Stool Antigen Test Research Articles

Association Between Helicobacter Pylori Infection and Vitiligo

Objective: To determine the association between Helicobacter pylori infection and vitiligo in patients visiting a tertiary care hospital of Punjab, Pakistan. Study Design: Case control study. Place and Duration of Study: Department of Dermatology, Combined Military Hospital, Lahore Pakistan, from Oct 2021 to Mar 2022. Methodology: A total of 60 adult vitiligo patients and 60 healthy controls, of both genders, were included in the study. Their ages ranged from 18-70 years. All study participants underwent stool antigen test to detect the presence of Helicobacter pylori antigen. Results: The mean age of the cases was 43.47±8.16 years whereas it was 40.08±7.42 years in the controls. The mean duration of disease was 4.133±1.21 months. H. pylori Infection was detected in 36(60%) cases as compared to 11(18.3%) controls (p<0.001, OR=6.68); which was found to be statistically significant. Conclusion: Significant association between H. pylori infection and vitiligo was demonstrated in the current study.

Effectiveness of long-term low-dose aspirin in the prevention of gastric cancer after Helicobacter pylori eradication: study design and rationale of Ardabil gastric cancer randomized placebo-controlled prevention trial (AGCPT)

BackgroundIn addition to Helicobacter pylori (H. pylori) infection eradication, some medications, including aspirin, metformin, and statins, have been suggested to have protective effects against gastric cancer (GC) development in observational studies. We launched the Ardabil gastric cancer randomized placebo-controlled prevention trial (AGCPT) to evaluate the effectiveness of long-term low-dose aspirin use for the prevention of development and mortality of GC after H. pylori eradication.Methods/designAGCPT is a prospective population-based double-blind, randomized clinical trial. The study sample was targeted at 21,000 participants aged from 35 to 70 years old, both sexes, in Ardabil, a province in northwest Iran with relatively high rates of GC incidence and mortality. All eligible participants were initially tested for H. pylori infection using a H. pylori stool antigen test. Participants with positive tests undergo H. pylori eradication by standard treatment regimens. All participants with a negative test and those with a positive test with a subsequent confirmed H. pylori eradication test were entered into the intervention phase. In the intervention phase, participants were allocated randomly into either the treatment (daily oral consumption of 81 mg enteric-coated aspirin tablets) arm or the control (placebo) arm using permuted balanced blocks. Subjects will be followed for an average period of 10 years to evaluate the incidence and mortality rates of GC.DiscussionIn addition to preventing other diseases like cardiovascular events, aspirin may prevent GC incidence and mortality. AGCPT will investigate the difference between the two study arms in the proportion of the cumulative incidence and mortality rates of GC. The study’s results may help policymakers and researchers update the strategies for GC prevention.Trial registrationThis trial with the registry name of “The effect of Low-dose Aspirin in the Prevention of Gastric Cancer” was registered in the Iranian Registry of Clinical Trials, IRCT.ir, under the identifier IRCT201105082032N3. Registered on April 21, 2017.

Prevalence of intestinal parasites and Helicobacter pylori coinfection, and contributing factors among patients with gastrointestinal manifestations at Addis Zemen primary hospital, Northwest Ethiopia

