Use of stool culture as a non invasive method for the diagnosis of <i>Helicobacter pylori</i> from stool of diarrhoeic children in western Nigeria

Abstract

Background: Helicobacter pylori has been associated with chronic diarrhoea, iron deficiency anaemia, growth retardation, gastric malignancies, peptic ulcer disease, and gastritis among children. Diagnosis of this infection has been invasive using biopsies while stool culture is not common or routinely practiced. This study was designed to detect and isolate H.pylori from stool of diarrhoeic children and highlight possible use of such for routine laboratory diagnosis of H.pylori infections.

Material and methods: Two hundred and sixty faecal samples obtained from diarrhoeic children were screened for H. pylori antigen, using H. pylori stool antigen test kit (HpSA) and cultured on modified DENTS medium. Cholestyramine and nitrobluetetrazolium salt were added to the stool and the medium respectively to aid isolation of H. pylori. Correlation of BMI and H. pylori infection of the children was also evaluated.

Results: Twenty-six (10%) samples showed growth on culture while 91 (35%) tested positive for H. pylori antigen. Of the 26 children with positive culture, 16 had a low BMI. HpSA has sensitivity and specificity of 11.5% and 62.4%. There was a significant association (χ² = 12.86, df=2, P-value = 0.004) between age group of participants and use of HpSA kit.

Conclusion: Stool culture for recovery of H. pylori is feasible in our environment and diarrhoeic children should be screened for H. pylori using both HpSA and culture. H. pylori is suggested to be screened routinely especially among children having diarrhoea and are underweight. Albeit, other causes should be eliminated before concluding on the reason for the underweight.

Keywords:  Helicobacter pylori, stool culture, HpSA, BMI, Cholestyramine, Nitrobluetetrazolium salt