Immunochromatographic monoclonal test for detection of Helicobacter pylori antigen in stool is useful in children from high-prevalence developing country.
BACKGROUND
Tests to detect Helicobacter pylori antigens in feces for diagnosis of infection in children demonstrate controversial results. One novel and fast monoclonal test improves diagnostic accuracy in adults, but clinical evidence of its usefulness at pediatric age is insufficient to date. The objective of this work was to evaluate the diagnostic accuracy of this test in a sample of Mexican children.


METHODS
We conducted a transversal study in 150 selected children with digestive symptoms suggestive of organic disease in whom a clinical history was conducted in addition to a fast monoclonal test (ImmunoCardSTAT HpSA, Meridian Diagnostics) performed by immunochromatography. Patients were submitted to endoscopy and histopathologic study.


RESULTS
Of the 150 children (mean age 7.8 +/- 4.7 years), 107 (71.3%) were positive for the test, and presence of H. pylori was confirmed histologically in 109 (72.7%) children, with sensitivity of 96.3% (95% CI = 95.8-96.8), specificity of 95.1% (95% CI = 93.9-96.4), and accuracy of 96.0% (95% CI, -95.6 to -96.3); pretest probability was 0.73, while post-test probability was 0.98. Infection rate and test accuracy increased with age.


CONCLUSIONS
This test is useful for detecting H. pylori infection in children of all ages, and is a good alternative for screening studies in developing countries with elevated prevalence, due to its being fast, noninvasive, inexpensive, and easy to carry out.
Department of Nutrition and Pediatric Gastroenterology, High Specialty Medical Unit No. 71, Mexican Institute of Social Security, Torreón, Coahuila, Mexico. veromart@internetual.com.mx
Jesús
J
Nares-Cisneros
Yolanda
Y
Jaramillo-Rodríguez
Verónica Araceli
VA
Martínez-Ordaz
Victor Manuel
VM
Velasco-Rodríguez
Agustín
A
Madero
Gilberto
G
Mena-Arias
Luis
L
Manriquez-Covarrubias
D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000276:immunology; D000942:Antigens, Bacterial / Q000032:analysis* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005243:Feces / Q000382:microbiology*; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007159:Immunologic Tests / Q000379:methods*; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D000911:Antibodies, Monoclonal; D000942:Antigens, Bacterial