BackgroundThe urease-producing Helicobacter pylori increase the likelihood that pathogenic intestinal protozoa will use the stomach’s increased hydrogen potential to propagate the disease. Coinfections exacerbate the onset and severity of gastrointestinal symptoms. This study aimed to assess the prevalence of intestinal parasites/Helicobacter pylori coinfection and contributing factors in patients with gastrointestinal symptoms at Addis Zemen Primary Hospital, Northwest Ethiopia.MethodsFrom April to July 2023, patients with gastrointestinal problems participated in a cross-sectional study carried out in a hospital. To collect the clinical and sociodemographic data, a questionnaire was employed. Intestinal parasites and Helicobacter pylori were detected using the saline stool wet mount and Helicobacter pylori stool antigen tests, respectively. SPSS version 20 was used to analyze the data and variables with p-values < 0.05 were considered statistically significant.ResultThe study included 384 participants in total, of which 47.3% (182/384) were farmers and 50.3% (193/384) were women. Of the study subjects, 69/384 or approximately 18%, had intestinal parasitic infections. In 12% of cases (46/384), Helicobacter pylori were detected. A coinfection of Helicobacter pylori and intestinal parasites was found in 5.5% (21/384) of the subjects. Multiple logistic regression revealed increased risk of coinfection of Helicobacter pylori and intestinal parasites in patients who drink surface water (AOR: 10.7, p = 0.03) family history of Helicobacter pylori (AOR: 3.3, p = 0.024) and those with untrimmed fingers (AOR: 4.9, p = 0.031).ConclusionsGiardia lamblia and Entamoeba histolytica/dispar/ moshkovskii/ bangladeshi complex are the most common protozoans that cause coinfection with Helicobacter pylori. Drinking surface water, family history of Helicobacter pylori and untrimmed fingers are the contributing factors to intestinal parasites/Helicobacter pylori coinfection.

Advances in Diagnostic Modalities for Helicobacter pylori Infection.

Helicobacter pylori (H. pylori) infection is a widespread global health issue with a varying prevalence influenced by geography, socioeconomic status, and demographics. In the U.S., the prevalence is lower, though certain groups, such as older adults and immigrants from high-prevalence regions, show higher rates. The decrease in infection rates in developed countries is due to improved sanitation, antibiotics, and healthcare, whereas developing countries continue to experience high rates due to poor living conditions. H. pylori infection can be asymptomatic or cause symptoms like dyspepsia, abdominal pain, bloating, nausea, and loss of appetite. Pathophysiologically, H. pylori contribute to conditions such as gastritis, peptic ulcers, and gastric cancer through mechanisms including urease production and the release of virulence factors, leading to chronic inflammation and an increased cancer risk. Diagnostic methods for H. pylori have progressed significantly. Non-invasive techniques, such as serological assays, stool antigen tests, and urea breath tests, are practical and sensitive. Invasive methods, including endoscopic biopsy and molecular diagnostics, are more definitive but resource intensive. Recent advancements in diagnostic technology, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), biosensor technology, and next-generation sequencing (NGS), promise improved speed, accuracy, and accessibility. These innovations are expected to enhance the detection and management of H. pylori, potentially reducing the global disease burden. This review aims to discuss these diagnostic modalities with a focus on further advances under investigation.

Introducing HeliEns: A Novel Hybrid Ensemble Learning Algorithm for Early Diagnosis of Helicobacter pylori Infection

The Gram-negative bacterium Helicobacter pylori (H. infection) infects the human stomach and is a major cause of gastritis, peptic ulcers, and gastric cancer. With over 50% of the global population affected, early and accurate diagnosis of H. infection infection is crucial for effective treatment and prevention of severe complications. Traditional diagnostic methods, such as endoscopy with biopsy, serology, urea breath tests, and stool antigen tests, are often invasive, costly, and can lack precision. Recent advancements in machine learning (ML) and quantum machine learning (QML) offer promising non-invasive alternatives capable of analyzing complex datasets to identify patterns not easily discernible by human analysis. This research aims to develop and evaluate HeliEns, a novel quantum hybrid ensemble learning algorithm designed for the early and accurate diagnosis of H. infection infection. HeliEns combines the strengths of multiple quantum machine learning models, specifically Quantum K-Nearest Neighbors (QKNN), Quantum Naive Bayes (QNB), and Quantum Logistic Regression (QLR), to enhance diagnostic accuracy and reliability. The development of HeliEns involved rigorous data preprocessing steps, including data cleaning, encoding of categorical variables, and feature scaling, to ensure the dataset’s suitability for quantum machine learning algorithms. Individual models (QKNN, QNB, and QLR) were trained and evaluated using metrics such as accuracy, precision, recall, and F1-score. The ensemble model was then constructed by integrating these quantum models using a hybrid approach that leverages their diverse strengths. The HeliEns model demonstrated superior performance compared to individual models, achieving an accuracy of 94%, precision of 97%, recall of 92%, and an F1-score of 94% in detecting H. infection infection. The quantum ensemble approach effectively mitigated the limitations of individual models, providing a robust and reliable diagnostic tool. HeliEns significantly improved diagnostic accuracy and reliability for early H. infection detection. The integration of multiple quantum ML algorithms within the HeliEns framework enhanced overall model performance. The non-invasive nature of the HeliEns model offers a cost-effective and user-friendly alternative to traditional diagnostic methods. This research underscores the transformative potential of quantum machine learning in healthcare, particularly in enhancing diagnostic efficiency and patient outcomes. HeliEns represents a significant advancement in the early diagnosis of H. infection infection, leveraging quantum machine learning to provide a non-invasive, accurate, and reliable diagnostic tool. This research highlights the importance of QML-driven solutions in healthcare and sets the stage for future research to further refine and validate the HeliEns model in real-world clinical settings.

