Chromatographic immunoassays for Helicobacter pylori detection--are they reliable in Mali, West Africa?

INTRODUCTION

Gastrointestinal diseases are major reasons for morbidity in Mali. As Helicobacter pylori is known to play a major role in gastritis and gastric ulcer we wanted to find a simple method for detection.

METHODS

Twenty-nine volunteers with confirmed gastric ulcer by gastroscopy and 59 randomly selected volunteers were diagnosed by using the rapid serological test Clearview(®) H. Pylori. The ImmunoCard STAT!(®) HpSA(®)test was applied on stool from 65 volunteers seeking help for gastrointestinal related ailments.

RESULTS

A Helicobacter pylori prevalence of 21% was found among the individuals with confirmed gastric ulcer, 44% among the randomly selected volunteers and 14% in individuals with gastrointestinal related ailments.

CONCLUSION

According to what is already known about the aetiology of gastric ailments and the prevalence of Helicobacter pylori in neighboring countries, the infection rates in our study appear strikingly low. This might indicate that Clearview(®) H. Pylori and ImmunoCard STAT!(®) HpSA(®) have low sensitivities in the populations studied. Strain variability of H. pylori may be an explanation. The tests need to be properly evaluated in Mali before they can be relied upon as diagnostic tools.