00000ctm a22000004a 4500 UP-1685523046125428638 Buklod 20230503092606.0 a r |||| u| ta 071031s xx d r |||| u| (iLib)UPMNL-00000056054 LG 995 2000 E6 D34 Daez, Ma. Lourdes O. Evaluation of two rapid urease tests in the diagnosis of helicobacter pylori infection Ma. Lourdes O. Daez. 68 leaves. Thesis (Master of Science in Epidemiology)--University of the Philippines Manila. Objective: To compare the validity of two rapid urease tests: Modified Rapid Urease (MRU) and Local Urease Broth (LUB), in the diagnosis of Helicobacter pylori infection with histology and Campylobacter-like organism (CLO) test-confirmed Helicobacter pylori in gastric antrum or body biopsy specimen as the gold standard. Design: This is a cross-sectional standard criterion study evaluating two rapid urease tests in an independent and blinded comparison with a gold standard, histology and CLO test. Setting: The study was conducted at the Gastrointestinal Clinic of UP-PGH, a tertiary care hospital, from the period April 1, 1997 to November 30, 1998. Patients/Participants: Included were three hundred seventy-five (375) consecutive patients who satisfied the following inclusion and exclusion criteria. Inclusion Criteria: 1)male or female age 18-80 years; 2)with indications for endoscopy (dyspeptic symptoms, upper gastrointestinal bleeding (UGIB), clearance, gastric outlet obstruction); and 3) with written informed consent to be included in all aspects of the study and to undergo upper gut endoscopy with biopsy. Exclusion Criteria: 1) intake of antibiotics, bismuth compounds, H2 blockers or proton-pump inhibitors within 4 weeks prior to entry; 2) previous resective gastric surgery; 3) pregnancy; 4)caustic ingestion; and 5) any illness or other contraindication that precludes safe endoscopy. Intervention: Multiple biopsies of the gastric antrum and body during endoscopy were placed in the two rapid urease tests, CLO test and histopathology. Results: The reliability of the histologic readings of the two pathologists was low at 0.10 and therefore, histology could not be used as part of the gold standard. With the CLOtest as gold standard, the MRU sensitivity and specificity rates were 97.5% (95% CI: 93.2-99.2%) and 100% (95%CI:97.8-100%), respectively. The LUB had sensitivity and specificity rates of 93% (95% CI:87.6-96.3%) and 100% (95% CI:97.8-100%), respectively. The specificity rates of the two tests were not significantly different from one another. However, the MRU was more sensitive that the LUB. Other advantages of the MRU over LUB were: the ease of preparing MRU, and faster positively rate with MRU within 30 minutes. The prevalence rate of H. pylori using CLOtest in this sample population was 42.1% (95% CI:37.1-47.3%). Conclusions: Histology could not be used as part of the gold standard since its reliability is poor between pathologists. Using CLOtest as the gold standard, both the MRU and the LUB are highly sensitive, specific and accurate. Either one of them can be recommended for rapid diagnosis of H.pylori in patients who will undergo endoscopy. Helicobacter pylori infections. Urease. UPMNL MED LG 995 2000 E6 D34 Thesis