COMPARISON BETWEEN A RAPID OFFICE-BASED AND ELISA SEROLOGIC TEST IN SCREENING FOR HELICOBACTER-PYLORI IN CHILDREN

Background. The rapid diagnostic serological test for detection of Hel icobacter pylori (H. pylori) infection in children has a significant a dvantage over the standard enzyme immunoassay (EIA) method, for its si mplicity and rapid availability of results in a physician's office set ting. We compared the immunochromatographic test with a standard enzym e immunoassay test in the pediatric population. Materials and Methods. A retrospective analysis of 1147 serum samples from asymptomatic chil dren and prospective analysis of 62 serum samples from symptomatic chi ldren undergoing diagnostic upper endoscopy were evaluated for the det ection of H. pylori antibody by two commercially available serology te sts. Each serum sample was tested by a rapid test (FlexSure(R) HP, Smi thKline Diagnostics, Inc.) and compared to the standard EIA method (HM -CAP, Enteric Products, Inc.). Results, The rapid test, FlexSure(R) HP , was comparable to the rapid EIA test in screening for H. pylori infe ction in symptomatic and asymptomatic children with sensitivity and sp ecificity of 83-90% and 90-100%, respectively. Both methods had a comp arable sensitivity and specificity for the detection of H. pylori-asso ciated gastritis (60-70% and 94%, respectively). Conclusion. The rapid test is comparable to the standard EIA test and may be used by physic ians in symptomatic children. The use of FlexSure(R) HP as a screening tool for the prevalence of H. pylori infection in asymptomatic childr en may be limited by its low positive predictive value compared to the EIA method.