Antibody-based detection tests for the diagnosis of Helicobacter pylori infection in children: A meta-analysis

PLoS ONE

Volumn 3, Issue 11, 2008, Pages

  Leal, Yelda A ^a   Flores, Laura L ^b   García Cortés, Laura B ^a   Cedillo Rivera, Roberto ^a   Torres, Javier ^a  

^a INSTITUTO MEXICANO DEL SEGURO SOCIAL   (Mexico)

^b UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CELL ANTIGEN; IMMUNOGLOBULIN A; IMMUNOGLOBULIN G; BACTERIAL ANTIGEN; BACTERIUM ANTIBODY; IMMUNOGLOBULIN;

ANTIBODY DETECTION; ARTICLE; CELL HETEROGENEITY; CHILD; CLINICAL TRIAL; COST BENEFIT ANALYSIS; DIAGNOSTIC ACCURACY; ENZYME LINKED IMMUNOSORBENT ASSAY; HELICOBACTER INFECTION; HELICOBACTER PYLORI; HOME DIAGNOSTIC TEST; HUMAN; META ANALYSIS; SENSITIVITY AND SPECIFICITY; SYSTEMATIC REVIEW; WESTERN BLOTTING; ADOLESCENT; GENETICS; IMMUNOLOGY; INFANT; METABOLISM; METHODOLOGY; PRESCHOOL CHILD; REPRODUCIBILITY; ROC CURVE;

HELICOBACTER PYLORI;

ADOLESCENT; ANTIBODIES, BACTERIAL; ANTIGENS, BACTERIAL; BLOTTING, WESTERN; CHILD; CHILD, PRESCHOOL; ENZYME-LINKED IMMUNOSORBENT ASSAY; HELICOBACTER INFECTIONS; HELICOBACTER PYLORI; HUMANS; IMMUNOGLOBULINS; INFANT; REPRODUCIBILITY OF RESULTS; ROC CURVE; SENSITIVITY AND SPECIFICITY;

EID: 56649121764     PISSN: None     EISSN: 19326203     Source Type: Journal    
DOI: 10.1371/journal.pone.0003751     Document Type: Article

References (102)

