Diagnosis of Helicobacter pylori infection in a developing country: comparison of two ELISAs and a seroprevalence study.
Serology to detect antibodies to Helicobacter pylori is not frequently used as a diagnostic tool in developing countries. When compared to a commercial ELISA, an ELISA constructed and validated in Thailand had a higher sensitivity (98% vs. 85%), specificity (76% vs. 66%), and negative predictive value (97% vs. 76%) for the detection of H. pylori infection among 104 patients with dyspepsia evaluated by endoscopy. The positive predictive value was 88% for both tests. Serum antibody levels fell significantly 5-8 months after eradication of infection in 8 Thai patients (P = .009). By 8 years of age, > 50% of Thai persons living in urban and rural locations were seropositive. The low negative predictive value of the commercial ELISA limits the usefulness of this assay as a diagnostic tool in Thailand and suggests a need to reevaluate H. pylori serologic tests when used in populations living in developing countries.
Bodhidatta
L
L
Department of Bacteriology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
Hoge
C W
CW
Churnratanakul
S
S
Nirdnoy
W
W
Sampathanukul
P
P
Tungtaem
C
C
Raktham
S
S
Smith
C D
CD
Echeverria
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D013785:Thailand / Q000453:epidemiology
D000907:Antibodies, Bacterial