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Int J Mol Epidemiol Genet 2011;2(2):178-184

Original Article
Comparison of PCR with other diagnostic techniques for the detection of H.
pylori infection in patients presenting with gastroduodenal symptons in Nigeria

Stella I. Smith, Muinah A. Fowora MA, Jesse A. Otegbayo JA, Fatimah B. Abdulkareem F, Emmanuel A. Omonigbehin, Akere
Adegboyega, Monica Contreras , Rainer Haas

Molecular Biology and Biotechnology Division, Nigerian Institute of Medical Research, 6 Edmond Crescent, Yaba, Lagos,
Nigeria; Department of Medicine, University College Hospital, Ibadan; Department of Morbid Anatomy, College of Medicine,
University of Lagos, Nigeria; Instituto Venezolano de Investigaciones Cientificas, Caracas; Max von Pettenkofer Institut,
Pettenkoferstr. 9a, Munich, Germany.

Received November 10, 2010; accepted January 11, 2011; Epub January 15, 2011; published May 15, 2011

Abstract: The study was aimed at comparing PCR methods of direct detection from biopsy using the boiling method and one
other method with two known gold standards (histology and CLO test) for the diagnosis of H. pylori in Nigeria. A total of 168
biopsies (three from antrum and one from corpus each) were taken from 42 patients presenting with various gastroduodenal
symptons after informed consent was obtained from them.The biopsies  were analysed using the CLO test kit and histology,
while the boiling method as described by Holmes and Quigley (1981) was used to obtain DNA and then PCR using the 16S
rRNA gene, glmM gene and cagA gene. With CLO test 15/42 (35.71%) were positive, histology 13/42 (30.95%) were positive,
16S rRNA 22/42 (52.38%) were positive, glmM 19/42 (45.24%) were positive, cagA 19/42 (45.24%) were positive.  The
sensitivity and specificity of the PCR tests with CLO as the gold standard showed that the tests were 100% sensitive and varied
between 74.1% to 84.1% in specificity. The PPV and NPV showed that the NPV was almost 100%, while the PPV was between
68.2% and 75%. Using the histology as the gold standard, the sensitivity was almost 100% while the specificity, the PPV were
reduced in comparison to the CLO test. The PCR test using the glmM gene appears to be the most reliable test for diagnosis
of H. pylori in Nigeria most especially where culture is difficult due to the power outages. (IJMEG1011005).

Keywords: PCR, biopsies, CLO test, histology

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Address all correspondence to:
Dr. Stella I. Smith
Molecular Biology and Biotechnology Division
Nigerian Institute of Medical Research
6 Edmond Crescent, Yaba
Lagos, Nigeria
Tel: +234 1 4822269; Fax: + 234 1 3452 171
E-mail:
stellaismith@yahoo.com