1. Go MF (2002) Review article: natural history and epidemiology of Helicobacter pylori infection. Aliment Pharmacol Ther 16: 3-15.
2. Perez-Perez GI, Rothenbacher D, Brenner H (2004) Epidemiology of Helicobacter pylori infection. Helicobacter 9(Suppl 1): 1-6.
3. Blaser MJ, Chyou PH, Nomura A (1995) Age at establishment of Helicobacter pylori infection and gastric carcinoma, gastric ulcer, and duodenal ulcer risk. Cancer Res 55: 562-565.
4. Peek RM Jr, Blaser MJ (2002) Helicobacter pylori and gastrointestinal tract adenocarcinomas. Nat Rev Cancer 2: 28-37.
5. Malaty HM, El-Kasabany A, Graham DY, Miller CC, Reddy SG, et al. (2002) Age at acquisition of Helicobacter pylori infection: a follow-up study from infancy to adulthood. Lancet 359: 931-935.
6. Graham DY, Malaty HM, Evans DG, Evans DJ Jr, Klein PD, et al. (1991) Epidemiology of Helicobacter pylori in an asymptomatic population in the United States. Effect of age, race, and socioeconomic status. Gastroenterology 100: 1495-1501.
7. Torres J, Leal-Herrera Y, Perez-Perez G, Gomez A, Camorlinga-Ponce M, et al. (1998) A community-based seroepidemiologic study of Helicobacter pylori infection in Mexico. J Infect Dis 178: 1089-1094.
8. Blaser MJ, Nomura A, Lee J, Stemmerman GN, Perez-Perez GI (2007) Early-life family structure and microbially induced cancer risk. PLoS Med 4: e7.
9. Torres J, Perez-Perez G, Goodman KJ, Atherton JC, Gold BD, et al. (2000) A comprehensive review of the natural history of Helicobacter pylori infection in children. Arch Med Res 31: 431-469.
10. Gold BD, Colletti RB, Abbott M, Czinn SJ, Elitsur Y, et al. (2000) Helicobacter pylori infection in children: recommendations for diagnosis and treatment. J Pediatr Gastroenterol Nutr 31: 490-497.
11. Bourke B, Ceponis P, Chiba N, Czinn S, Ferraro R, et al. (2005) Canadian Helicobacter Study Group Consensus Conference: Update on the approach to Helicobacter pylori infection in children and adolescents-an evidence-based evaluation. Can J Gastroenterol 19: 399-408.
12. Bode G, Piechotowski I, Rothenbacher D, Brenner H (2002) Helicobacter pylori-specific immune responses of children: implications for future vaccination strategy. Clin Diagn Lab Immunol 9: 1126-1128.
13. Crabtree JE, Mahony MJ, Taylor JD, Heatley RV, Littlewood JM, et al. (1991) Immune responses to Helicobacter pylori in children with recurrent abdominal pain. J Clin Pathol 44: 768-771.
14. Mitchell HM, Hazell SL, Kolesnikow T, Mitchell J, Frommer D (1996) Antigen recognition during progression from acute to chronic infection with a cagA-positive strain of Helicobacter pylori. Infect Immun 64: 1166-1172.
15. Dzierzanowska-Fangrat K, Lehours P, Megraud F, Dzierzanowska D (2006) Diagnosis of Helicobacter pylori infection. Helicobacter 11: 6-13.
16. Oderda G, Rapa A, Bona G (2004) Diagnostic tests for childhood Helicobacter pylori infection: invasive, noninvasive or both? J Pediatr Gastroenterol Nutr 39: 482-484.
17. Pellicano R, Smedile A, Ponzetto A, Berrutti M, Astegiano M, et al. (2005) How accurate is the culture of Helicobacter pylori in a clinical setting? An appraisal. Panminerva Med 47: 191-194.
18. Yanez P, la Garza AM, Perez-Perez G, Cabrera L, Munoz O, et al. (2000) Comparison of invasive and noninvasive methods for the diagnosis and evaluation of eradication of Helicobacter pylori infection in children. Arch Med Res 31: 415-421.
19. Kato S, Ozawa K, Konno M, Tajiri H, Yoshimura N, et al. (2002) Diagnostic accuracy of the 13C-urea breath test for childhood Helicobacter pylori infection: a multicenter Japanese study. Am J Gastroenterol 97: 1668-1673.
20. Ballam LD, Mendall MA, Asante M, Morris J, Strachan DP, et al. (2000) Western blotting is useful in the salivary diagnosis of Helicobacter pylori infection. J Clin Pathol 53: 314-317.
21. Kato S, Tachikawa T, Ozawa K, Konno M, Okuda M, et al. (2001) Urine-based enzyme-linked immunosorbent assay for the detection of Helicobacter pylori infection in children. Pediatrics 107: E87.
