Comparative Evaluation of Stool Antigen Immunoassay and Blood Antibody Test Methods for the Screening of Helicobacter Pylori Infection in Asymptomatic Adult Population in Delta State, Nigeria

Aim: To compare the H.pylori positivity between stool antigen and blood antibody test methods and to determine the accuracy, sensitivity, specificity of the stool antigen and IgG serology tests as well as sex, age and geographical area variations with the rate of H. pylori positivity. Methods: 408 asymptomatic volunteers (aged 32.55 ± 11.98 years) participated in this study. Stool and serum samples were obtained and assayed quantitatively using the stool antigen Accu-Diag H. pylori Antigen and Accu-Bind antibody ELISA Kits respectively. The stool samples were also assayed qualitatively using the monoclonal fecal H. pylori antigen rapid test kit (Aria H. Pylori Ag Combo Rapid Test. Results: The overall positivity rate of H. pylori stool antigen test (28.2%) was significantly lower (P=0.02) compared to that of the serology test (48.3%). No statistical differences were observed between genders and among age groups and geographical areas in both the stool and serology tests. The positivity in age group of ≥ 60 yrs in the IgG antibody test was significantly (p<0.05) greater compared with age groups 18-39 years and 40-59 years respectively. The stool antigen test had a higher sensitivity (100% vs. 59.8%), specificity (98.7% vs. 57.9%), accuracy (99% vs. 60%) and area under the Receiver Operator Characteristic curve (99.3% vs. 61.4%) compared with the IgG serology test. Conclusion: The present study suggests that H. pylori stool antigen test would be a more appropriate and reliable first-line routine test for diagnosis of H. pylori infection in Delta region of Nigeria. The rate of positivity was not affected by sex and geographical areas, but high prevalence rate of H. pylori infection was observed within the oldest population.

Author(s): Omosor Kingsley Ifeanyichukwu, Omosor Omasan Herrienta, Adejumo Babatunde Ishola Gabriel, Ibeh Isaiah Nnana and Dimkpa Uchechukwu

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