Comparison of Helicobacter pylori in hospitalized COVID-19 patients with and without gastrointestinal symptoms.

Helicobacter pylori plays an important role in causing digestive diseases. The purpose of this study is to investigate Helicobacter pylori in COVID-19 patients with and without gastrointestinal symptoms. In this case-control study, all patients with COVID-19 admitted to Imam Khomeini Hospital in Jiroft city in 2021 were convenience sampled and divided into two homogeneous groups. Ninety-five patients with COVID-19, who presented with gastrointestinal symptoms, were included in the case group, while 95 patients with COVID-19 without gastrointestinal symptoms were included in the control group. Noninvasive diagnostic methods, including serology and stool antigen tests, were used to identify Helicobacter pylori in the studied patients. Fifty-three people (55.8%) from the case group had Helicobacter pylori, and 48 (50.5%) from the control group had Helicobacter pylori. Among the 53 people from the case group, 27 (50.9%) were men and 26 (49.1%) were women. Nineteen people (35.8%) were taking pantoprazole, 10 people (18.8%) were taking nonsteroidal anti-inflammatory drugs, 20 people (37.7%) were taking narcotics, and 7 people (13.2%) had peptic ulcer. Seven people (13.2%) had an H2 blocker, and 21 people had an underlying disease. A significant relationship between infection with Helicobacter pylori and the use of pantoprazole, nonsteroidal anti-inflammatory drugs, narcotics, peptic ulcer, underlying disease, and H2 blocker in COVID-19 patients with gastrointestinal symptoms and without gastrointestinal symptoms was present (P-value < 0.05). The prevalence of Helicobacter pylori infection in patients with COVID-19, who have gastrointestinal symptoms, is high and should be considered as a treatment criterion for people infected with COVID-19.

Helicobacter pylori infection and associated risk factors among HIV-positive and HIV-negative individuals in Northern Ethiopia

BackgroundH. pylori infection is a common bacterial infection worldwide, but its prevalence varies widely between different regions and populations. The objective of this study was to determine the prevalence of H. pylori infection and associated risk factors among HIV-positive and HIV-negative individuals in northern Ethiopia. MethodsA cross-sectional study was conducted from June to September 2020 in four randomly selected health facilities located in the Tigray region of Ethiopia. A total of 463 study participants were enrolled, of whom 288 were HIV-positive and 175 were HIV-negative individuals. H. pylori stool antigen tests were performed to detect H. pylori infection. Additionally, CD4+ T cell counts were measured from only a certain number of participants. ResultsThe overall prevalence of H. pylori infection among enrolled study participants was 39.7 %. Notably, the H. pylori infection rate was significantly higher in HIV-positive patients (43.4 %) compared to HIV-negative individuals (33.7 %); χ2 = 4.27, p = 0.039. Higher H. pylori prevalence was observed in participants with higher CD4+ T cell counts in both HIV-positive and HIV-negative individuals. Khat chewing habit, education, and monthly income levels were significantly associated with H. pylori infection in HIV-negative individuals, while the association between Body mass index (BMI) and H. pylori infection was observed in HIV-positive patients, but not HIV-negative individuals. ConclusionThis study demonstrates a higher prevalence of H. pylori infection in HIV-positive patients compared to HIV-negative individuals, emphasizing the importance of comprehensive diagnostics, patient care, and management of H. pylori infection in HIV-positive individuals.

