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Table of Contents
Year : 2021  |  Volume : 20  |  Issue : 1  |  Page : 6-11

Comparison between stool antigen test and urea breath test for diagnosing of Helicobacter pylori infection among Children in Sulaymaniyah City

1 Department of Pediatrics/College of Medicine/University of Sulaimani; Dr. Jamal Ahmed Rashid Teaching Hospital for Pediatrics, Sulaymaniyah/ Kurdistan Region, Iraq
2 Dr. Jamal Ahmed Rashid Teaching Hospital for Pediatrics, Sulaymaniyah/ Kurdistan Region, Iraq

Date of Submission30-Aug-2020
Date of Decision28-Oct-2020
Date of Acceptance24-Nov-2020
Date of Web Publication13-Apr-2021

Correspondence Address:
Dr. Hayder Fakhir Mohammad
Lecturer, University of Sulaimani, Kurdistan Region
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/MJ.MJ_30_20

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Objectives: Due to increasing incidence of Helicobacter pylori infections among children, it is important to understand which diagnostic test among the noninvasive tests is more accurate, specific, and sensitive. Methodology: Forty-five children who underwent osophagogastroduodenoscopy by the same pediatric gastroenterologist, with Urea Breath Test (UBT) and Stool Antigen Test (SAT); their data were analyzed by retrospective study (2013–2019) to make a comparison between UBT and SAT (Specificity, Sensitivity, and Accuracy) using biopsy finding (histopathological finding) as confirmatory tool for diagnosis. Patients were selected according to their clinical presentations and inclusion criteria in this study are: (pediatric age group, have clinical presentation of H. pylori infection, full information in history, clinical examination, and tests). Patients with incomplete information were excluded. Results: Male (75.56%) more common than female (24.44%), abdominal pain (53.3%) is the major presentation followed by hematemesis (20%), UBT is more influenced by demographic characteristics than other tests, UBT has a statistical significant correlation with result of biopsy, also it is more accurate and more sensitive than SAT, but they share same positive predictive value and same specificity. Conclusions: UBT more preferable than SAT specially in children above 6-year-old.

Keywords: Children, Helicobacter pylori, osophagogastroduodenoscopy, stool antigen test, Sulaymaniyah, urea breath test

How to cite this article:
Hassan AM, Ali Faraj HH, Mohammad HF. Comparison between stool antigen test and urea breath test for diagnosing of Helicobacter pylori infection among Children in Sulaymaniyah City. Mustansiriya Med J 2021;20:6-11

How to cite this URL:
Hassan AM, Ali Faraj HH, Mohammad HF. Comparison between stool antigen test and urea breath test for diagnosing of Helicobacter pylori infection among Children in Sulaymaniyah City. Mustansiriya Med J [serial online] 2021 [cited 2022 Aug 18];20:6-11. Available from: https://www.mmjonweb.org/text.asp?2021/20/1/6/313661

  Introduction Top

Helicobacter pylori (H. pylori) infections are considered one among the most common bacterial infections of gastrointestinal system in humans; these bacteria are Gram negative, S-shaped rods which produce urease, catalase, and oxidase, that might play a role in the pathogenesis of peptic ulcer disease. The mode of transmission for H. pylori still not certainly known, but many epidemiological studies strongly support human-to-human transmission and fecal-oral and oral-oral routes. Infections are thought to occur early in life (during the childhood period), and school age children in developing countries are at higher risk of H. pylori infection. In children H. pylori infection can manifest with abdominal pain, heart burn, nausea and/or vomiting and less often refractory iron deficiency anemia or growth retardation.[1],[2],[3],[4]

Urea breath test (UBT) has been used for almost many years (around 30 years) and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. By the urease activity of H. pylori, the13C-or14C-labeled urea ingested by the patient is hydrolyzed to labeled CO2 in stomach, then labeled CO2 is absorbed in the blood and exhaled by breathing in which labeled CO2 can be measured. Although several factors including patient, bacteria and the test itself influence the results of UBT, the UBT is a highly accurate and reproducible test with near 95% sensitivity and specificity under standardized procedures. UBT is also useful for epidemiological studies and for assessing the efficacy of eradication therapy.[5],[6],[7]

