Diagnostic accuracy of rapid urease test for the diagnosis of Helicobacter pylori gastic biopsies in Nigerian with dyspepsia

Abstract

Background: The strong association of Helicobacter pylori (H. pylori) with dyspepsia has caused a major paradigm shift in patients’ management. It has been observed that histology is usually employed as the routine test for the diagnosing H. pylori in centres where  Oesophagogastroduodenoscopy (OGD) is available in Nigeria. Because of the drawbacks attendant to the use of histology, in terms of cost effectiveness and technical expertise, it is necessary to evaluate the diagnostic accuracy of a simpler alternative for ease of management of patients with dyspepsia.
Objective: This study evaluated the diagnostic accuracy of rapid urease test (RUT) in the diagnosis of Helicobacter pylori (H. pylori) in patients with dyspepsia.
Methods: Eighty-six consecutive adult patients with dyspeptic symptoms presenting for endoscopy were recruited after giving informed consent. Gastric antral biopsies were collected at endoscopy for RUT and histology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of RUT was calculated using histology as the reference
standard.
Results: Of the 86 subjects, there were 39 (45.3%) males and 47(54.7%) females. The mean age was 49.19±13.75 years. The age range was 23 to 85 years. The sensitivity, specificity, PPV, NPV of RUT was 93.33%, 75.6 %, 80.76 %, and 91.17 % respectively.
Conclusion: RUT is accurate for the diagnosis of H. pylori infection. Its use will serve as a good alternative to histology in management of patients with dyspepsia in resource poor environments, except in patients who need histology for reasons other than H. Pylori diagnosis.

Key words: Dyspepsia, Helicobacter pylori, Rapid Urease test, Histology.