Diagnosis Study of Peptic Ulcer in Iraqi Patients Students

Background: Even in the absence of a Helicobacter pylori infection, psychological stress and a need for fast food can cause peptic ulcer. Research on the relationship between sociodemographic traits and peptic ulcers has revealed a number of risk factors, including a packed family, poor income, unemployment, marital tension, and physical and mental strain. The aim of the current study is to determine the clinical picture of gastric ulcer based on medical history and social status in a sample of Iraqi patients. Methods: Students studying science and medicine who had signs of peptic ulcer disease were the subjects of a cross-sectional investigation. The sample was collected during the period of one year, November 2021 to February 2022. Initially, the procedure was elucidated to the patients, and informed consent was obtained from all enrolled individuals. Peptic ulcer disease was diagnosed by routine examinations, Helicobacter pylori diagnosis by stool antigen test, and gastroduodenoscopy of the patients, in addition to taking the medical history and information about the social status. Results: The study included 45 patients with peptic ulcer, 15 (33.33%) males and 30 (66.66%) females, aged 19-26 years. The control group was 25 healthy individuals, and their symptoms were either acute abdominal pain proven to be caused by peptic ulcer in the patients or hematemesis in 13 (28.88%) patients. Conclusion: Peptic ulcers can be visualised and bleeding can occur, so there should be awareness of pain management and prompt treatment. There should be good and effective analgesia, reassurance, and empathy with patients, and advice on protection against gastric and intestinal ulcers when needed.

Chilean consensus by expert panel using the Delphi technique for primary and secondary prevention of gastric cancer

IntroductionGastric cancer (GC) is the first cause of cancer-related death in Chile and 6th in Latin America and the Caribbean (LAC). Helicobacter pylori (H. pylori) is the main gastric carcinogen, and its treatment reduces GC incidence and mortality. Esophageal-gastro-duodenoscopy (EGD) allows for the detection of premalignant conditions and early-stage GC. Mass screening programs for H. pylori infection and screening for premalignant conditions and early-stage GC are not currently implemented in LAC. The aim of this study is to establish recommendations for primary and secondary prevention of GC in asymptomatic standard-risk populations in Chile. MethodsTwo on-line synchronous workshops and a seminar were conducted with Chilean experts. A Delphi panel consensus was conducted over 2 rounds to achieve >80% agreement on proposed primary and secondary prevention strategies for the population stratified by age groups. Results10, 12, and 12 experts participated in two workshops and a seminar, respectively. In the Delphi panel, 25 out of 37 experts (77.14%) and 28 out of 52 experts (53.85%) responded. For the population aged 16–34, there was no consensus on non-invasive testing and treatment for H. pylori, and the use of EGD was excluded. For the 35–44 age group, non-invasive testing and treatment for H. pylori is recommended, followed by subsequent test-of-cure using non-invasive tests (stool antigen test or urea breath test). In the ≥45 age group, a combined strategy is recommended, involving H. pylori testing and treatment plus non-invasive biomarkers (H. pylori IgG serology and serum pepsinogens I and II); subsequently, a selected group of subjects will undergo EGD with gastric biopsies (Sydney Protocol), which will be used to stratify surveillance according to the OLGA classification (Operative Link for Gastritis Assessment); every 3 years for OLGA III–IV and every 5 years for OLGA I–II. ConclusionA “test-and-treat” strategy for H. pylori infection based on non-invasive studies (primary prevention) is proposed in the 35–44 age group, and a combined strategy (serology and EGD) is recommended for the ≥45 age group (primary and secondary prevention). These strategies are potentially applicable to other countries in LAC.