While stool antigen test (SAT) is the other noninvasive method with relatively good sensitivity and specificity (94% and 97%) respectively in global meta-analysis as reported by many articles, in the diagnosis of H. pylori infection. This method detects the presence of H. pylori antigen in stool samples. There are two types of SATs used for H. pylori detection, enzyme immunoassay (EIA), and immunochromatography assay (ICA)-based methods, using either polyclonal antibodies or monoclonal antibodies. In general, monoclonal antibody-based tests are more accurate than polyclonal antibody-based tests and EIA-based tests provide more reliable results than ICA-based tests.[8],[9],[10] The accuracy of SAT is influenced by several factors, such as antibiotic, proton pump inhibitors (PPI), N-Acetylcysteine, bowel movement, and upper gastrointestinal bleeding. Preservation of the specimen, like temperature and transport time before testing, and cut off value also have impacts on the diagnostic accuracy of SAT.[11],[12]

Other recent like polymerase chain reaction (PCR) detection test using different samples including gastric biopsy, gastric juice, stool, saliva, and dental plaque. PCR has excellent diagnostic approaches for the detection of H. pylori. In addition, it also tracks the several genetic alterations in bacilli for understanding the drugs resistance characteristics and co-infection of pathogens in gastric disease.[6],[8],[10]

Meanwhile, the histopathological study considered to be the gold standard for diagnosis of H. pylori infection. The accuracy of result could be affected by PPI, so it is recommended to stop PPI at least 2 weeks before performing histopathological study.[6]

This study is carried out to compare the sensitivity, specificity, and accuracy of UBT and SAT using the result of histology as a standard for comparison.

  Methodology Top

This retrospective study includes 45 children, their ages ranging from 2 to 17-year-old, all were complaining of signs and symptoms highly suggestive of H. pylori infection, data were collected from medical documents (from 2013 to 2019) in Pediatric Gastrointestinal Department in Dr. Jamal Ahmed Teaching Hospital for Pediatrics (age, gender, chief complain, SAT, UBT, and biopsy histopathological findings), the osophagogastroduodenoscopy (OGD) were done by the same pediatric gastroenterologist and biopsy taken from stomach and the histopathological result considered as confirmatory tool for diagnosis. The SAT was done using monoclonal EIA and UBT was done by Richen C13 UBT products.

Information taken from documents (of more than 6 years 2013–2019) and they were selected for investigations according to their clinical presentations at that time (such as nausea, vomiting, heartburn, and abdominal pain) and the inclusion criteria in this study are the following: Clinical presentation suspension of H. pylori infection, pediatric age group, valuable history information, and were sent for UBT, SAT, and OGD. Any case with incomplete information was excluded from the study. This study has approval from Ethical Committee of Faculty of Medicine, University of Sulaimani.

Regarding statistical analysis, sensitivity, specificity, and accuracy of UBT and SAT were measured in comparison to biopsy result. Statistical Package for the Social Science (SPSS), version 26 was used, and descriptive analysis used to analyze variables. P value considered statistically significant if less than (0.05).

  Results Top

The demographic characteristics of the 45 patients regarding age, gender, and clinical presentation is shown in [Table 1]. The majority of patients were boys (75.56%). Forty percent belong age group of 6–11 years, the mean age was (7.9 ± 4.09), and the main complaint was abdominal pain (53.3%), followed by hematemesis (20%), as shown in [Figure 1].
Table 1: The demographic characteristics and clinical presentations of 45 patients

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Figure 1: Frequency of patient's presentations

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The correlation between the demographic characteristics and the SAT, UBT, and biopsy results are shown in [Table 2]. Both UBT and SAT were done before biopsies. The correlation of the demographic characteristics with UBT was statistically significant (P = 0.015).
Table 2: Correlations between demographic characteristics and results (urea breath test, stool antigen test and biopsy)

