Diagnosis of Helicobacter pylori Infection in a High-prevalence Pediatric Population: A Comparison of 2 Fecal Antigen Testing Methods and Serology

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Abstract

Objectives: Accurate methods for diagnosing active Helicobacter pylori infection in children have been limited to invasive or time-consuming techniques. Recently, fecal antigen testing has been used successfully for the diagnosis of H pylori infection in the pediatric population. We compared 2 monoclonal fecal antigen diagnostic methods in a population of children with a suspected high prevalence of H pylori infection. We also assessed the diagnostic performance of H pylori immunoglobulin G scrology.Materials and Methods: In a cross-sectional study of African refugee children (< 16 years) we compared an immunochromatographic technique (ICT) and serology with a monoclonal fecal antigen enzyme immunoassay (MFAT) method for the detection of active H pylori infection. Following the manufacturer's instructions, an optical density of >= 0.190 was used as a cutoff for MFAT. Sensitivity, specificity, and positive and negative predictive values were calculated.Results: Of the 193 eligible children enrolled, active H pylori infection was detected in 149 of 182 (81.9%) in whom MFAT was performed. The prevalence of active infection increased with age; children with active infection were significantly older, and there were no sex differences. ICT and serology underperformed in comparison with MFAT (ICT sensitivity 74.6%, specificity 63.6%, positive predictive value 89.8%, negative predictive value 36.8%; and serology sensitivity 57.9%, specificity 77.4%, positive predictive value 92.0%, negative predictive value 29.9%).Conclusions: Monoclonal enzyme immunoassay fecal antigen testing is a practical and feasible alternative to traditional invasive diagnostic methods in high-prevalence pediatric populations. Neither immunochromatography nor serology is useful for the diagnosis of active H pylori infection in these children.
Original languageEnglish
Pages (from-to)130-135
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume47
Issue number2
DOIs
Publication statusPublished - 2008

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Helicobacter Infections
Serology
Helicobacter pylori
Pylorus
Pediatrics
Antigens
Infection
Population
Sensitivity and Specificity
Immunochromatography
Refugees
Immunoenzyme Techniques
Sex Characteristics
Cross-Sectional Studies
Immunoglobulin G

Cite this

@article{03bcfc5b642f46de89da65fba100afe0,
title = "Diagnosis of Helicobacter pylori Infection in a High-prevalence Pediatric Population: A Comparison of 2 Fecal Antigen Testing Methods and Serology",
abstract = "Objectives: Accurate methods for diagnosing active Helicobacter pylori infection in children have been limited to invasive or time-consuming techniques. Recently, fecal antigen testing has been used successfully for the diagnosis of H pylori infection in the pediatric population. We compared 2 monoclonal fecal antigen diagnostic methods in a population of children with a suspected high prevalence of H pylori infection. We also assessed the diagnostic performance of H pylori immunoglobulin G scrology.Materials and Methods: In a cross-sectional study of African refugee children (< 16 years) we compared an immunochromatographic technique (ICT) and serology with a monoclonal fecal antigen enzyme immunoassay (MFAT) method for the detection of active H pylori infection. Following the manufacturer's instructions, an optical density of >= 0.190 was used as a cutoff for MFAT. Sensitivity, specificity, and positive and negative predictive values were calculated.Results: Of the 193 eligible children enrolled, active H pylori infection was detected in 149 of 182 (81.9{\%}) in whom MFAT was performed. The prevalence of active infection increased with age; children with active infection were significantly older, and there were no sex differences. ICT and serology underperformed in comparison with MFAT (ICT sensitivity 74.6{\%}, specificity 63.6{\%}, positive predictive value 89.8{\%}, negative predictive value 36.8{\%}; and serology sensitivity 57.9{\%}, specificity 77.4{\%}, positive predictive value 92.0{\%}, negative predictive value 29.9{\%}).Conclusions: Monoclonal enzyme immunoassay fecal antigen testing is a practical and feasible alternative to traditional invasive diagnostic methods in high-prevalence pediatric populations. Neither immunochromatography nor serology is useful for the diagnosis of active H pylori infection in these children.",
author = "Sarah Cherian and David Burgner and Christine Carson and Frank Sanfilippo and Angus Cook and David Forbes",
year = "2008",
doi = "10.1097/MPG.0b013e31815bc5b3",
language = "English",
volume = "47",
pages = "130--135",
journal = "Journal of Pediatric Gastroenterology and Nutrition",
issn = "0277-2116",
publisher = "Lippincott Williams & Wilkins",
number = "2",

