Use of a urea breath test versus invasive methods to determine the prevalence ofHelicobacter pylori in zaire

  • Y. Glupczynski
  • L. Bourdeaux
  • M. Verhas
  • C. DePrez
  • D. DeVos
  • T. Devreker


The prevalence ofHelicobacter pylori infection in Zaire was determined by means of a [14C] urea breath test in 133 asymptomatic subjects, by culture and histological examination of biopsies in 324 consecutive endoscopy patients with chronic epigastric complaints, and by both the breath test and culture/histology in a subset of 92 patients. Sixty healthy Belgian students or hospital laboratory workers were also included for comparison. The prevalence ofHelicobacter pylori was significantly higher in asymptomatic Zairian subjects (77.4 %) than in the Belgians (30 %; p<10−6). Infection was also acquired much earlier in life in Africans, 66% of the children aged 5 to 9 years already being infected versus none of the Belgian subjects below the age of 20 years. In Zaire, however, the prevalence ofHelicobacter pylori in patients with gastroduodenal disorders (87.5 %) was similar to that in the group of asymptomatic subjects (77.5 %) after adjustment for age and other epidemiological parameters (gender, place of residency, education level, smoking and drinking habits) in a multivariate analysis. The high rate of acquisition ofHelicobacter pylori infection in Zaire emphasizes the need to consider the baseline prevalence ofHelicobacter pylori in a defined population when studying its association with various diseases.