Prevalence and associated risk factors for Helicobacter pylori infection using stool antigen test among children presenting to the outpatient clinic of a tertiary hospital in Nigeria

Prevalence and associated risk factors for <i>Helicobacter pylori</i> infection using stool antigen test among children presenting to the outpatient clinic of a tertiary hospital in Nigeria

Comparison of Four Tests for the Diagnosis of Helicobacter pylori Infection.

Due to lower operational costs, health maintenance organizations (HMOs) may prioritize Helicobacter pylori stool antigen testing (HpStAg) for the non-invasive diagnosis of H. pylori infection over 13C-urea breath tests (13C-UBTs). The aim of our study was to compare the accuracy of the diagnostic tests for H. pylori. We performed histology, rapid urease test (RUT), 13C-UBT and HpStAg on consecutive patients referred for gastroscopy. Monoclonal stool antigen test was performed using the LIAISON Meridian chemiluminescent immunoassay. Histology was examined with hematoxylin and eosin, and additional stains were performed at the pathologist's discretion. For the assessment of 13C-UBT, we compared concordant histology and RUT. HpStAg was compared to the concordant results of two of the three remaining tests. 103 patients were included (36 males (35.0%), age 50.1 ± 18.4 years). The indication for gastroscopy was dyspepsia in 63 (61.2%). Agreement between RUT and histology was 95.9%. For 13C-UBT and HpStAg, respectively, H. pylori positivity was 30% (30/100) and 27.16% (22/81); sensitivity was 97% and 70%; specificity was 100% and 94.4%; accuracy was 98% and 86%; positive predictive value (PPV) was 100% and 86.4%; negative predictive value (NPV) was 93% and 86%. No demographic, clinical, or endoscopic predictors of HpStAg accuracy were identified using logistic regression. 13C-UBT performs better than HpStAg at our institution. When interpreting results, clinicians should consider test limitations.

Feco-prevalence, endoscopic pattern and associated factors of Helicobacter Pylori infection among symptomatic adult patients in Northern Tanzania.

Africa has consistently had the highest prevalence (70.1%) of H. pylori, and this has led to significant cases of dyspepsia, gastric cancers, and upper gastrointestinal bleeding. However, most studies have used sero-prevalence, which might not give the current state of the infection. Among the tests, the stool antigen test is simple, quick, and effective. The study aimed to determine the feco-prevalence, endoscopic pattern, and associated factors of H. pylori infection among symptomatic adult patients in Northern Tanzania. A hospital-based, cross-sectional study was conducted from October 2022 to April 2023 among adults attending the gastroenterology clinic at Kilimanjaro Chistian Medical Centre. A systematic random sampling was used to select the participants with indications of undergoing esophagogastroduodenoscopy. Questionnaires, stool and blood samples, and endoscopy were used to collect variable data. Numerical and categorical variables were summarized into narrations and tables. Logistic regression was used to assess the factors associated with H. pylori. The feco-prevalence of H. pylori was 43.4%. Chronic gastritis (51.1%) was the most common endoscopic pattern, whereas duodenal ulcers and gastric ulcers were significantly associated with H. pylori infection. Increasing in age (p <0.001) and blood group (p <0.001) were significantly associated with H. pylori infection in the adjusted analysis. The feco-prevalence of H. pylori is high in this setting. H. pylori stool antigen can be used as the initial workup for symptomatic patients before the initiation of proton pump inhibitors. Additionally, due to other causes of dyspepsia, it is advised that H. pylori stool antigen testing be part of the initial evaluation and esophagogastroduodenoscopy be considered in the absence of other alarm symptoms if symptoms persist despite an appropriate trial of medical therapy.