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[Table 3] shows the results of SAT and UBT in relation to biopsy results. UBT was significantly associated with the biopsy results (P = 0.006).
Table 3: Cross-tabulation of stool antigen test, urea breath test and biopsy

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The sensitivity of UBT was much higher than that of SAT 85.7% versus 35.7%, while the specificity was similar in both 100%. The accuracy of UBT 86.7% was much higher than the accuracy of SAT 40%, as shown in [Table 4].
Table 4: Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of stool antigen test and urea breath test

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  Discussion Top

Because of increasing in awareness of pediatricians in the last years about H. pylori infections among children in our locality, the suspected cases were dramatically increased, necessitating an accurate noninvasive, cheap and applicable test for diagnosis the illness properly in order to have a better outcome. There are many tests used worldwide for diagnosing H. pylori, and these tests can be divided into invasive and noninvasive tests. This study is an attempt to make a comparison between sensitivity, specificity and accuracy of UBT and SAT with proved cases of H. pylori that were already diagnosed by biopsy (which is considered as invasive definitive diagnostic test for H. pylori).

It is well known that biopsy remains the gold standard test for diagnosing H. pylori, the UBT is safe, simple, easy to perform, and noninvasive and is more sensitive and more accurate than SAT in diagnosing of H. pylori infection in children. The UBT is a highly accurate and reproducible test with near 95% sensitivity and specificity under standardized procedures.[5]

The majority of our patients were male 34 (75.56%), this result is quitely consistent with a study done by Castillo-Montoya et al. in Mexico that showing 59 (54%) were male and 51 (46%) female, and a study by Ertem et al. in Istanbul Turkey, 169 (51.7%) were boys and 158 (48.3%) were girls, while a study in Kurdistan/Duhok by Yahya, female (53%) were quite more than males (47%), the same result in study by Saeed in Sulaimni the male were less than female (46.9%), (53.1%), respectively,[13],[14],[15],[16] these differences could be related to the sample sizes and methods used for collections of these samples and in order to have an accurate estimation whether male or female more liable to develop H. pylori we need more further studies containing large samples and for longer durations because our result may be due to relatively small sample size.

It is worthy to mention that majority of cases belong to the age group of 6–11-year-old (40%), while only (13.3%) were below 3-year-old, and this may be due to difficulty of diagnosing cases with H. pylori below this age group. The mean of ages in general is (7.9 ± 4.09), a similar result found by Ceylan et al. in Turkey (42.18%) between 6 and 10 years and (10.18%) below 5-year-old respectively, another study in Kampala by Hestvik et al. they have this result (54.8%) in the age group of 6–9-year-old.[17],[18] Meanwhile a study in Erbil by Al-Mashhadany he has only (7%) from 1 to 11-year-old, but this study including all age groups and this percent consider quite common after (16%) in age group from 11 to 20-year-old,[19] the possible reason behind increasing frequency of infection above toddler age group may be related to the difficulty in taking an accurate history from toddlers and difficulty in performing some test like UBT in this age group, another possible reason could be related to breast feeding during the first 2 years of life which is considered to be protective against all types of gastrointestinal infections, in addition to other possible factors like neglecting the measures for food decontamination for children above 3 years old by parents or caregivers.

Twenty-four patients (53.3%) presented with abdominal pain, and 9 (20%) with hematemesis, while dysphagia, melena, vomiting, and pallor 3 (6.6%) for each. Most of studies about H. pylori sharing similar results about the abdominal pain as major symptoms in H. pylori infection in many reports such as (75%) in Alimohammadi et al., (54%) in Harris P et al., (76.2%) in Galal et al., and (63%) in Galal et al.[20],[21],[22],[23] Although abdominal pain is subjective symptoms and difficult to be obtained in children particularly below 3-year-old, most of patients whether in pediatric age or adult their main complaint was abdominal pain with other signs and symptoms, and this fact mentioned in most of the text books.[1] Meanwhile other symptoms and signs may be the only presentation or together with others in some patients, like hematemesis which present in (20%) of our patients but in a study in Lebanon by Al-Kirdy et al. was (2.8%) only.[24] The possibility of hematemesis may increase in patients with bleeding disorders and this finding was evident in the study of Kim et al.[25] However, another study by Ankouane et al. have a result similar to our study with a percentage equal to (23.5%) among patients with associated peptic ulcer.[26]

