Noninvasive Helicobacter pylori Diagnostic Methods in Indonesia.
Noninvasive Helicobacter pylori Diagnostic Methods in Indonesia.
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DOI：
10.5009/gnl19264
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发表时间：
2020-09-15
期刊：
影响因子：
3.4
通讯作者：
Miftahussurur, Muhammad
中科院分区：
文献类型：
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作者：
Miftahussurur, Muhammad
虽然印尼的幽门螺杆菌感染率低于其他国家，但H。幽门螺杆菌仍然是与严重胃粘膜损伤和消化不良症状相关的重要病原体。由于缺乏内窥镜中心和社会保险没有完全覆盖的高成本，侵入性诊断方法并不理想。在非侵入性方法中，尿素呼气试验在印度尼西亚广泛使用，并被建议作为确保成功根除H.幽门。尚未对使用13C或14C的尿素呼气试验进行本地验证。粪便抗原检测是廉价的，适用于活动性感染之前和之后根除;然而，习俗和习惯是及时提供新鲜粪便的障碍。只有多克隆抗体和灵敏度低的定性粪便抗原检测试剂盒可用。血清学是一种广泛验证的方法，具有良好的准确性，但它不能区分活动性和非活动性感染。根据我们的观察，血清学是专家和患者的主要选择，因为它简单，廉价和广泛的知名度。尿检是降低成本和内窥镜工作量的替代方法，准确性高，但灵敏度低。进一步的研究是必要的，以证明尿液测试的有效性，在整个印度尼西亚，特别是在与H流行率低的地区使用。幽门感染总之，经验证的尿素呼气试验和粪便抗原试验被认为是检测H。印度尼西亚的幽门螺杆菌感染，血清学和尿液检测作为替代方法。
Although the prevalence of Helicobacter pylori infection in Indonesia is lower than that in other countries, H. pylori is still an essential pathogen associated with severe gastric mucosal damage and dyspeptic symptoms. Invasive diagnostic methods are not ideal due to the lack of endoscopic centers and high costs without full coverage by social insurance. Among the noninvasive methods, the urea breath test is widely available in Indonesia and has been suggested as the primary option to ensure the successful eradication of H. pylori. There has been no local validation for the urea breath test utilizing 13C or 14C. The stool antigen test is inexpensive and suitable for use in active infections before and after eradication; however, customs and habits are obstacles to delivering fresh stool on time. Only polyclonal antibodies and qualitative stool antigen test kits with low sensitivity are available. Serology is a widely validated method and has good accuracy, but it cannot distinguish between active and inactive infections. According to our observations, serology is the main choice of experts and patients, as it is simple, inexpensive and widely known. The urine test is an alternative for reducing costs and endoscopic workload, with high accuracy but low sensitivity. Further studies are necessary to prove the validity of the urine test to be used throughout Indonesia, especially in areas with a low prevalence of H. pylori infection. In conclusion, the validated urea breath test and the stool antigen test are considered noninvasive practical approaches for the detection of H. pylori infection in Indonesia, with serological and urine tests as alternatives.