22. Koletzko S, Konstantopoulos N, Bosman D, Feydt-Schmidt A, van der EA, et al. (2003) Evaluation of a novel monoclonal enzyme immunoassay for detection of Helicobacter pylori antigen in stool from children. Gut 52: 804-806.
23. Konstantopoulos N, Russmann H, Tasch C, Sauerwald T, Demmelmair H, et al. (2001) Evaluation of the Helicobacter pylori stool antigen test (HpSA) for detection of Helicobacter pylori infection in children. Am J Gastroenterol 96: 677-683.
24. Haggerty TD, Perry S, Sanchez L, Perez-Perez G, Parsonnet J (2005) Significance of transiently positive enzyme-linked immunosorbent assay results in detection of Helicobacter pylori in stool samples from children. J Clin Microbiol 43: 2220-2223.
25. Perez-Perez GI, Sack RB, Reid R, Santosham M, Croll J, et al. (2003) Transient and persistent Helicobacter pylori colonization in Native American children. J Clin Microbiol 41: 2401-2407.
26. Goossens H, Glupczynski Y, Burette A, Van den Borre C, DePrez C, et al. (1992) Evaluation of a commercially available complement fixation test for diagnosis of Helicobacter pylori infection and for follow-up after antimicrobial therapy. J Clin Microbiol 30: 3230-3233.
27. Herbrink P, van Doorn LJ (2000) Serological methods for diagnosis of Helicobacter pylori infection and monitoring of eradication therapy. Eur J Clin Microbiol Infect Dis 19: 164-173.
28. Reilly TG, Poxon V, Sanders DS, Elliott TS, Walt RP (1997) Comparison of serum, salivary, and rapid whole blood diagnostic tests for Helicobacter pylori and their validation against endoscopy based tests. Gut 40: 454-458.
29. Dunn BE, Cohen H, Blaser MJ (1997) Helicobacter pylori. Clin Microbiol Rev 10: 720-741.
30. Newell DG, S AR (1992) The serology of Helicobacter pylori infections. In: Rathbone BJ HR, ed. Helicobacter pylori and gastroduodenal disease. Oxford: Blackwell Scientific Publications. pp 64-73.
31. Torres J, Camorlinga-Ponce M, Perez-Perez G, Munoz L, Munoz O (2002) Specific serum immunoglobulin G response to urease and CagA antigens of Helicobacter pylori in infected children and adults in a country with high prevalence of infection. Clin Diagn Lab Immunol 9: 97-100.
32. Westblom TU, Madan E, Gudipati S, Midkiff BR, Czinn SJ (1992) Diagnosis of Helicobacter pylori infection in adult and pediatric patients by using Pyloriset, a rapid latex agglutination test. J Clin Microbiol 30: 96-98.
33. Shimoyama T, Crabtree JE (1998) Bacterial factors and immune pathogenesis in Helicobacter pylori infection. Gut 43: S2-S5.
34. Dzierzanowska-Fangrat K, Raeiszadeh M, Dzierzanowska D, Gladkowska-Dura M, Celinska-Cedro D, et al. (2003) IgG subclass response to Helicobacter pylori and CagA antigens in children. Clin Exp Immunol 134: 442-446.
35. Vilaichone RK, Mahachai V, Kositchaiwat C, Graham DY, Yamaoka Y (2003) Relation between seroreactivity to low-molecular-weight Helicobacter pylori-specific antigens and disease presentation. Clin Diagn Lab Immunol 10: 1025-1028.
36. Simor AE, Lin E, Saibil F, Cohen L, Louie M, et al. (1996) Evaluation of enzyme immunoassay for detection of salivary antibody to Helicobacter pylori. J Clin Microbiol 34: 550-553.
37. Sonmezoglu M, Baysal B, Ergen A, Barut SG (2005) Detection and evaluation of salivary antibodies to Helicobacter pylori in dyspeptic patients. Int J Clin Pract 59: 433-436.
38. Fujisawa T, Kaneko T, Kumagai T, Akamatsu T, Katsuyama T, et al. (2001) Evaluation of urinary rapid test for Helicobacter pylori in general practice. J Clin Lab Anal 15: 154-159.
39. Leodolter A, Vaira D, Bazzoli F, Schutze K, Hirschl A, et al. (2003) European multicentre validation trial of two new non-invasive tests for the detection of Helicobacter pylori antibodies: urine-based ELISA and rapid urine test. Aliment Pharmacol Ther 18: 9279-9231.
40. Alemohammad MM, Foley TJ, Cohen H (1993) Detection of immunoglobulin G antibodies to Helicobacter pylori in urine by an enzyme immunoassay method. J Clin Microbiol 31: 2174-2177.
41. Loy CT, Irwig LM, Katelaris PH, Talley NJ (1996) Do commercial serological kits for Helicobacter pylori infection differ in accuracy? A meta-analysis. Am J Gastroenterol 91: 1138-1144.