FREQUENCY OF HELCIOBACTER PYLORI AMONGST PATIENTS WITH GASTROINTESTINAL TRACT SYMPTOMS

Worldwide, H. pylori is recognised as a serious concern for public health that causes peptic ulcer disease, gastric cancer and chronic gastritis. The frequency of H. pylori infection ranges from 13% to 81%. Globally, H. pylori infection accounts for around 89% of stomach cancer. Objective: To determine the frequency of helicobacter pylori amongst patients with gastrointestinal tract symptoms. Methodology: The current cross-sectional study was carried out at the Department of Medicine General Hospital Peshawar from September 2023 to February 2024. The overall sample size of the current study was 150 patients. All the patients were assessed for the pylori SAT (Stool antigen test). All the information was gathered on a specialized proforma designed for our research. All the data was analysed using SPSS version 23.0. Results: In the current study, 150 patients were enrolled. Male patients were 100 (66.67%) while female patients were 50 (33.33%), with a ratio of males to females of 1:2. Among 150 patients, 129 (86%) individuals tested positive for H. pylori, whereas 21 (14%) patients tested negative. The enrolled patients' ages ranged from 15 to 85 years with a mean age (SD) of 50.3 (11.01). After analysing the endoscopic reports of patients, it was found that fifteen patients (25%) had chronic gastritis, thirty-five patients (58%) had duodenal ulcers, ten patients (16.6%) had stomach ulcers, and eight patients (13.3%) had non-ulcer dyspepsia. Conclusion: Our study concludes that Helicobacter pylori is the most prevalent problem among patients with gastrointestinal tract symptoms. Early diagnosis and timely treatment are fundamental to avoiding this severe problem.

Non-improvement of atrophic gastritis in cases of gastric cancer after successful Helicobacter pylori eradication therapy.

Helicobacter pylori (H. pylori) infection is closely related to the development of gastric cancer (GC). However, GC can develop even after H. pylori eradication. Therefore, it would be extremely useful if GC could be predicted after eradication. The Kyoto classification score for gastritis (GA) is closely related to cancer risk. However, how the score for GC changes after eradication before onset is not well understood. To investigate the characteristics of the progression of Kyoto classification scores for GC after H. pylori eradication. Eradication of H. pylori was confirmed in all patients using either the urea breath test or the stool antigen test. The Kyoto classification score of GC patients was evaluated by endoscopy at the time of event onset and three years earlier. In addition, the modified atrophy score was evaluated and compared between the GC group and the control GA group. In total, 30 cases of early GC and 30 cases of chronic GA were evaluated. The pathology of the cancer cases was differentiated adenocarcinoma, except for one case of undifferentiated adenocarcinoma. The total score of the Kyoto classification was significantly higher in the GC group both at the time of cancer onset and three years earlier (4.97 vs 3.73, P = 0.0034; 4.2 vs 3.1, P = 0.0035, respectively). The modified atrophy score was significantly higher in the GC group both at the time of cancer onset and three years earlier and was significantly improved only in the GA group (5.3 vs 5.3, P = 0.5; 3.73 vs 3.1, P = 0.0475, respectively). The course of the modified atrophy score is useful for predicting the onset of GC after eradication. Patients with severe atrophy after H. pylori eradication require careful monitoring.

