The Stool Antigen Test is Efficient at Detecting Helicobacter Pylori Infection in Bangladeshi Peptic Ulcer Patients

Aims: Helicobacter pylori (H. pylori) is the primary causative agent of peptic ulcer in multiple developing countries, including Bangladesh. This study was designed to investigate the diagnostic value of a rapid immunochromatography-based H. Pylori stool antigen (HpSAg) test to screen H. pylori infection in Bangladeshi population. Methodology and results: A total of 140 suspected peptic ulcer patients who underwent upper gastrointestinal endoscopy at Chittagong Medical College and Hospital, Chattogram, Bangladesh, were included in the study. Histopathology, Rapid Urease Test (RUT), and Microscopic examination of the stained smears were conducted to define H. pylori positive cases. Later, stool antigen detection test was done in H. pylori positive status group, H. pylori negative status group, indeterminate status group, and healthy controls. Out of 140 peptic ulcer suspected patients, 75 (53.6%) patients were confirmed to have peptic ulcer or erosions. Although the proportion of antral erosion was 57.4% in patients who were below 40 years, the proportion decreased to 23.4% in patients over 40 years. Patients over 40 years were mostly suffering from Prepyloric erosion (42.9%). All peptic ulcer patients were also positive on histopathological analysis. However, micorscopic grading of curved bacilli and RUT found 93.3% (70/75) and 89.3% (67/75) patients positive, respectively. High sensitivity (95%), specificity (80%), and diagnostic accuracy (91%) scores for HpSAg assay was obtained in our study. Conclusions, significance and impact of studies: The HpSAg test, for a comparatively less sophisticated assay, can be efficient in detecting the presence of H. pylori pre-and post-therapy and provide more valid test results than other invasive test methods.