Forty-two (93.3%) from 45 patients with clinical presentations suggestive of H. pylori infection have positive results in biopsy, 36 (80%) in UBT and only 15 (33.3%) in SAT respectively. Biopsy and histopathological study considered as the cornerstone for diagnosis of H. pylori infection. A study in Romania by Domsa et al. reinforces the fact that invasive methods, such as (endoscopy with biopsy) should remain the (criterion standard) for diagnosing H. pylori infection in children.[27]

In the current study, UBT had a statistical significant result with some demographic characters of patients in contrary to SAT and biopsy (P = 0.038 in UBT, it is more accurate if the age of patient above 3-year-old) and (P = 0.015 with gender, which shows more positive test with male gender), a similar result to a study by Kindermann et al. which proved that age is negatively correlated with the positive UBT (P < 0.001), a similar result was found by Zevit et al.[28],[29] Regarding gender differences a study for adult patients in Israel by Eisdorfer et al. proved quantitative differences between men and women, also they found that environmental or host-related factors might affect quantitative value of UBT.[30]

In comparison of the positive results of UBT and SAT with the results of histopathological studies by biopsies, we can notice a clear significant statistical association between UBT and biopsy in general (P = 0.006) in opposite to SAT (P = 0.540), and as biopsy consider the most accurate test for diagnosis, so UBT is relatively more accurate than SAT, our result is consistent with Manes et al. study, Kato et al., and Jenson H.,[31],[32],[33] but these studies still recommending SAT as a quite sensitive noninvasive test for diagnosing H. pylori because it is noninvasive, cheap, applicable and can be performed in all ages. A recent study in 2017 by Syrjänen et al. recommend the use of Panel of serum biomarker (GastroPanel) for limitation both the false negative and false positive tests by both SAT and UBT.[34] There are other studies which classify the accuracy of diagnosing tests for H. pylori like in a study of Khalifehgholi et al. in Tehran which put the accuracies of tests in this way (Rapid urease test > PCR > Histology > SAT > Serology) and these results according to their finding which could require further estimation for the accuracy.[35]

In order to identify which test is more accurate (whether SAT or UBT) we calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the accuracy, in the current study results, both have same specificity and PPV while sensitivity, NPV and accuracy were more in UBT. These finding are in agreement with a study by El-Shabrawi et al. which recommend UBT as more affordable, simpler to perform and more tolerable with accuracy about (91.7%).[36] Another study evaluating a SAT in asymptomatic children by Saijuddin et al. reach to a conclusion that sensitivity and specificity of SAT in asymptomatic children with H. pylori infection is lower than other diagnostic tests.[37] Meanwhile an article review by Yang reveal a clear differences between children and adult in diagnosing H. pylori and recommend a noninvasive tests in diagnosing H. pylori in children due to excellent diagnostic accuracy before and after H. pylori eradication therapy. As children younger than 6 years tend to have high false-positive rates in applying the UBT because of difficulty in performing this test in younger children, so SAT is quietly consider as suitable test for diagnosis in this age group in spite of its sensitivity and specificity, but biopsy remains the gold standard for diagnosis in all age groups.[38]

An updated information about UBT by Sankararaman and Moosavi mentioning that UBT is the most accurate testing among the noninvasive tests, while SAT is cheaper but slightly less accurate than UBT and need stool collection which may be difficult for parents or may be not performed by some patients. UBT is useful for both the initial diagnosis of (test-and-treat strategy) and also in the evaluation of posttreatment status. However, serological testing may be useful for epidemiological studies and for screening larger populations in places with a higher prevalence rate. Antigen-specific serological tests in whole blood, saliva are not recommended due to their lower predictive values.[39]

  Conclusions Top

UBT is preferred over SAT specially in children more than 6 years of age as it is more reliable and noninvasive test and quite dependable in diagnosing H. pylori infection in children, but in some occasions, SAT is consider useful when there is a difficulty in performing UBT or when it is not available, meanwhile biopsy remain superior.


