (IQR: 27.8-39.4) pmol/ml which was significantly higher than controls 5.1 (IQR; 3.1-7.7) pmol/ml. From the constructed ROC curve, a value of 14.5 pmol/ml was taken as the cut-off for sepsis. Pro-ADM had 100% sensitivity, specificity, and positive predictive values (PPV) in detecting sepsis at 14.5 pmol/ml. Among cases, a decrease in Pro-ADM level by 10 pmol/ml was associated with 99% survival. Pro-ADM value of 35 pmol/ml had 100% specificity and PPV in predicting mortality. Conclusion. Pro-ADM can be used as a single biomarker for detecting neonatal sepsis, predicting clinical outcome and prognosis.


Author(s):  
Sandra FRUGIS ◽  
Nicolau Gregori CZECZKO ◽  
Osvaldo MALAFAIA ◽  
Artur Adolfo PARADA ◽  
Paula Bechara POLETTI ◽  
...  

ABSTRACT Background: Helicobacter pylori has been extensively studied since 1982 it is estimated that 50% of the world population is affected. The literature lacks studies that show the change of its prevalence in the same population over time. Aim: To compare the prevalence of H. pylori in 10 years interval in a population that was submitted to upper endoscopy in the same endoscopy service. Method: Observational, retrospective and cross-sectional study comparing the prevalence of H. pylori in two samples with 10 years apart (2004 and 2014) who underwent endoscopy with biopsy and urease. Patients were studied in three consecutive months of 2004, compared to three consecutive months of 2014. The total number of patients was 2536, and 1406 in 2004 and 1130 in 2014. Results: There were positive for H. pylori in 17 % of the sample as a whole. There was a significant decrease in the prevalence from 19.3% in 2004 to 14.1% in 2014 (p<0.005). Conclusion: There was a 5.2% reduction in the prevalence of H. pylori comparing two periods of three consecutive months with 10 years apart in two equivalent population samples.


2016 ◽  
Vol 53 (2) ◽  
pp. 108-112 ◽  
Author(s):  
Naser HONAR ◽  
Alireza MINAZADEH ◽  
Nader SHAKIBAZAD ◽  
Mahmood HAGHIGHAT ◽  
Forough SAKI ◽  
...  

ABSTRACT Background - Helicobacter pylori infection is the gram negative bacillus with the close association with chronic antral gastritis. Objective - In this study, we evaluate the accuracy of urea breath test (UBT) with carbon isotope 13 in comparison with histopathology of gastric antrum for detection of H. pylori infection in children with dyspepsia. Methods - This cross-sectional study was performed at specialized laboratory of Shiraz Gastroenterohepatology Research Center and Nemazee Hospital, Iran, during a 12-months period. This study investigated the sensitivity, specificity, and positive and negative predictive values of UBT in comparison with biopsy-based tests. We included a consecutive selection of 60 children who fulfilled Rome III criteria for dyspepsia. All children were referred for performing UBT with carbon isotope 13 (C13) as well as endoscopy. Biopsies were taken from antrum of stomach and duodenum. The pathologic diagnosis was considered as the standard test. Results - The mean age of the participants was 10.1±2.6 (range 7-17 years). From our total 60 patients, 28 (46.7%) had positive UBT results and 32 (53.3%) had negative UBT results. Pathologic report of 16 (57.1%) out of 28 patients who had positive UBT were positive for H. pylori and 12 (42.9%) ones were negative. Sensitivity and specificity of C13-UBT for detection of H. pylori infection were 76.2% and 69.2% respectively. Conclusion - Sensitivity and specificity of C13-UBT for detection of H. pylori infection were 76.2% and 69.2% respectively. Another multicenter study from our country is recommended.


2017 ◽  
Vol 23 (1) ◽  
pp. 92 ◽  
Author(s):  
Jill Benson ◽  
Razlyn Abdul Rahim ◽  
Rishi Agrawal

The hypothesis of this study was that those refugee children with Helicobacter pylori are thinner than their non-infected counterparts. This cross-sectional study investigated the height and weight of newly arrived refugee children up to age 19 years, who were screened for H. pylori using a stool antigen test at the Migrant Health Service in Adelaide between August 2010 and October 2013. Of 460 children, 21% were infected with H. pylori. After adjusting for vitamin B12 and iron levels, ethnicity, age and sex, the odds of being thin in the 10- to 19-year-old age group was 4.28-fold higher (95% CI 1.48–12.4) if they were H. pylori positive compared with those who were H. pylori negative. The difference between the two groups is statistically significant (P=0.01). Screening and treatment for H. pylori in the general population in developed countries is not recommended unless there are symptoms such as dyspepsia or risk of peptic ulcer, duodenal ulcer or gastric cancer. Given the findings of this study, a recommendation could be made that newly arrived refugee children who are thin should be tested for H. pylori. Thinness in children may influence their cognitive ability, school performance, physical endurance and hence their ability to successfully settle into their new country.


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