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 val...

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Bibliographic Details
Published in:The Journal of infectious diseases 1993-12, Vol.168 (6), p.1549-1553
Main Authors: Bodhidatta, Ladapom, Hoge, Charles W., Churnratanakul, Suraphol, Nirdnoy, Warawadee, Sampathanukul, Pichet, Tungtaem, Chatchai, Raktham, Suwanee, Smith, C. Dahlem, Echeverria, Peter
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antibodies
Antibodies, Bacterial - blood
Bacterial diseases
Bacterial diseases of the digestive system and abdomen
Biological and medical sciences
Biopsies
Child
Child, Preschool
Concise Communications
Developing countries
Endoscopy
Enzyme linked immunosorbent assay
Enzyme-Linked Immunosorbent Assay - methods
Gastritis
Helicobacter Infections - diagnosis
Helicobacter Infections - epidemiology
Helicobacter pylori
Helicobacter pylori - isolation & purification
Human bacterial diseases
Humans
Infant
Infections
Infectious diseases
Medical sciences
Middle Aged
Predictive Value of Tests
Prevalence
Sensitivity and Specificity
Seroepidemiologic Studies
Serologic tests
Thailand - epidemiology
Tropical medicine
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Summary: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.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/168.6.1549