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Diagnostic Accuracy of Helicobacter pylori Stool Antigen Test in Iranian Children

Mehrazma, Mitra MD*; Nakhaii, Shahrbanoo MD; Talachian, Elham MD; Harahdashti, Arash Lahouti MD

Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e31829c39b8
Original Articles

Background: Infection with Helicobacter pylori is very common in children. H pylori stool antigen (HpSA) test is among the most widely used tests for the diagnosis of this infection. This study aimed to evaluate the HpSA test as a noninvasive diagnostic test in Iranian children with symptoms suggestive of infection with H pylori.

Methods: This was a prospective comparative study using histologic examination as reference standard. Seventy children with symptoms suggestive of infection with H pylori (dyspepsia, epigastric pain, or failure to thrive) were enrolled.

Results: The mean age of the patients was 7.3 years (range, 9 months to 17 years). H pylori stool antigen had a sensitivity of 82.4 (95% confidence interval, 55.8–95.3) and specificity of 92.4 (95% confidence interval, 80.1–97.5). Analysis of receiver operator characteristic curve yielded an overall accuracy of the HpSA test of 87.4% (77.4%–97.4%). Further analysis revealed that the accuracy of the test increases when applied to children aged 5 years or older (overall accuracy, 95.4%; sensitivity, 100%; and specificity, 90.1%).

Limitation: This study is limited by relatively small number of sample size.

Conclusion: H pylori stool antigen is a reliable test for the diagnosis of H pylori infection particularly in children older than 5 years.

Author Information

From the *Oncopathology Research Center, †Department of Pediatric Gastroenterology, Ali-Asghar Children’s Hospital, and ‡Ali-Asghar Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Correspondence to: Arash Lahouti Harahdashti, MD, Ali-Asghar Pediatric Hospital, Tehran University of Medical Sciences, 24 Deldar and Rahmani Streets, Sadr Expressway, Tehran, Iran. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2014 by Lippincott Williams & Wilkins.