Evaluation of Invasive and Non-Invasive Methods of Diagnosing Helicobacter pylori Infection in Port Harcourt, Nigeria

Abstract

Several diagnostic approaches are available for the detection of Helicobacter pylori The aim of this study was to evaluate the non-invasive and invasive methods of diagnosing H. pylori infections. A total of three hundred (300) samples each for stool and blood were subjected to non-invasive techniques. The invasive method used in this study was the polymerase chain reaction method (PCR) targeting the 16SrRNA from stool samples while the non-invasive methods used were stool antigen test, urea breath, and serology test. The amplified 16SrRNA fragments of H. pylori from various samples on agarose gel showed their bands at 380 base pairs.  Results obtained from this study showed that the PCR method recorded a 54% prevalence rate, the stool antigen test recorded a 13.7% prevalence rate while serology and urea breath test methods recorded a prevalence rate of 14.7% and 11.7% respectively. This study recorded a prevalence rate of 33.6% based on the study location, with females recording the highest prevalence rate in all the diagnostic methods used. The sensitivities of the various methods used against PCR were 90.3% for the stool antigen test method, 64.5% for the urea breath test, and 100% for the serology test method; while their specificities were 26.3% for both the stool antigen test and urea breathe test and 79% for serology test. The serology method showed a likelihood ratio of 4.76 while that of the stool antigen test and urea breath test were 2.354 and 0.462 respectively. In conclusion, this study has shown that the order of accuracy of diagnostic methods can be arranged as follows: PCR> serology > stool antigen test > urea breath test. However, the order might slightly change among related studies. Generally, the invasive method is preferred over the non-invasive method in developed countries while simultaneous use of more than one non-invasive method is encouraged in developing countries.