Depending mostly on UBT if choosing the noninvasive method for diagnosis, and if possible on both tests to decrease the possibility of false-negative and false-positive results, and if the results still confusing the solution will be by biopsy test. It is recommended to open the gate for further evaluation of H. pylori infections in children by encouraging more studies in different part of Iraq that including larger samples in order to have valuable data for better estimation and better outcome.


Small sample size, lack of data for many patients, only one pediatric gastroenterologist who perform the OGD, and lack of some facilities in government hospital (like some laboratory tests).

Ethical Issues

The Ethics Committee of Sulaimani University/School of Medicine approved the study.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Samra S. Blanchard J, Steven J. Peptic ulcer disease in children. In: Klingemann R, Bonita F, Joseph W, Nina F, Richard E, editors. Nelson Textbook of Pediatrics. 20th ed.., Vol. 1. Philadelphia: Elsevier; 2016. p. 1816-9.  Back to cited text no. 1
Eshraghian A. Epidemiology of Helicobacter pylori infection among the healthy population in Iran and countries of the Eastern Mediterranean Region: A systematic review of prevalence and risk factors. World J Gastroenterol 2014;20:17618-25.  Back to cited text no. 2
Sethi A, Chaudhuri M, Kelly L, Hopman W. Prevalence of Helicobacter pylori in a First Nations population in northwestern Ontario. Can Fam Physician 2013;59:e182-7.  Back to cited text no. 3
Tsongo L, Nakavuma J, Mugasa C, Kamalha E. Helicobacter pylori among patients with symptoms of gastroduodenal ulcer disease in rural Uganda. Infect Ecol Epidemiol 2015;5:26785.  Back to cited text no. 4
Ferwana M, Abdulmajeed I, Alhajiahmed A, Madani W, Firwana B, Hasan R, et al. Accuracy of urea breath test in Helicobacter pylori infection: Meta-analysis. World J Gastroenterol 2015;21:1305-14.  Back to cited text no. 5
Yagi K, Saka A, Nozawa Y, Nakamura A. Prediction of Helicobacter pylori status by conventional endoscopy, narrow-band imaging magnifying endoscopy in stomach after endoscopic resection of gastric cancer. Helicobacter 2014;19:111-5.  Back to cited text no. 6
Gong Y, Wei W, Yuan Y. Association between abnormal gastric function risk and Helicobacter pylori infection assessed by ELISA and 14C-urea breath test. Diagn Microbiol Infect Dis 2014;80:316-20.  Back to cited text no. 7
Gisbert JP, de la Morena F, Abraira V. Accuracy of monoclonal stool antigen test for the diagnosis of H. pylori infection: A systematic review and meta-analysis. Am J Gastroenterol 2006;101:1921-30.  Back to cited text no. 8
Korkmaz H, Kesli R, Karabagli P, Terzi Y. Comparison of the diagnostic accuracy of five different stool antigen tests for the diagnosis of Helicobacter pylori infection. Helicobacter 2013;18:384-91.  Back to cited text no. 9
Kesli R, Gokturk HS, Erbayrak M, Karabagli P, Terzi Y. Comparison of the diagnostic values of the 3 different stool antigen tests for the noninvasive diagnosis of Helicobacter pylori infection. J Investig Med 2010;58:982-6.  Back to cited text no. 10
Demirtürk L, Yazgan Y, Tarçin O, Ozel M, Diler M, Oncül O, et al. Does N-acetyl cystein affect the sensitivity and specificity of Helicobacter pylori stool antigen test? Helicobacter 2003;8:120-3.  Back to cited text no. 11