}

TY - JOUR

T1 - Diagnosis of Helicobacter pylori Infection in a High-prevalence Pediatric Population: A Comparison of 2 Fecal Antigen Testing Methods and Serology

AU - Cherian, Sarah

AU - Burgner, David

AU - Carson, Christine

AU - Sanfilippo, Frank

AU - Cook, Angus

AU - Forbes, David

PY - 2008

Y1 - 2008

N2 - Objectives: Accurate methods for diagnosing active Helicobacter pylori infection in children have been limited to invasive or time-consuming techniques. Recently, fecal antigen testing has been used successfully for the diagnosis of H pylori infection in the pediatric population. We compared 2 monoclonal fecal antigen diagnostic methods in a population of children with a suspected high prevalence of H pylori infection. We also assessed the diagnostic performance of H pylori immunoglobulin G scrology.Materials and Methods: In a cross-sectional study of African refugee children (< 16 years) we compared an immunochromatographic technique (ICT) and serology with a monoclonal fecal antigen enzyme immunoassay (MFAT) method for the detection of active H pylori infection. Following the manufacturer's instructions, an optical density of >= 0.190 was used as a cutoff for MFAT. Sensitivity, specificity, and positive and negative predictive values were calculated.Results: Of the 193 eligible children enrolled, active H pylori infection was detected in 149 of 182 (81.9%) in whom MFAT was performed. The prevalence of active infection increased with age; children with active infection were significantly older, and there were no sex differences. ICT and serology underperformed in comparison with MFAT (ICT sensitivity 74.6%, specificity 63.6%, positive predictive value 89.8%, negative predictive value 36.8%; and serology sensitivity 57.9%, specificity 77.4%, positive predictive value 92.0%, negative predictive value 29.9%).Conclusions: Monoclonal enzyme immunoassay fecal antigen testing is a practical and feasible alternative to traditional invasive diagnostic methods in high-prevalence pediatric populations. Neither immunochromatography nor serology is useful for the diagnosis of active H pylori infection in these children.

AB - Objectives: Accurate methods for diagnosing active Helicobacter pylori infection in children have been limited to invasive or time-consuming techniques. Recently, fecal antigen testing has been used successfully for the diagnosis of H pylori infection in the pediatric population. We compared 2 monoclonal fecal antigen diagnostic methods in a population of children with a suspected high prevalence of H pylori infection. We also assessed the diagnostic performance of H pylori immunoglobulin G scrology.Materials and Methods: In a cross-sectional study of African refugee children (< 16 years) we compared an immunochromatographic technique (ICT) and serology with a monoclonal fecal antigen enzyme immunoassay (MFAT) method for the detection of active H pylori infection. Following the manufacturer's instructions, an optical density of >= 0.190 was used as a cutoff for MFAT. Sensitivity, specificity, and positive and negative predictive values were calculated.Results: Of the 193 eligible children enrolled, active H pylori infection was detected in 149 of 182 (81.9%) in whom MFAT was performed. The prevalence of active infection increased with age; children with active infection were significantly older, and there were no sex differences. ICT and serology underperformed in comparison with MFAT (ICT sensitivity 74.6%, specificity 63.6%, positive predictive value 89.8%, negative predictive value 36.8%; and serology sensitivity 57.9%, specificity 77.4%, positive predictive value 92.0%, negative predictive value 29.9%).Conclusions: Monoclonal enzyme immunoassay fecal antigen testing is a practical and feasible alternative to traditional invasive diagnostic methods in high-prevalence pediatric populations. Neither immunochromatography nor serology is useful for the diagnosis of active H pylori infection in these children.

U2 - 10.1097/MPG.0b013e31815bc5b3

DO - 10.1097/MPG.0b013e31815bc5b3

M3 - Article

VL - 47

SP - 130

EP - 135

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

SN - 0277-2116

IS - 2

ER -