42. Laheij RJ, Straatman H, Jansen JB, Verbeek AL (1998) Evaluation of commercially available Helicobacter pylori serology kits: a review. J Clin Microbiol 36: 2803-2809.
43. Pai M, McCulloch M, Enanoria W, Colford JM Jr (2004) Systematic reviews of diagnostic test evaluations: What's behind the scenes? ACP J Club 141: A11-A13.
44. Deeks JJ (2000) Systematic reviews of evaluation of diagnostic and screening tests. BMJ 323: 157-162.
45. Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM (2003) The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol 56: 1129-1135.
46. Smidt N, Rutjes AW, van der Windt D, Ostelo R, Bossuyt PM, et al. (2005) Reproducibility of the STARD checklist: an instrument to assess the quality of reporting of diagnostic accuracy studies. BMC Med Res Methodol 6: 12-21.
47. Honest H, Khan KS (2002) Reporting of measures of accuracy in systematic reviews of diagnostic literature. BMC Health Serv Res 2: 4-7.
48. Pai M, McCulloch M, Gorman JD, Pai N, Enanoria W, et al. (2004) Systematic reviews and meta-analyses: an illustrated, step-by-step guide. Natl Med J India 17: 86-95.
49. Lijmer JG, Bossuyt PM, Heisterkamp SH (2002) Exploring sources of heterogeneity in systematic reviews of diagnostic tests. Stat Med 21: 1525-153.
50. Jones CM, Athanasiou T (2005) Summary receiver operating characteristic curve analysis techniques in the evaluation of diagnostic tests. Ann Thorac Surg 79: 16-20.
51. Walter SD (2002) Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Stat Med 21: 1237-1256.
52. Kindermann A, Konstantopoulos N, Lehn N, Demmelmair H, Koletzko S (2001) Evaluation of two commercial enzyme immunoassays, testing immunoglobulin G (IgG) and IgA responses, for diagnosis of Helicobacter pylori infection in children. J Clin Microbiol 39: 3591-3596.
53. Day AS, Sherman PM (2002) Accuracy of office-based immunoassays for the diagnosis of Helicobacter pylori infection in children. Helicobacter 7: 205-209.
54. Sabbi T, De AP, Colistro F, Dall'Oglio L, di Abriola GF, et al. (2005) Efficacy of noninvasive tests in the diagnosis of Helicobacter pylori infection in pediatric patients. Arch Pediatr Adolesc Med 159: 238-41.
55. Bode G, Marchildon P, Peacock J, Brenner H, Rothenbacher D (2002) Diagnosis of Helicobacter pylori infection in children: comparison of a salivary immunoglobulin G antibody test with the [(13)C]urea breath test. Clin Diagn Lab Immunol 9: 493-495.
56. Raymond J, Sauvestre C, Kalach N, Bergeret M, Dupont C (2000) Immunoblotting and serology for diagnosis of Helicobacter pylori infection in children. Pediatr Infect Dis J 19: 118-121.
57. Malaty HM, Haveman T, Graham DY, Fraley JK (2002) Helicobacter pylori infection in asymptomatic children: impact of epidemiologic factors on accuracy of diagnostic tests. J Pediatr Gastroenterol Nutr 35: 59-63.
58. Frenck RW Jr, Fathy HM, Sherif M, Mohran Z, El MH, et al. (2006) Sensitivity and specificity of various tests for the diagnosis of Helicobacter pylori in Egyptian children. Pediatrics 118: e1195-e1202.
59. Camorlinga-Ponce M, Torres J, Perez-Perez G, Leal-Herrera Y, Gonzalez-Ortiz B, et al. (1998) Validation of a serologic test for the diagnosis of Helicobacter pylori infection and the immune response to urease and CagA in children. Am J Gastroenterol 93: 1264-1270.
60. Rutigliano V, Ierardi E, Francavilla R, Castellaneta S, Margiotta M, et al. (1999) Helicobacter pylori and nonulcer dyspepsia in childhood: clinical pattern, diagnostic techniques, and bacterial strains. J Pediatr Gastroenterol Nutr 28: 296-300.
61. Ni YH, Lin JT, Huang SF, Yang JC, Chang MH (2000) Accurate diagnosis of Helicobacter pylori infection by stool antigen test and 6 other currently available tests in children. J Pediatr 136: 823-827.
62. de Oliveira AM, Rocha GA, Queiroz DM, Mendes EN, de Carvalho AS, et al. (1999) Evaluation of enzyme-linked immunosorbent assay for the diagnosis of Helicobacter pylori infection in children from different age groups with and without duodenal ulcer. J Pediatr Gastroenterol Nutr 28: 157-161.
