ABSTRACT
Only few epidemiological studies have examined the rate of active H. pylori infection in the symptomatic population in Pakistan. This retrospective study presents the laboratory data collected during the past 13 years (2002 to 2015) from 2315 symptomatic patients referred to the BreathMAT Lab, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad for the diagnosis of active H. pylori infection using the 13C Urea Breath Test. Rate of infection and its association with gender and age were evaluated. The overall rate of active H. pylori infection was 49.5% and there was no association of this rate of infection with gender. An increase in rate of infection was observed with increasing age with significant difference (p < 0.05). The patients that tested negative for this infection might be having symptoms due to stress and indiscriminate use of non-steroidal antiinflammatory drugs (NSAIDs) in this community. The fact that half of the symptomatic patients were negative needs to be highlighted and further suggests that symptomatic patients should be tested by the 13C UBT before prescribing antibiotic treatment for H. pylori eradication. In addition, there is a need to educate this community about the harmful and side effects of self medication and overuse of NSAIDs.
ABSTRACT
Prevalence of H. pylori infection is higher in developing countries including Pakistan. The basic purpose of this study was to investigate the prevalence of H. pylori infection and determination of possible risk factors. A prospective epidemiologic survey of H. pylori infection was accomplished in 2008 and 2009 involving 516 asymptomatic individuals of Barakaho, Islamabad, Pakistan. Data were obtained by questionnaire and H. pylori positivity was checked by 13C UBT. A total of 516 individuals participated in the study of which 384 [74.4%] were positive for H. pylori infection. The prevalence was 73.5% in males and 75.4% in females [p = 0.622] and increased with increasing age [p < 0.001]. Presence of household animals [p = 0.004] and more family members [p = 0.025] were significantly correlated with H. pylori prevalence while no association was seen with other risk factors such as education level, drinking water source, number of rooms in house and monthly family income. High prevalence of H. pylori infection in Pakistani population is comparable to the data of developing countries. H. pylori infection was significantly associated with presence of household animals and more family members
ABSTRACT
High frequency of Helicobacter [H.] pylori infection has been reported in Pakistan mainly for dyspeptic patients, while the published data is inadequate regarding asymptomatic population. The non-invasive [13]C urea breath test [UBT] was used to determine the frequency of H. pylori infection in 516 asymptomatic individuals and to find out its association with gender and age. Overall prevalence was 74.4% [384/516] while 63.5% [113/178] children were positive for [13]C-UBT and the percentage increased with age in both the genders with significantly higher prevalence in adolescents [p=0.003] and adults [p < 0.001]. Moreover, there was non-significant between the prevalence of H. pylori infection in males and females in all age categories. The reported high frequency of H. pylori infection warrants further studies to identify epidemiological and environmental risk factors
ABSTRACT
The vacuolating cytotoxin VacA and cytotoxin associated gene product CagA, encoded by vacA and cagA are major virulence determinants associated with pathogenesis of Helicobacter pylori. The presence and prevalence of two major H. pylori virulence associated genes among gastric biopsies of Pakistani children were investigated in the current study. Fifty one gastric biopsy specimens of children were analysed for 16S rRNA, vacA and cagA genes using PCR. The results showed that 21 (41.2%) biopsies were positive for H. pylori as determined by 16S rRNA PCR. In the 21 H. pylori positive gastric biopsies, 19 (90.5%) showed vacA s1a, 1 (4.75%) was vacA s1b and 1 (4.75%) was vacA s2 whereas, 5 (23.8%) were vacA m1 and 16 (76.2%) were vacA m2. None of the H. pylori positive biopsies carried vacA s1c subtype. The cagA gene was found in 13 (61.9%) of H. pylori infected biopsies and different vacA combinations were found with or without cagA gene. H. pylori was detected with high frequency of cagA while vacA s1a and vacA m2 regions with vacA s1a/m2 genotype were predominant in H. pylori infected gastric biopsies of children.
ABSTRACT
To compare urea breath and stool antigen in children, with hisotological diagnosis for helicobacter pylori [H.pylori] infection. Cross-sectional study. From June 2005 to December 2005 carried out at KRL Hospital, Islamabad and Children Hospital, PIMS, Islamabad. Children between 3 and 15 years of age reporting in pediatric outpatient department with upper gastrointestinal symptoms were included. All the participating children underwent an upper gastrointestinal endoscopy and 3 tests namely: histopathological identification of H.pylori [the traditional gold standard], urea breath test and stool antigen test were carried out on each child. The sensitivity, specificity, and positive predictive values were calculated for each noninvasive test used in the study. A total of 54 patients completed the study with a mean age of 8.2 years. On histological examination, 725 [39] were positive for H.pylori infection. On gross endoscopic examination, only 9 patients had signs of gastritis as compared to 39 histological positives. The sensitivity, specificity and positive predictive value of stool antigen test were: 77%, 73% and 89% respectively whereas the same for urea breath test: 79%, 80% and 91% respectively. Both the noninvasive tests were found to be sensitive and specific as compared with histological identification, for the diagnosis of H.pylori in our pediatric population. The accuracy of urea breath test was better than the stool antigen test but later was easier to perform and could fulfill the criteria for a rapid bedside diagnostic test