Validity and cost comparison of 14carbon urea breath test for diagnosis of H Pylori in dyspeptic patients

doi:10.3748/wjg.v13.i6.925

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Feb 14, 2007 (publication date) through Nov 21, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Feb 14, 2007; 13(6): 925-929
Published online Feb 14, 2007. doi: 10.3748/wjg.v13.i6.925

Validity and cost comparison of ¹⁴carbon urea breath test for diagnosis of H Pylori in dyspeptic patients

Shahid Rasool, Shahab Abid, Wasim Jafri

Shahid Rasool, Shahab Abid, Wasim Jafri, Section of Gastroenterology, Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.

Author contributions: All authors contributed equally to the work.

Supported by University Research Council Grant, No. 041F431YC

Correspondence to: Dr. Shahab Abid, MBBS, FCPS, Associate Professor, Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan. shahab.abid@aku.edu

Telephone: +92-21-4864656 Fax: +92-21-4934294

Received: October 17, 2006
Revised: December 1, 2006
Accepted: December 22, 2006
Published online: February 14, 2007

Abstract

AIM: To validate and compare the cost of microdose ¹⁴C urea breath test (UBT) with histology and rapid urease test for the diagnosis of H Pylori.

METHODS: Ninety-four consecutive patients with dyspeptic symptoms undergoing gastroscopy were enrolled. Gastric biopsies were taken for histology and rapid urease test. UBT was performed after gastroscopy by microdose ¹⁴C urea capsules. Sensitivity, specificity and accuracy of UBT were calculated and compared with histology and rapid urease test. Cost comparison of these tests was also performed.

RESULTS: H pylori was diagnosed by histology and rapid urease test in 66 (70%) and 61 (65%) patients, while ¹⁴C UBT detected infection in 63 (67%). Accuracy of UBT was 93% in comparison with histology while its positive and negative predictive values were 97% and 84%, respectively. Comparison of ¹⁴C UBT with rapid urease test gives an accuracy of 96%, with positive and negative predictive values of 95% and 97%, respectively. These results were highly reproducible with a Kappa test (P value < 0.001). Cost of histology or rapid urease test with gastroscopy was 110 USD or 95 USD respectively while the cost of UBT was 15 USD.

CONCLUSION: Microdose ¹⁴C UBT was comparable to histology and rapid urease test. ¹⁴C UBT is an economical, self sufficient and suitable test to diagnose active H pylori infection in less developed countries.

Keywords: H pylori; Microdose; ¹⁴C urea breath test; Diagnosis; Reliable; Economical