Test Preferences for the Diagnosis of Helicobacter pylori Infection in Developing Countries: a Systematic Review - Abstract
Study Aims: The purpose of this study was to evaluate the test preferences for Helicobacter pylori detection in developing countries.
Patients and methods: A systematic search of PubMed, Web of Science, EMBASE, ClinicalTrials.Gov, OVID, and the Cochran Library databases was performed to identify relevant review articles, editorials, and original studies published in the English language using the following.
Results: Sufficient information was available to pool data from 67 randomized trials for meta-analyses. Non-invasive diagnostic methods, including the stool antigen test, were used in three studies to determine H. pylori infection. Another 64 (96%) studies were designed with invasive tests to address diagnoses related to H. pylori infection. The enzyme-linked immunosorbent assay method was used in 21 (32.3%) studies. Diagnostic processes in another 44 studies were performed with endoscopic biopsy specimens. Culture results were reported only in two studies with histopathology, and molecular test results were discussed in six studies, whereas histopathology results were given in only six studies. A significant difference in H. pylori positivity was found among countries.
Conclusions: In light of these results, it will be important to address the following question: Which test is best for H. pylori diagnosis in developing countries? This is a complicated question, but changing H. pylori testing policies in developing countries is urgently needed to grant better access to service. Future studies should focus on clarifying which test is more appropriate for patients with an H. pylori infection while taking into account clinical characteristics, pre-infection status, and availability and cost.