Diagnostic performance of biopsy-based methods for determination of Helicobacter pylori infection in dyspeptic Mozambican patients.

Background: Helicobacter pylori (H. pylori) is a Gram-negative bacterium capable of colonizing the human stomach, which can lead to various gastrointestinal conditions. Several invasive and non-invasive methods exist for diagnosing H. pylori; however, none can be considered the gold standard. This study aimed to evaluate the performance of three biopsy-based methods (rapid urease test - RUT, histopathology - HIST, and polymerase chain reaction - PCR) in diagnosing H. pylori, and to assess their combined effect in confirming the infection.

Methodology: Eighty dyspeptic patients were recruited for this study, and gastric biopsies were collected from each of them using upper digestive endoscopy. H. pylori was diagnosed using three biopsy-based methods: RUT, HIST, and PCR. RUT was performed using the commercially available PYLO DRYTM Kit, HIST was conducted with Hematoxylin & Eosin and Giemsa staining, and PCR was performed by amplifying the 16S rRNA and 23S rRNA genes. The patient had to test positive in at least two combined diagnostic methods to be confirmed as a case.

Results: The three biopsy-based methods (RUT, HIST, and PCR) showed positivity rates of 100% (80/80), 35% (28/80), and 65% (52/80), respectively. When all methods were combined to confirm H. pylori infection, 75% (60/80) of cases were confirmed, while the remaining 25% (20/80) were classified as undetermined, as they were positive only for RUT.

Conclusions: Despite slight differences, RUT and PCR performed well in diagnosing H. pylori compared to HIST. However, when all three methods were combined, they improved the accuracy of H. pylori diagnosis and infection confirmation.