|LETTER TO THE EDITOR
|Year : 2020 | Volume
| Issue : 3 | Page : 1108
Seroprevalence of Helicobacter pylori infection among school children in Al Qulubia governorate
Mahmood D Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
|Date of Submission||28-Feb-2019|
|Date of Decision||11-Mar-2019|
|Date of Acceptance||25-Mar-2019|
|Date of Web Publication||30-Sep-2020|
Mahmood D Al-Mendalawi
PO Box 55302, Baghdad Post Office, Baghdad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Al-Mendalawi MD. Seroprevalence of Helicobacter pylori infection among school children in Al Qulubia governorate. Menoufia Med J 2020;33:1108
|How to cite this URL:|
Al-Mendalawi MD. Seroprevalence of Helicobacter pylori infection among school children in Al Qulubia governorate. Menoufia Med J [serial online] 2020 [cited 2021 Apr 18];33:1108. Available from: http://www.mmj.eg.net/text.asp?2020/33/3/1108/296646
In their interesting study, Deeb et al.  estimated the seroprevalence of Helicobacter pylori infection and assessed its correlation with certain epidemiological and demographic variables among school children in Al Qulubia governorate, Egypt. On employing the enzyme-linked immunosorbent assay test, the authors found that the overall H. pylori seroprevalence was 44%, and the frequency of seropositive cases increased highly significantly with advance in age. They also found a highly significant difference between seropositive and seronegative cases considering the family income, socioeconomic status, occupational status of the parents, and educational status of the parents (P = 0.001). However, no significant differences between seropositive and seronegative cases were found considering the sex and water supply (P = 0.304) . I assume that these results ought to be cautiously interpreted. This is based on the presence of the following methodological limitation related to diagnostic tool employed in the study. It is explicit that the confirmatory diagnosis of H. pylori infection is by endoscopic biopsy, followed by histopathological examination using hematoxylin and eosin stain or special stains such as Giemsa stain and Warthin–Starry stain. Special stains are more accurate than hematoxylin and eosin stain . However, in developing countries with limited resources, noninvasive diagnostic tools are often employed, particularly in epidemiological studies and screening. For a particular noninvasive test to be employed, it must be easy to apply, not expensive, well tolerated, and has a high diagnostic precision. Among these noninvasive tests, serology and stool antigen test have gained ample consideration. The authors obviously mentioned in their study that 'the value of using immunoglobulin A or immunoglobulin M for H. pylori detection is controversial. However, neither was found to be an effective indicator in pediatric pylori infection' . Despite that notion, they surprisingly employed the serology in the study methodology. It is worthy to mention that H. pylori stool antigen test is recently proved to be a reliable, more affordable, simpler to perform, and more tolerable method for the primary diagnosis of H. pylo ri infections in Egyptian children . I assume that if the authors referred to that H. pylori stool antigen test rather than serology in the study methodology, more accurate results might be obtained. Despite the aforementioned limitation, the reported worryingly high H. pylori seroprevalence (44%) in the study  requires implementing strategic actions to contain further rise in the pediatric H. pylori seroprevalenec and counteract the related risk factors.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Deeb MM, Bahbah WA, Abou-Elela DH, Hessen MM. Seroprevalence of Helicobacter pylori
infection among school children in Al Qulubia governorate. Menoufia Med J 2018; 31
Best LM, Takwoingi Y, Siddique S, Selladurai A, Gandhi A, Low B, et al.
Non-invasive diagnostic tests for Helicobacter pylori
infection. Cochrane Database Syst Rev 2018; 3
El-Shabrawi M, El-Aziz NA, El-Adly TZ, Hassanin F, Eskander A, Abou-Zekri M, et al.
Stool antigen detection versus 13C-urea breath test for non-invasive diagnosis of pediatric Helicobacter pylori
infection in a limited resource setting. Arch Med Sci 2018; 14