For the detection of Helicobacter pylori infection, endoscopic biopsy related tests such as urease test, culture, and histology with special staining of bacteria are most widely used standard methods and most accurate.
However, they are invasive, time consuming and not easy to perform in asymptomatic children.
Serologic test is non invasive and simple, and in adult, its diagnostic accuracy has been reported as comparable to that of the biopsy related tests. However, differences in humoral response to Helicobacter pylori have been noted between adults
and
children.
The aims of this study are to measure the prevalence of H.pylori seropositivity in healthy Korean school children, and to evaluate the diagnostic accuracy of IgG GAP test in children for the detection of H. pylori infection.
Serum samples were taken from 950 healthy Korean school children(age 6-14 years) and IgG GAP test(Bio-Rad) were done. Gastroscopic biopsy were performed from the gastric antrum in 310 children (1 mo-15 years) with gastrointestinal symptoms, and
diagnostic accuracy of the IgG CAP test was compared with bropsy related tests (Urease, Culture, Giemsa stain).
The prevalence of Helicobacter pylori seropositivity in 950 healthy Korean school children increased with age(8.1% in the age group 6<8 years, 12.4% in 8-<10) years, 18.5% in 10-12 years, 21.0% in 12-<14 years and 30.6% in 14-<15 years).
There was a significant difference in overall prevalence of H. pylori seropositivity between healthy Korean school children(16.5%) and children with gastrointestinal symptoms(28%).
Serologic diagnosis by Helicobacter pylori specific IgG GAP test was very sensitive(94.9%) and specific(92.4%) in comparison with CLO test, Culture and Giemsa stain of biopsy specimens by Gastroscopy.
Children with Helicobacter pylori was treated for 4 weeks (Denol for 4 weeks and Amoxicillin for 2 weeks) and negative conversions at the completion of treatment were 85.7% by CLO test, 87.8% by Giemsa stain, 69.5% by culture and 30% by serologic
test.
Immediate evaluation of therapeutic response by antibody titer was not adequate.
In children as reported in adults, serodiagnosis by Helicobacter pylori specific IgG antibody was very reliable and convenient for studying the prevalence in a large series of the population.
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