Application of a Stool Antigen Test To Evaluate the Incidence ofHelicobacter pyloriInfection in Children and Adolescents from Tehran, Iran

Abstract

Helicobacter pylori infection is acquired mainly in childhood, especially in developing countries, where a low-cost, rapid diagnostic technique which is reliable for all age groups may be useful for the management of H. pylori infection. For this purpose, we used an HpSA test (Equipar) to detect H. pylori infection in children and adolescents from Tehran, Iran. Thirty-five children who were positive or negative for H. pylori infection by endoscopy-based tests were used as positive and negative controls for the HpSA test. Stools were collected from 430 randomly selected children and adolescents (4 to 18 years old) from southwest, near the center, and northwest of Tehran. A questionnaire that included presence of recurrent abdominal pain (RAP), family history of infection and/or peptic ulcer disease (PUD), and income of parents was completed. A good agreement was found between the results of endoscopy-based tests and those of the HpSA test; the sensitivity and specificity of the Equipar-HpSA test were 100% and 83.4%, respectively. Among 430 children and adolescents, 47% were positive by the HpSA test, of whom 82% had RAP. No difference in incidence was observed between the two sexes; the various categories of age showed an increasing incidence, ranging from 24% (ages 4 to 6) to 58% (ages 16 to 18). The rate of infection in children and adolescents from the southwest was significantly higher (70%) than the rate in those from the northwest (32%), and a family history of H. pylori infection or PUD was observed in 59% of the HpSA positive subjects. The HpSA test is a useful test to detect H. pylori infection in children and adolescents from developing countries.Helicobacter pylori infection is acquired mainly in childhood, especially in developing countries (40), where the influence of socioeconomic factors on the prevalence of H. pylori infection has been shown (11,30,37). Many investigators have studied the criteria for diagnosis and treatment of children infected by H. pylori, but association of symptoms with H. pylori infection in children presenting with nonulcer dyspepsia is controversial (3,14,22). One important controversy relates to the presence of recurrent abdominal pain (RAP) in children, where an important association was observed between RAP and H. pylori infection in some populations (4,10,19,27,28,31,34). Although endoscopy-based tests are the best methods to diagnose active H. pylori infection, their application in children is more difficult and unpleasant than in adults. Moreover, in developing regions, for socioeconomic reasons, most infected children are not diagnosed and/or treated for H. pylori infection. To circumvent these difficulties, a noninvasive test with reliability for all age groups of children and adolescents is required. Among the noninvasive methods, serological tests cannot be applied to young children because of low sensitivity. In addition, the 13 C urea breath test is cumbersome, expensive, and consequently unavailable in certain countries; furthermore, it is not reliable in very...

Helicobacter pylori Stool Antigen Feco-prevalence in Food Workers in Van

“…3 Among these tests, the stool antigen test is stated to be an easy-to-use, rapid, and useful for both the identification of the present infection and eradication of H.pylori. [4][5][6] Previous studies report that the prevalence of HpSA in our region is between 23.0% and 39.9% 7,8 , while other regions of our country have varying degrees of the antigen (20.3% to 64.0%). [9][10][11] This bacteria most likely transmitted from person to person contact.…”

Prevalence of Helicobacter pylori Infection evaluated by Stool antigen test in Khuzestan Province since September to October 2009, south-west of Iran: a population based study

“…63% in Turkey and Tehran (10,11), but lower than India (80%) (12), and Pakistan (79%) (13). The lower rate of infection among Iranian adults might be the result of frequent antibiotic usage among Iranian society or gradual improvement of socioeconomic status during the last two decades.…”

Role of Helicobacter Pylori stool antigen test in the diagnosis of Helicobacter Pylori infection

“…[10][11][12] The H. pylori infection prevalence is very high among the Iranian general population. 1 There are studies evaluating the accuracy of HpSA for detection of H. pylori in children 14,15 and hemodialysis patients, 12,16 but studies about HpSA accuracy in adults with GI complaints in Iran are few. 10,11, 17 Here, we examined the role of HpSA in diagnosing H. pylori infection in patients with upper GI complaints.…”