Vitamin B12 Deficiency among Cases of Helicobacter Pylori Gastritis: A Cross Sectional Study

Background: Helicobacter pylori (H. pylori) is a gram-negative bacterium associated with various gastrointestinal diseases, including peptic ulcer disease, gastric cancer, and vitamin B12 deficiency. Recent research has highlighted a potential link between chronic H. pylori infection and significant malabsorption of vitamin B12, particularly in populations with high prevalence rates of infection. Objective: This study aims to investigate the frequency of vitamin B12 deficiency among patients with H. pylori gastritis and to explore the association between H. pylori infection and vitamin B12 levels. Methods: A cross-sectional study was conducted from September 2023 to March 2024 at the Department of Medicine, Ayub Teaching Hospital, Abbottabad. A total of 120 patients presenting with symptoms of gastritis were enrolled after obtaining ethical approval from the hospital’s review board. Exclusion criteria included patients already on vitamin B12 supplementation. Diagnostic testing for H. pylori was performed using stool antigen tests, and vitamin B12 levels were assessed through serum measurements. Data analysis was conducted using IBM SPSS Statistics version 23, with the Chi Square test applied to examine the association between H. pylori infection and vitamin B12 deficiency, setting the level of significance at p ≤ 0.05. Results: Out of the 120 patients studied, 49 (40.8%) tested positive for H. pylori. Vitamin B12 deficiency was observed in 35 (29.2%) patients. Among those infected with H. pylori, 51.0% (25 patients) also had vitamin B12 deficiency, compared to 14.1% (10 patients) among those not infected (p = 0.0001). Conclusion: The findings indicate a significant association between H. pylori infection and vitamin B12 deficiency. This study suggests that H. pylori is a potential risk factor for vitamin B12 deficiency, underscoring the need for screening and appropriate management of H. pylori in patients presenting with vitamin B12 deficiency.

Should All Patients With Stage IE Gastric Mucosa-Associated Lymphoid Tissue Lymphoma Receive Antibiotic Eradication Therapy for Helicobacter pylori?

H. pylori eradication therapy (HPE) can lead to tumor regression in H. pylori-positive (HPP) gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, some patients do not have detectable H. pylori (HP) infection (H. pylori-negative [HPN]) and the guidelines differ in their initial approach to HPN patients. The National Comprehensive Cancer Network (NCCN) recommends proceeding to radiation therapy, whereas European Society for Medical Oncology suggests HPE for every patient, even those who are HPN. To address this issue, we evaluated the effectiveness of HPE in limited-stage gastric MALT lymphoma. We retrospectively reviewed patients newly diagnosed with stage IE gastric MALT lymphoma between January 2002 and December 2022. The primary outcome was the complete remission (CR) rate defined as no macroscopic findings of lymphoma and negative gastric biopsy at the follow-up gastric endoscopy. Fifty-two patients were reviewed, and HP infection was detected in 19 (36.5%) patients-14 by immunostaining, three by serology, and one each by stool antigen and urea breath test. All 19 HPP and eight of the 33 HPN patients received HPE treatment. The CR rate was 63% (12/19) in HPP patients and 13% (1/8) in HPN patients (P = .033). After a median follow-up of 89.7 months, only two of the 12 HPP patients achieving CR have relapsed; the one HPN patient who received HPE remains in CR at 12+ months. For limited-stage HPP gastric MALT lymphoma, HPE is an effective and durable first-line treatment and should be used. For HPN patients, the CR rate with HPE is very low in our experience and is thus in support of the NCCN guideline.

Epidemiology, pathogenicity, risk factors, and management of Helicobacter pylori infection in Saudi Arabia.

