Detection of Helicobacter pylori antigen in stool samples for diagnosis of infection in children

Area of Science:

• Pediatric Gastroenterology
• Infectious Diseases
• Diagnostic Accuracy Studies

Background:

• Helicobacter pylori infection is a common cause of pediatric dyspeptic symptoms.
• Accurate diagnosis is crucial for effective treatment and management.
• Non-invasive diagnostic methods are desirable for pediatric populations.

Purpose of the Study:

• To evaluate the diagnostic performance of a non-invasive stool antigen test for H. pylori in children.
• To compare the stool antigen test results against the gold standard of gastric biopsy histopathology.
• To determine the sensitivity, specificity, and predictive values of the stool test.

Main Methods:

• A cohort of 96 children (aged 1-15 years) with dyspeptic symptoms underwent endoscopy.
• Gastric biopsies were analyzed via histopathology as the gold standard for H. pylori diagnosis.
• Stool samples were tested for H. pylori antigen, and results were compared to histopathology findings.

Main Results:

• The stool antigen test demonstrated a sensitivity of 54.8% and a specificity of 79.4% compared to histopathology.
• Positive predictive value was 82.9%, and negative predictive value was 49.9%.
• Out of 62 histopathology-positive children, 34 tested positive by stool antigen; out of 34 histopathology-negative children, 27 tested negative.

Conclusions:

• The non-invasive stool antigen test exhibits suboptimal sensitivity and specificity for diagnosing H. pylori infection in children when compared to biopsy.
• The test's low negative predictive value limits its utility for ruling out infection.
• Despite limitations, the stool antigen test might hold potential for mass screening initiatives for H. pylori in pediatric populations.