Shimoyama T. Stool antigen tests for the management of Helicobacter pylori infection. World J Gastroenterol 2013;19:8188-91.  Back to cited text no. 12
Castillo-Montoya V, Ruiz-Bustos E, Valencia-Juillerat ME, Álvarez-Hernández G, Sotelo-Cruz N. Detection of Helicobacter pylori in children and adolescents using the monoclonal coproantigen immunoassay and its association with gastrointestinal diseases. Cir Cir 2017;85:27-33.  Back to cited text no. 13
Ertem D, Harmanci H, Pehlivanoğlu E. Helicobacter pylori infection in Turkish preschool and school children: Role of socioeconomic factors and breast feeding. Turk J Pediatr 2003;45:114-22.  Back to cited text no. 14
Yahya N. Helicobacter pylori seropositive among children in Duhok city/Iraq. Sci J Univ Zanko 2018;6:82-4.  Back to cited text no. 15
Saeed H. Endoscopic diagnosis of suspected H. pylori infection in sulaimani pediatric teaching hospital. JSMC 2019;9:173-8.  Back to cited text no. 16
Ceylan A, Kirimi E, Tuncer O, Türkdoğan K, Ariyuca S, Ceylan N. Prevalence of Helicobacter pylori in children and their family members in a district in Turkey. J Health Popul Nutr 2007;25:422-7.  Back to cited text no. 17
Hestvik E, Tylleskar T, Kaddu-Mulindwa D, Ndeezi G, Grahnquist L, Olafsdottir E, et al. Helicobacter pylori in apparently healthy children aged 0-12 years in urban Kampala, Uganda: A community-based cross sectional survey. BMC Gastroenterol 2010;10:62. Available from: http://www.biomedcentral.com/1471-230X/10/62. [Last accessed on 2018 Feb 21].  Back to cited text no. 18
Al-Mashhadany D. Application of stool antigen test for monitoring Helicobacter pylori among human in Erbil governorate, Kurdistan Region/Iraq. Int J Pharm Pharm Sci 2018;10:49-53.  Back to cited text no. 19
Alimohammadi H, Fouladi N, Salehzadeh F, Alipour SA, Javadi MS. Childhood recurrent abdominal pain and Helicobacter pylori infection, Islamic Republic of Iran. East Mediterr Health J 2017;22:860-4.  Back to cited text no. 20
Harris PR, Wright SW, Serrano C, Riera F, Duarte I, Torres J, et al. Helicobacter pylori gastritis in children is associated with a regulatory T-cell response. Gastroenterology 2008;134:491-9.  Back to cited text no. 21
Galal Y, Ghobrial C, Labib J, Elsayed Abou-Zekri M. Helicobacter pylori among symptomatic Egyptian children: prevalence, risk factors, and effect on growth. J Egypt Public Health Assoc 2019;94:17. Available from: https://doi.org/10.1186/s42506-019-0017-6. [Last accessed on 2018 Feb 21].  Back to cited text no. 22
Tindberg Y, Nyrén O, Blennow M, Granström M. Helicobacter pylori infection and abdominal symptoms among Swedish school children. J Pediatr Gastroenterol Nutr 2005;41:33-8.  Back to cited text no. 23
AL Kirdy F, Rajab M, El-Rifai N. Helicobacter pylori infection: Clinical, endoscopic, and histological findings in Lebanese pediatric patients. Int J Pediatr 2020;2020;4648167. Available from: https://doi.org/10.1155/2020/4648167. [Last accessed on 2018 Mar 01].  Back to cited text no. 24
Kim J, Choi Y, Lee K. A Clinical significance of Helicobacter pylori infection in hemophilic children with gastrointestinal hemorrhage. Blood 2009;114:4442. Available from: https://doi.org/10.1182/blood.V114.22.4442.4442. [Last accessed on 2018 Mar 01].  Back to cited text no. 25
