Background and Aim: The high cost of the 13C-urea breath test (UBT) limits its wide application for both epidemiological and clinical studies for diagnosing Helicobacter pylori infection. This study examined if a lower-dose UBT, applying 1 mg/kg of bodyweight (maximum 25 mg, UBT 25), could introduce cost savings while preserving high diagnostic yields for primary H. pylori infection. Methods: Children aged less than 16 years were recruited after obtaining consent. Those children with administration of antibiotics or proton pump inhibitors within 1 month of the tests were excluded. Positive tests for both the UBT with 50 mg urea (UBT50) and the H. pylori stool antigen (HpSA) were qualifying criteria for H. pylori infection. Negative results for both indicated non-infection. The UBT 25 was conducted 1 week after the UBT50. The cut-off points for the UBT25 ranging from 2δ to 5δ were examined for their sensitivity, specificity and accuracy rates. Results: A total of 153 children were recruited (55% male; mean age 9.1 ± 3.5 years). Both the UBT50 and HpSA test were positive in 18 (13.1%) and negative in 119 children, respectively. The sensitivity and specificity of the UBT25 were optimally achieved at 88.9% (95% confidence interval [CI]: 71.4-100) and 95.0% (95% CI: 91.1-99.9), judged with a cut-off point at 3.5δ. The diagnostic accuracy was significantly higher for children older than 7 years than for those younger than 7 years (98% vs 85%, P = 0.009). Conclusion: Lower-dose UBT titration by bodyweight can cut costs while maintaining a highly reliable method to screen primary H. pylori infection in children older than 7 years, which is generally beyond school age.
|Number of pages||5|
|Journal||Journal of Gastroenterology and Hepatology (Australia)|
|Publication status||Published - 2007 Mar|
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