Helicobacter pylori (H. pylori) is a gastric microbial pathogen that infects approximately half of the global population. This bacterium significantly contributes to various gastroduodenal diseases, including chronic active gastritis, peptic ulcerations, and malignant transformations. This review focuses on epidemiology, pathogenicity, virulence genes, risk factors, and management of H. pylori infection, specifically within the context of Saudi Arabia. The results presented here are grounded in studies conducted in Saudi Arabia, contrasting with mere bibliographic reviews of findings from other countries. H. pylori infection has been observed in Saudi Arabia, with substantial differences in the prevalence, ranging between 10-96% among various studied populations. Several risk factors for H. pylori infection have been identified, encompassing socioeconomic status, medical history, personal hygiene, and behavioral practices. Among the virulence genes harbored by H. pylori, cytotoxin-associated gene A (cagA) and vacuolating cytotoxin (vacA) are most common, with their presence correlating with the pathogenicity and clinical manifestations of the associated diseases. A range of invasive and non-invasive diagnostic assays have been utilized to identify H. pylori infection, with their employment being influenced by factors like availability, cost, patient age, gastric symptoms, and the specifics of clinical information sought. While detection methods like the H. pylori stool antigen test and the urea breath test offer more accuracy and speed, culturing remains indispensable for determining the antimicrobial susceptibility profile. The emergence of resistant strains across varying regional settings poses a significant challenge to treatment endeavors, necessitating an assessment of local antimicrobial resistance rates prior to formulating treatment strategies. The findings of this review highlight the importance of continuous implementation of screening, control, and prevention of H. pylori infection to combat the spreading infection and other related complications.

Stool antigen testing and serology’s accuracy in identifying helicobacter pylori infections in suspected patients

Stool antigen testing and serology’s accuracy in identifying helicobacter pylori infections in suspected patients

Co-infection of Helicobacter pylori and intestinal parasites in children of selected low-income communities in Lagos State, Nigeria

Helicobacter pylori and intestinal parasites cause gastrointestinal diseases with a high prevalence in children in resource limited developing countries. There is paucity of information in Nigeria on co-infection of H. pylori and intestinal parasites. The study was conducted to determine the prevalence of H. pylori and parasite co-infection in children from selected low-income communities in Lagos, Nigeria. Fecal samples were collected from 151 healthy children aged ≤11 years across six low-income communities in Lagos. H. pylori was detected using stool antigen test and conventional PCR assay, intestinal parasites were detected using formol-ether concentration and nested PCR assay. Structured questionnaires were administered to parents and legal guardians of the children by an interviewer to collect relevant data on demographic and lifestyle factors. The prevalence of H. pylori was 31.79% (48), with a higher prevalence in children aged 2–3 years. The prevalence of intestinal parasites was 21.19% (32) with the lowest frequency found in children aged 8–9 years. The parasites detected include: A. lumbricoides (10.6%), G. intestinalis (7.3%), hookworm (1.99%), E. histolytica (0.66%), S. mansoni (0.66%). There was co-infection prevalence of 10.6% (16) which was associated with the parasites: G. intestinalis (7.3%) and A. lumbricoides (3.97%). Polyparasitism with G. intestinalis and A. lumbricoides was reported in 2 children infected with H. pylori. This study which is the first reported in Lagos established a low prevalence of H. pylori and intestinal parasite co-infection in children and provides better understanding of the epidemiology of H. pylori infection associated with intestinal parasites in Nigeria.

Change in Diagnosis of Helicobacter pylori Infection in the Treatment-Failure Era.

Helicobacter pylori (H. pylori) infection is a prevalent global health issue, associated with several gastrointestinal disorders, including gastritis, peptic ulcers, and gastric cancer. The landscape of H. pylori treatment has evolved over the years, with increasing challenges due to antibiotic resistance and treatment failure. Traditional diagnostic methods, such as the urea breath test, stool antigen test, and endoscopy with biopsy, are commonly used in clinical practice. However, the emergence of antibiotic-resistant strains has led to a decline in treatment efficacy, necessitating a re-evaluation of common diagnostic tools. This narrative review aims to explore the possible changes in the diagnostic approach of H. pylori infection in the era of treatment failure. Molecular techniques, including polymerase chain reaction and whole genome sequencing, which have high sensitivity and specificity, allow the detection of genes associated with antibiotic resistance. On the other hand, culture isolation and a phenotypic antibiogram could be used in the diagnostic routine, although H. pylori is a fastidious bacterium. However, new molecular approaches are promising tools for detecting the pathogen and its resistance genes. In this regard, more real-life studies are needed to reveal new diagnostic tools suitable for identifying multidrug-resistant H. pylori strains and for outlining proper treatment.