Evaluation of Bio M pylori serologic test and C-13 urea breath test for H. pylori infection in children with recurrent abdominal pain: a pilot study
Background Diagnosing Helicobacter pylori infection in children
is still a problem. Urea breath test is the gold standard for noninvasive
diagnostic test, but it is expensive and not available in
most hospitals. The Bio M Pylori serologic test has good diagnostic
value in adults, less expensive and more practical, but had never
been evaluated in children.
Objective To determine the prevalence of H. pylori infection and
the diagnostic accuracy of Bio M Pylori serologic test in children
with recurrent abdominal pain.
Methods This study was conducted in May - June 2009. Children
aged 12-15 years with recurrent abdominal pain were examined
with urea breath test and the Bio M Pylori serologic test.
Sensitivity, specificity, area under the curve (AUC), predictive
values, and likelihood ratios were calculated for the Bio M Pylori
Results Most subjects aged 13 years (83%). Girls outnumbered
boys, and most were undernourished. The prevalence ofH. pylori
infection detected by urea breath test and Bio M Pylori serologic
test was 8% and 52%, respectively. The Bio M Pylori serologic
test had sensitivity and specificity of 100% and 53%, respectively.
Area under the curve (AUC) was 0.764. Positive and negative
predictive values were 16 and 100%, whereas positive and
negative likelihood ratios are 2.12 and 0. The overall accuracy
of this test is 5 7%
Conclusions The Bio M Pylori serologic test has high sensitivity
value (100%). This diagnostic kit can be considered as a good
pre-endoscopic screening tool in children with recurrent
abdominal pain caused by H. pylori infection.
Helicobacter pylori in children: when and how? Am J Med.
2. Hegar B. Infeksi Helicobacter pylori pada anak. Sari Pediatri.
3. Czin SJ. Helicobacter pylori infection: detection, investigation,
and management. J Pediatr. 2005;146:21-6S.
4. Kalach N, Mentran K, Guimber D, Michaud L, Spyckerelle C,
Gottrand F. Helicobacter pylori infection is not associated with
specific symptoms in nonulcer-dyspeptic children. [serial on
the internet]. [cited 2005 March 18]. Available from: http://
5. Das BK, Kakkar S, Dixit VK, Kumar M, Nath G, Mishra OP.
Helicobacter pylori infection and recurrent abdominal pain in
children. J Trop Pedtr. 2003 ;49:250-2.
6. Susanto FM. Gambaran endoskopi dan histopatologi saluran
cerna atas pada anak dengan sakit perut berulang perhatikan
khusus pad a infeksi Helicobacter pylori[ thesis] . Jakarta: Universitas
7. Peek RM, Blaser MJ. Pathophysiology of Helicobacter
pylori-induced gastritis and peptic ulcer disease. Am J Med.
8. Malfertheiner P, Megraud F, O'Morain C, Hurgins APS,
Jones R, Axon A. Current concepts in the management of
104 â€¢ Paediatr Indones, Vol. 50, No. 2, March 2010
Helicobacter pylori infection-The Maastricht 2-2000 consensus
report. Aliment Pharmacol Ther. 2002;16:167-80.
9. Megraud F. Comparison of non-invasive tests to detect
Helicobacter pylori infection in children and adolescents: result
of a multicenter European Study. J Pediatr. 2005; 146: 198-203.
10. Vandenplas Y, Hegar B. Helicobacter pylori infection in
children. Indones J Gastroenterol Hepatol Dig Endoscopy.
11. Kato S, Ozawa K, Konno M, Tajiri H, Yoshimura N, Shimizu
T, et al. Diagnostic accuracy of the 13C-urea breath test
for childhood Helicobacter pylori infection: A multicenter
Japanese study. Am J Gastroenterol. 2002;97:1668-7 3.
12. Vaira D, Holton], Menegatti M, Ricci C, GattaL, Geminiani
A, et al. Review article: Invasive and non-invasive tests
for Helicobacter pylori infection. Alimnet Pharmacol Ther.
2000; l 4:13S-22S.
13. Vakil N, Vaira D. Non-invasive tests for the diagnosis of H.
pylori infection. Rev Gastroenterol Disord. 2004;4:1-6.
14. Harris AW, Misiewicz JJ. Helicobacter pylori. London:
Blackwell Healthcare Communications, 1996; p. 26-33.
15. Soemohardjo S, Gunawan S, Muttaqin Z, Muliaty D,
Suparyantmo JB, Budyono M, et al. Pentingnya antigen strain
lokal untuk pembuatan kit diagnostik untuk deteksi antibody
terhadap Helicobacter pylori. Dexa media. 1995;4:23-6.
16. Muttaqin Z, Sumarsidi D, Gunawan S, Soemohardjo S.
Pengembangan kit diagnostik untuk mendeteksi antibodi
Helicobacter pylori (ELISA) menggunakan antigen isolate.
Proceeding of the Gastroenterohepatology Conference; 2004
May 8-9; Lombok, Indonesia.
17. Perri F, Pastore M, Clemente R, Festa V, Quitadamo M,
Niro G, et al. Helicobacter pylori infection may undergo
spontaneous eradication in children: a 2-year follow-up study.
J Pediatr Gastroenterol Nutr. 1998;27:181-3.
18. Raymond J, Kalach N, Bergeret M, Barber JP, Benamou
PH, Gendrel D, et al. Evaluation of a serological test for
diagnosis of Helicobacter pylori infection in children. Eur J
Clin Microbiol Infect Dis. 1996;15:415-7.
19. Logan RPH, Walker MM. ABC of the upper gastrointestinal
tract. Epidemiology and diagnosis of Helicobacter pylori
infection. BMJ. 2001;323:920-1.
20. Syam AF, Rani AA, Abdullah M, Manan C, Makmun D,
Simadibrata M, et al. Accuracy of Helicobacter pylori stool
antigen for the detection of Helicobacter pylori infection in
dyspeptic patients. World J Gastroenterol. 2005;11:386-8.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.