Of two hundred Ethiopian patients with dyspepsia, multiple biopsies we
re taken from the antrum of the stomach, Helicobacter pylori was cultu
red from 85% of duodenal ulcer and in 75% of chronic antral gastritis
patients, The overall Helicobacter pylori positivity was 70%. The sens
itivity, specificity, positive and negative predictive values of the t
ests as compared to culture were as follows, respectively: direct urea
se test 100%/87%/95%/100%, direct gram stain 60%/98%/99%/51%, histolog
ical gram stain 66%/97%/98%/56%, Giemsa stain 100%/97%/99%/100% and Gi
menez stain 100%/87%/95%/100%. It is concluded that gram staining of d
irect tissue smear or histology is an insensitive method in the diagno
sis of Helicobacter pylori, All the other tests, are shown to be valid
, Urease test is an excellent test for provision of presumptive diagno
sis of Helicobacter pylori while awaiting confirmation either by cultu
re or histology.