63. Elitsur Y, Aflak R, Neace C, Triest WE (2000) Helicobacter pylori serology and the diagnosis of H. pylori infection in children. W V Med J 96: 564-566.
64. Gonzalez FC, Serrano HC, Harris PR (2007) Diagnosis of Helicobacter pylori infection in children based on stool antigen test. Rev Med Chil 135: 182-188.
65. Sunnerstam B, Kjerstadius T, Jansson L, Giesecke J, Bergstrom M, et al. (1999) Detection of Helicobacter pylori antibodies in a pediatric population: comparison of three commercially available serological tests and one in-house enzyme immunoassay. J Clin Microbiol 37: 3328-3331.
66. Malaty HM, Logan ND, Graham DY, Ramchatesingh JE, Reddy SG (2000) Helicobacter pylori infection in asymptomatic children: comparison of diagnostic tests. Helicobacter 5: 155-159.
67. Bonamico M, Strappini PM, Bonci E, Ferri M, Crisogianni M, et al. (2004) Evaluation of stool antigen test, PCR on ORAL samples and serology for the noninvasive detection of Helicobacter pylori infection in children. Helicobacter 9: 69-76.
68. Gilger MA, Tolia V, Johnson A, Rabinowitz S, Jibaly R, et al. (2002) The use of an oral fluid immunoglobulin G ELISA for the detection of Helicobacter pylori infection in children. Helicobacter 7: 105-110.
69. Raymond J, Sauvestre C, Kalach N, de Korwin JD, Valverde V (1999) Evaluation of a new serologic test for diagnosis of Helicobacter pylori infection in children. Eur J Clin Microbiol Infect Dis 18: 192-198.
70. Ogunc D, Artan R, Ongut G, Gelen T, Colak D, et al. (2003) Evaluation of a Western blot technique (Helicoblot 2.1) for the diagnosis of Helicobacter pylori infection in children. Pathology 35: 157-160.
71. Oleastro M, Matos R, Cabral J, Barros R, Lopes AI, et al. (2002) Evaluation of a Western blot test, Helico blot 2.1, in the diagnosis of Helicobacter pylori infection in a pediatric population. Helicobacter 7: 210-215.
72. Eltumi M, Brueton MJ, Francis N (1999) Diagnosis of Helicobacter pylori gastritis in children using the 13C urea breath test. J Clin Gastroenterol 28: 238-240.
73. Parejo CR, Olivares MF, Escobar CH, Jimenez AI, de Rafael NL, et al. (1998) A comparative analysis of diagnostic methods for Helicobacter pylori infection in children. An Esp Pediatr 49: 257-263.
74. Kolho KL, Korhonen J, Verkasalo M, Lindahl H, Savilahti E, et al. (2002) Helicobacter pylori serology at diagnosis and follow-up of biopsy-verified infection in children. Scand J Infect Dis 34: 177-182.
75. Tindberg Y, Bengtsson C, Bergstrom M, Granstrom M (2001) The accuracy of serologic diagnosis of Helicobacter pylori infection in school-aged children of mixed ethnicity. Helicobacter 6: 24-30.
76. Gonzalez-Cuevas A, Juncosa T, Jene M, Varea V, Gene A, et al. (2001) Helicobacter pylori infections: antigen detection in stool samples. Enferm Infecc Microbiol Clin 19: 49-52.
77. Okuda M, Nakazawa T, Booka M, Miyashiro E, Yosikawa N (2004) Evaluation of a urine antibody test for Helicobacter pylori in Japanese children. J Pediatr 144: 196-199.
78. Khanna B, Cutler A, Israel NR, Perry M, Lastovica A, et al. (1998) Use caution with serologic testing for Helicobacter pylori infection in children. J Infect Dis 178: 460-465.
79. Megraud F (2005) Comparison of non-invasive tests to detect Helicobacter pylori infection in children and adolescents: results of a multicenter European study. J Pediatr 146: 198-203.
80. Vinette KM, Gibney KM, Proujansky R, Fawcett PT (2004) Comparison of PCR and clinical laboratory tests for diagnosing H. pylori infection in pediatric patients. BMC Microbiol 4: 5.
81. Harris P, Perez-Perez G, Zylberberg A, Rollan A, Serrano C, et al. (2005) Relevance of adjusted cut-off values in commercial serological immunoassays for Helicobacter pylori infection in children. Dig Dis Sci 50: 2103-2109.
82. Corvaglia L, Bontems P, Devaster JM, Heimann P, Glupczynski Y, et al. (1999) Accuracy of serology and 13C-urea breath test for detection of Helicobacter pylori in children. Pediatr Infect Dis J 18: 976-979.
