Correlation between Gastric mucosal histology and Faecal antigen test for the detection of Helicobacter pylori infection among dyspeptic patients in a tertiary hospital in south-west Nigeria.

Abstract

Background and objectives: Dyspepsia is a term used to describe upper abdominal pain or discomfort often associated with eating, early satiety, postprandial abdominal bloating or distention, and nausea. Many of these patients arc infected with Helicobacter pylori. A simpl e method of diagnosis becomes imperative, to rcducc the burden on endoscopy services. This study was aimed at determining the correlation between faecal antigen test and gastric mucosal histology in the diagnosis of Helicobacter pylori infection amongst patients undergoing upper gastrointestinal endoscopy. Methods: A cross-sectional study of consecutive, consenting patients with dyspepsia presenting for uppe r gastrointestina l endoscopy. Fresh stool samples (rectal smears) were obtained from patients for Helicobacter pylori stool antigen test. Bio-data and results were recorded. Upper gastrointestinal endoscopy was performed using Pcntax FG-29W gastroscopc with a video monitor and detailed findings noted. Gastric biopsies (3 corpus and 3 antrum) were taken for histological diagnosis of Helicobacter pylori. Data were entered into SPSS (version 20) and analyzed using descriptive and inferential statistics. Results: Ther e wer e 150 patients comprisin g 61 (40.7%) males and 89 (59.3%) females. The mean age (±SD) was 45.5 (±14.7) years with a range of 18 - 79 years. Helicobacter pylori wa s present in 93(62%) of patients on histology, and in 80 (53.3%) of them using Helicobacter pylori Stool Antigen Test (p = 0.000). The sensitivity, specificity, diagnostic accuracy. Positive predictiv e value . Negativ e prcdictivc valu e and Are a unde r the receive r operating characteristic curvc for Helicobacter pylori stool antigen test were 79.6%, 89.5%, 83.3%, 92.5, 72.9% and 0.827 respectively. Positive and negative likelihood ratios were 7.58 and 0.228 respectively.