Prevalence, Management, and Outcomes of Non-Invasive Helicobacter pylori Testing in Children at a Tertiary Paediatric Hospital in Singapore
10.5223/pghn.2024.27.6.336
- Author:
Charanya RAJAN
1
;
Fang Kuan CHIOU
;
Christopher Wen Wei HO
Author Information
1. Division of Gastroenterology, Hepatology and Nutrition Service, Department of Paediatric Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
- Publication Type:Original Article
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2024;27(6):336-344
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Helicobacter pylori infections differ between children and adults. The Pediatric society practice guidelines recommend against a test-and-treat approach, characterized by the use of non-invasive tests for diagnosis (e.g. urea breath test [UBT] or stool antigen test). However, significant variations exist in clinical practice. This study examined the use of non-invasive testing for the screening and diagnosis of H. pylori infection in children at a tertiary pediatric hospital in Singapore, reviewing both management decisions and patient outcomes.
Methods:A retrospective review was conducted on children between the ages of 0 and 18 years who were tested for H. pylori infection using either a stool antigen test or UBT between January 2018 and June 2020.
Results:Among the 1,397 children tested, 117 (8.4%) had a positive stool H. pyloriantigen result, and 5 out of 85 tested (5.9%) had a positive UBT. Abdominal pain was the predominant symptom (n=98; 80.3%). Only 7 treatment-naïve children had biopsy-proven disease. Tissue biopsies for H. pylori culture were sent to 2 children, with 1 negative result. A total of 111 children (91.0%) received treatment, wherein proton pump inhibitor, amoxicillin, and clarithromycin for 14 days was the most common therapeutic regimen. Symptom resolution was observed in 62 children (50.8%).
Conclusion:A test-and-treat strategy was more widely utilized than endoscopy-based testing, showing a low compliance to existing guidelines for the management of H. pylori infections in children at our center and significant false-positive rates.
