Diagnostic Testing Accuracy for Helicobacter pylori Infection among Adult Patients with Dyspepsia in Cuba’s Primary Care Setting

Author:

Duquesne Amílcar1,Falcón Rosabel2ORCID,Galindo Belkys3,Feliciano Onelkis2ORCID,Gutiérrez Oderay2,Baldoquín Waldemar3ORCID,Fonseca Magile C.4ORCID,Llanes Rafael2,Sarmiento Luis5ORCID

Affiliation:

1. Teaching Orthopedical Hospital Fructuoso Rodríguez, Havana City 10400, Cuba

2. Department of Microbiology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba

3. Department of Epidemiology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba

4. Department of Virology, Center for Research, Diagnosis and Reference, “Pedro Kourí” Institute of Tropical Medicine, Havana City 11400, Cuba

5. Department of Clinical Sciences, Immunovirology Unit, Skåne University Hospital, Lund University, 21428 Malmö, Sweden

Abstract

Evidence of the effectiveness of the tests used to diagnose Helicobacter pylori (H. pylori) in primary healthcare is limited. This cross-sectional study aims to assess the accuracy of tests used for to diagnose H. pylori infection in primary care patients and its relationship with gastroduodenal pathologies. Over 12 months, 173 primary care patients with dyspeptic symptoms were referred for upper gastrointestinal endoscopy to obtain gastric biopsies, and venous blood was extracted from them. H. pylori infection was detected using a rapid urease test (RUT), real-time polymerase chain reaction (RT-PCR), H. pylori-IgG ELISA, and Western blot (WB). The culture and histological findings were used as the reference standard for H. pylori infection. H. pylori prevalence was 50%. There were no significant differences between men and women overall or by age group. The presence of H. pylori was associated with chronic moderate gastritis and its absence with chronic inactive gastritis, as well as the combination of gastritis and gastric lesions (p < 0.05). RUT and ELISA H. pylori -IgG tests showed the highest overall performance (accuracy 98.9% and 84.4%), followed by WB and RT-PCR (accuracy 79.3% and 73.9%). These findings support the notion that combined invasive and noninvasive methods, such as RUT and H. pylori-IgG ELISA, can be a primary diagnostic screening tool for detecting H. pylori among adult dyspeptic patients in Cuba’s primary care setting.

Publisher

MDPI AG

Subject

Virology,Microbiology (medical),Microbiology

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