COMPARISON BETWEEN UREA BREATH TEST AND STOOL ANTIGEN TEST FOR DIAGNOSIS OF HELICOBACTER PYLORI IN CHILDREN AND ADOLESCENT IN ERBIL CITY

Abstract

Background

Helicobacter pylori infection, a global health concern, has high childhood prevalence, often starting early and persisting for decades before causing diseases. Diagnostic tests include noninvasive (stool antigen test, urea breath test, blood test) and invasive (histology, rapid urease test, microbiological culture) methods. This study aimed to compare stool antigen and urea breath tests for diagnosing Helicobacter pylori in children in Erbil, Kurdistan, and explore variations by age, gender, family size, and parental economic status.

Patients and methods

This cross-sectional study, conducted in Erbil, Kurdistan region of Iraq from 1st January 2024 to1st December 2024, involved 49 patients, aged 6 to 16 years. The diagnosis of H. pylori was established through a combining clinical assessments, stool antigen tests or urea breath tests followed by histological examinations after upper gastrointestinal endoscopy. Specificity and sensitivity of both stool antigen test and urea breath test determined by comparing to endoscopic findings.

Results

This study found diagnostic tests, the stool antigen test (HpSA) demonstrated a sensitivity of 73.1%, specificity of 82.6%, and accuracy of 78%. In contrast, the 13C-urea breath test (UBT) showed higher performance metrics with a sensitivity of 88.5% and specificity of 91.3%. Also, strong links between Helicobacter pylori infection in children and family history of Helicobacter pylori infection. Hematological profiles showed no significant differences. Key symptoms were abdominal pain and vomiting.

Conclusion

The 13C-urea breath test demonstrated high accuracy for H. pylori diagnosis in children.