Ankouane F, Ngatcha G, Tagni M, Biwolé M, Ndjitoyap E. Helicobacter pylori infection and peptic ulcer disease in children and adolescents from the age range of 6 to 18 years old in Yaounde (Cameroon). Health Sci Dis 2015;16:1-6. Available from: https://www.hsd-fmsb.org. [Last accessed on 2018 Mar 01].  Back to cited text no. 26
Domşa AT, Lupuşoru R, Gheban D, Şerban R, Borzan CM. Helicobacter pylori gastritis in children The link between endoscopy and histology. J Clin Med 2020;9:1-10.  Back to cited text no. 27
Kindermann A, Demmelmair H, Koletzko B, Krauss-Etschmann S, Wiebecke B, Koletzko S. Influence of age on 13C-urea breath test results in children. J Pediatr Gastroenterol Nutr 2000;30:85-91.  Back to cited text no. 28
Zevit N, Niv Y, Shirin H, Shamir R. Age and gender differences in urea breath test results. Eur J Clin Invest 2011;41:767-72.  Back to cited text no. 29
Eisdorfer I, Shalev V, Goren S, Chodick G, Muhsen K. Sex differences in urea breath test results for the diagnosis of Helicobacter pylori infection: A large cross-sectional study. Biol Sex Differ 2018;9:1.  Back to cited text no. 30
Manes G, Zanetti MV, Piccirillo MM, Lombardi G, Balzano A, Pieramico O. Accuracy of a new monoclonal stool antigen test in post-eradication assessment of Helicobacter pylori infection: Comparison with the polyclonal stool antigen test and urea breath test. Dig Liver Dis 2005;37:751-5.  Back to cited text no. 31
Kato S, Nakayama K, Minoura T, Konno M, Tajiri H, Matsuhisa T, et al. Comparison between the 13C-urea breath test and stool antigen test for the diagnosis of childhood Helicobacter pylori infection. J Gastroenterol 2004;39:1045-50.  Back to cited text no. 32
Jenson H, Mégraud F. Comparison of non-invasive tests for H. pylori infection in children. Pediatrics 2005;146:198-203. Available from: https://www.reliasmedia.com/articles/86822. [Last accessed on 2018 Apr 12].  Back to cited text no. 33
Syrjänen K. False positive and false negative results in diagnosis of Helicobacter pylori infection can be avoided by a panel of serum biomarkers. J Gast Jan;1 2017;007. Available from: http://www.mathewsopenaccess.com. [Last accessed on 2018 Apr 12].  Back to cited text no. 34
Khalifehgholi M, Shamsipour F, Ajhdarkosh H, Ebrahimi Daryani N, Pourmand MR, Hosseini M, et al. Comparison of five diagnostic methods for Helicobacter pylori. Iran J Microbiol 2013;5:396-401.  Back to cited text no. 35
El-Shabrawi M, El-Aziz NA, El-Adly TZ, Hassanin F, Eskander A, Abou-Zekri M, et al. Stool antigen detection versus 13C-urea breath test for non-invasive diagnosis of pediatric Helicobacter pylori infection in a limited resource setting. Arch Med Sci 2018;14:69-73.  Back to cited text no. 36
Saijuddin S, Khaled M, Aminul I, Kurpad A, Mahalanabis D. Valuation of stool antigen test for Helicobacter pylori infection in asymptomatic children from a developing country using 13C-urea breath test as a standard. J Pediatr Gastroenterol Nutr 2005;40:552-4.  Back to cited text no. 37
Yang HR. Updates on the diagnosis of Helicobacter pylori infection in children: What are the differences between adults and children? Pediatr Gastroenterol Hepatol Nutr 2016;19:96-103.  Back to cited text no. 38
Sankararaman S, Moosavi L. Urea Breath Test. NCBI; Last Update 01 June, 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542286. [Last accessed on 2018 Apr 12].  Back to cited text no. 39


  [Figure 1]

  [Table 1], [Table 2], [Table 3], [Table 4]


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