83. Treepongkaruna S, Nopchinda S, Taweewongsounton A, Atisook K, Pienvichit P, et al. (2006) A rapid serologic test and immunoblotting for the detection of Helicobacter pylori infection in children. J Trop Pediatr 52: 267-2671.
84. Janulaityte-Gunther D, Kucinskiene R, Kupcinskas L, Pavilonis A, Labanauskas L, et al. (2005) The humoral immuneresponse to Helicobacter pylori infection in children with gastrointestinal symptoms. FEMS Immunol Med Microbiol 44: 205-212.
85. Rocha GA, Oliveira AM, Queiroz DM, Carvalho AS, Nogueira AM (2000) Immunoblot analysis of humoral immune response to Helicobacter pylori in children with and without duodenal ulcer. J Clin Microbiol 38: 1777-1781.
86. Sarker S, Nahar S, Rahman M, Bardhan PK, Nair GB, et al. (2004) High prevalence of cagA and vacA seropositivity in asymptomatic Bangladeshi children with Helicobacter pylori infection. Acta Paediatr 93: 1432-1436.
87. Mitchell HM, Hazell SL, Bohane TD, Hu P, Chen M, et al. (1999) The prevalence of antibody to CagA in children is not a marker for specific disease. J Pediatr Gastroenterol Nutr 28: 71-75.
88. Shimizu T, Yarita Y, Haruna H, Kaneko K, Yamashiro Y, et al. (2003) Urine-based enzyme-linked immunosorbent assay for the detection of Helicobacter pylori antibodies in children. J Paediatr Child Health 39: 606-610.
89. Kalach N, Briet F, Raymond J, Benhamou PH, Barbet P, et al. (1998) The urea breath test for the noninvasive detection of Helicobacter pylori in children: comparison with culture and determination of minimum analysis requirements. J Pediatr Gastroenterol Nutr 26: 291-296.
90. Leung WK, Chow TP, Ng EK, Chan FK, Chung SC, et al. (2001) Validation of a new immunoblot assay for the diagnosis of Helicobacter pylori in the Asian population. Aliment Pharmacol Ther 15: 423-428.
91. Leal-Herrera Y, Torres J, Monath TP, Ramos I, Gomez A, et al. (2003) High rates of recurrence and of transient reinfections of Helicobacter pylori in a population with high prevalence of infection. Am J Gastroenterol 98: 2395-2402.
92. Perri F, Pastore M, Clemente R, Festa V, Quitadamo M, et al. (1998) Helicobacter pylori infection may undergo spontaneous eradication in children: a 2-year follow-up study. J Pediatr Gastroenterol Nutr 27: 181-183.
93. Lee A, Logan SM, Trust TJ (1987) Demonstration of a flagellar antigen shared by a diverse group of spiral-shaped bacteria that colonize intestinal mucus. Infect Immun 55: 828-831.
94. Logan SM, Trust TJ (1983) Molecular identification of surface protein antigens of Campylobacter jejuni. Infect Immun 42: 675-682.
95. Lepper PM, Moricke A, Vogt K, Bode G, Trautmann M (2004) Comparison of different criteria for interpretation of immunoglobulin G immunoblotting results for diagnosis of Helicobacter pylori infection. Clin Diagn Lab Immunol 11: 569-576.
96. Nilsson I, Ljungh A, Aleljung P, Wadstrom T (1997) Immunoblot assay for serodiagnosis of Helicobacter pylori infections. J Clin Microbiol 35: 427-432.
97. Trautmann M, Moldrzyk M, Vogt K, Korber J, Held T, et al. (1994) Use of a receiver operating characteristic in the evaluation of two commercial enzyme immunoassays for detection of Helicobacter pylori infection. Eur J Clin Microbiol Infect Dis 13: 812-819.
98. von WH, Grote HJ, Gatermann S, Loning T, Berger B, et al. (1988) Immunoblot analysis of immune response to Campylobacter pylori and its clinical associations. J Clin Pathol 41: 653-659.
99. Deeks JJ, Altman DJ (2004) Diagnostic tests 4: likelihood ratios. BMJ 329: 168-169.
100. Ramelah M, Aminuddin A, Alfizah H, Isa MR, Jasmi AY, et al. (2005) cagA gene variants in Malaysian Helicobacter pylori strains isolated from patients of different ethnic groups. FEMS Immunol Med Microbiol 44: 239-242.
101. Drumm B, Koletzko S, Oderda G (2000) Helicobacter pylori infection in children: a consensus statement. European Paediatric Task Force on Helicobacter pylori. J Pediatr Gastroenterol Nutr 30: 207-213.
102. Rahman SH, Azam MG, Rahman MA, Arfin MS, Alam MM, et al. (2008) Non-invasive diagnosis of H pylori infection: Evaluation of serological tests with and without current infection marker CIM. World J Gastroenterol 14: 1231-1236.