Urea Histological Examination Laboratory Worker Breath Test Invasive Method 
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  1. 1.
    Parsonnet J: The epidemiology ofCampylobacter pylori. In: Blaser MJ (ed):Campylobacter pylori in gastritis and peptic ulcer disease. Igaku-Shoin, Tokyo, 1989, p. 51–60.Google Scholar
  2. 2.
    Graham DY:Helicobacter pylori in human populations: the present and predictions of the future based on the epidemiology of poliomyelitis. In: Menge H, Gregor M, Tytgat GNJ, Marshall BJ, McNulty CAM (ed):Helicobacter pylori 1990. Springer Verlag, Berlin, 1991, p. 97–102.Google Scholar
  3. 3.
    Jones DM, Eldridge J, Fox AJ, Sethi AJ, Whorwell PJ: Antibody to the gastric campylobacter-like organisms(“Campylobacter pyloridis”). Journal of Medical Microbiology 1986, 22: 57–62.Google Scholar
  4. 4.
    Mitchell HM, Lee A, Berkowicz J, Borody T: The use of serology to diagnose activeCampylobacter pylori infection. Medical Journal of Australia 1988, 149: 604–609.Google Scholar
  5. 5.
    Dwyer B, Kaldor J, Tee W, Marakowski E, Raios K: Antibody response toCampylobacter pylori in diverse ethnic groups. Scandinavian Journal of Infectious Diseases 1988, 20: 349–350.Google Scholar
  6. 6.
    Mégraud F, Brassens-Rabbé MP, Denis F, Belbouri A, Quynh Hoa D: Seroepidemiology ofCampylobacter pylori infection in various populations. Journal of Clinical Microbiology 1989, 27: 1870–1873.Google Scholar
  7. 7.
    Perez-Perez GI, Taylor DN, Bodhidatta L, Wongsrichalanai J, Baze WB, Dunn BE, Echeverria PD, Blaser MJ: Seroprevalence ofHelicobacter pylori infections in Thailand. Journal of Infectious Diseases 1990, 161: 1237–1241.Google Scholar
  8. 8.
    Morris A, Nicholson G, Lloyd G, Haines D, Rogers A, Taylor D: Seroepidemiology ofCampylobacter pyloridis. New Zealand Medical Journal 1986, 99: 657–659.Google Scholar
  9. 9.
    Kosunen TU, Hook J, Rautelin HI, Myllyla G: Age-dependent increase ofCampylobacter pylori antibodies in blood donors. Scandinavian Journal of Gastroenterology 1989, 24: 110–114.Google Scholar
  10. 10.
    Alpert LC, Graham DY, Evans DJ, Yoshimura HH, Hazell SL, Evans DG, Klein PD: Diagnostic possibilities forCampylobacter pylori infection. European Journal of Gastroenterology and Hepatology 1989, 1: 17–26.Google Scholar
  11. 11.
    Newell DG: Identification of the outer membrane proteins ofCampylobacter pyloridis and antigenic cross-reactivity betweenC. pyloridis andC. jejuni. Journal of General Microbiology 1987, 133: 163–170.Google Scholar
  12. 12.
    Graham DY, Klein PD, Evans DJ, Evans DG, Alpert LC, Opekun AR, Boutton TW:Campylobacter pylori detected noninvasively by the13 C-urea breath test. Lancet 1987, i: 1174–1177.Google Scholar
  13. 13.
    Surveyor I, Goodwin CS, Mullan BP, Geelhoed E, Warren JR, Murray RN, Waters TE, Sanderson CR: The14C-urea breath-test for the detection of gastricCampylobacter pylori infection. Medical Journal of Australia 1989, 151: 435–439.Google Scholar
  14. 14.
    Rauws EAJ, Royen EAV, Langenberg W, Woensel JV, Vrij AA, Tytgat GN:14C-urea breath test inC. pylori gastritis. Gut 1989, 30: 798–803.Google Scholar
  15. 15.
    Ormand JE, Talley NJ, Carpenter HA, Shorter RG, Conley CR, Wilson WR, DiMagno EP, Zinsmeister AR, Phillips SF: [14C]Urea breath test for diagnosis ofHelicobacter pylori. Digestive Diseases and Sciences 1990, 7: 879–884.Google Scholar
  16. 16.
    Graham DY, Klein PD, Opekun AR, Boutton TW, Evans DJ, Alpert LC, Michaletz PA, Yoshimura HH, Adam E: Epidemiology ofCampylobacter pylori infection: ethnic considerations. Scandinavian Journal of Gastroenterology 1988, 23, Supplement 142: 9–13.Google Scholar
  17. 17.
    Graham DY, Klein PD, Opekun AR, Boutton TW: Effect of age on the frequency of activeCampylobacter pylori infection diagnosed by the [13C]urea breath test in normal subjects and patients with peptic ulcer disease. Journal of Infectious Diseases 1988, 157: 777–780.Google Scholar
  18. 18.
    Verhas M, Conti S, Cadranel S, Glupczynski Y, van Tricht L, Deltenre M: Accuracy of urea C-14 breath test in detection ofCampylobacter pylori. European Journal of Nuclear Medicine 1988, 14: 245.Google Scholar
  19. 19.
    Henze H, Malfertheiner P, Clausen M, Burkhardt H, Adam WE: Validation of a simplified carbon-14-urea breath test for routine use for detectingHelicobacter pylori noninvasively. Journal of Nuclear Medicine 1990, 31: 1940–1944.Google Scholar
  20. 20.
    Langenberg W, Rauws EA, Houthoff HJ, Oudbier JH, van Bohemen CG, Tytgat GN, Rietra PJ: Follow-up study of individuals with untreatedCampylobacter pylori-associated gastritis and of noninfected persons with non-ulcer dyspepsia. Journal of Infectious Discases 1988, 157: 1245–1249.Google Scholar
  21. 21.
    Barthel JS, Westhlom TU, Havey AD, Gonzalez F, Everett ED: Gastritis andCampylobacter pylori in healthy, asymptomatic volunteers. Archives of Internal Medicine 1988, 148: 1149–1151.Google Scholar
  22. 22.
    Perez-Perez GI, Dworkin BM, Chodos JE, Blaser MJ:Campylobacter pylori in humans. Annals of Internal Medicine 1988, 109: 11–17.Google Scholar
  23. 23.
    Evans DJ, Evans DG, Graham DY, Klein PD: A sensitive and specific serologic test for detection ofCampylobacter pylori infection. Gastroenterology 1989, 96: 1004–1008.Google Scholar
  24. 24.
    Cadranel S, Glupczynski Y, Labbé M, DePrez C:Campylobacter pylori in children. In: Menge H, Gregor M, Tytgat GNJ, Marshall BJ (ed):Campylobacter pylori. Springer Verlag, Berlin, 1988, p. 111–117.Google Scholar
  25. 25.
    Nowottny U, Heilmann KL: Epidemiologie derHelicobacter pylori-Infektion. Leber Magen Darm 1990, 20: 180–186.Google Scholar
  26. 26.
    Conti-Nibali S, Baldari S, Vitulo F, Sferlazzas C, Russo E, Tedeschi A, Bonanno N, Magazzù G: The14CO2 urea breath test forHelicobacter pylori infection. Journal of Pediatric Gastroenterology and Nutrition 1990, 11: 284–285.Google Scholar
  27. 27.
    Gastrointestinal Physiology Working Group:Helicobacter pylori and gastritis in Peruvian patients: relationship to socioeconomic level, age, and sex. American Journal of Gastroenterology 1990, 85: 819–823.Google Scholar
  28. 28.
    Holcombe C, Lucas SB, Umar H, Abba A:Helicobacter (Campylobacter) pylori in Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene 1990, 84: 294–296.Google Scholar
  29. 29.
    Sullivan PB, Thomas JE, Wight DGD, Neale G, Eastham EJ, Corrah T, Lloyd-Evans N:Helicobacter pylori in Gambian children with chronic diarrhoea and malnutrition. Archives of Diseases of Childhood 1990, 65: 189–191.Google Scholar
  30. 30.
    Klein PD, The Gastrointestinal Physiology Working Group, Graham DY, Gaillour A, Opekun AR, O'Brian-Smith E: Water source as a risk factor forHelicobacter pylori infection in Peruvian children. Lancet 1991, 337: 1503–1506.Google Scholar
  31. 31.
    Albenque M, Tall F, Dabis F, Mégraud F: Epidemiological study ofHelicobacter pylori transmission from mother to child in Africa. Revista Española de Enfermedades Digestivas 1990, 78, Supplement 1: 48–49.Google Scholar
  32. 32.
    Gobert B, Labigne A, De Korwin JD, Conroy MC, Bene MC, Faure GC: Polymerase chain reaction forHelicobacter pylori. Revista Española de Enfermedades Digestivas 1990, 78, Supplement 1: 4.Google Scholar
  33. 33.
    Tovey FI: Geographical aspects of peptic ulcer surgery. World Journal of Surgery 1977, 1: 47–52.Google Scholar

Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1992

Authors and Affiliations

  • Y. Glupczynski
    • 1
  • L. Bourdeaux
    • 2
  • M. Verhas
    • 1
  • C. DePrez
    • 1
  • D. DeVos
    • 3
  • T. Devreker
    • 3
  1. 1.Departments of Clinical Microbiology, Pathology and Nuclear MedicineBrugmann University HospitalBrusselsBelgium
  2. 2.Department of SurgeryFomulac HospitalKatanaZaire
  3. 3.Department of Pediatrics and General Medical LaboratoryCEMUBAC Medical TeamLwiroZaire

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