Comparative study on detection of urease activity by CLO Test Kit and Microtiter Biopsy Urease Test Kit for evaluation of Helicobacter pylori

A Microtiter Biopsy Urease Test (MBUT) for the detection of Helicobacter pylori was evaluated in the drug trial study conducted in the Endoscopy Department of New Yangon General Hospital. The MBUT was compared with commercially available urease test (CLO Test). Both CLO test and MBUT were performed on antral and fundal gastric tissues biopsied from 35 subjects who underwent upper gastrointestinal endoscopy. 29 (83 percent) cases were positive for Helicobacter pylori when tested by CLO test and MBUT. Thus the sensitivity and specificity of MBUT relative to CLO test was both 100 percent respectively. Tested by MBUT, the urease reaction was positive in 83 percent of cases within 2 hours and 90 percent within 3 hours. Tested by CLO test, it was positive in 60 percent of cases within 2 hours and 67 percent within 3 hours. the accuracy of MBUT was thus similar to that of CLO test for the detection of Helicobacter pylori. Moreover, MBUT is not expensive, can be prepared locally, packed in test kit form and can be supplied to gastroenteroscopy units for diagnostic and treatment purposes.

Prevalence of upper gastrointestinal disease in relation to age: Endoscopic and clinical implications

Reports of 2005 endoscopies were reviewed to determine the age-related prevalence of upper gastrointestinal (UGI) disease as a guide to medical officers in primary and secondary centres for necessary referral to us for endoscopic examination. Results indicated that (1) there were positive findings in 1836 (92 percent) of all endoscopic examinations, and most symptomatic patients can be expected to have at least one UGI abnormality, (2) many patients with UGI symptoms have two or more reportable disease processes, (3) the prevalence of serious or life-threatening diseases such as cancer or large ulcers rises steasily with age, and (4) after age 50 approximately 51 percent of symptomatic patients have a serious UGI disease. Based on these findings, one should expect to diagnose at least one abnormality in most symptomatic patients, and should manage younger patients in their centres as an alternative. However, one should not hesitate to refer patients above 50 to an appropriate centre. Because of high prevalence of serious lesions in the elderly, endoscopy should also be condidered for the initial examination of an elderly patient if poor physical status renders the radiological examination difficult or unreliable.