Khanda Abdullateef Anwar a

a  Department of Microbiology, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

Submitted: 17/2/2019; Accepted: 3/5/2019; Published: 21/6/2019

DOI Link: https://doi.org/10.17656/jsmc.10196 



Helicobacter pylori is an important pathogen, that colonize the mucus layer of epithelial mucus of the stomach in approximately 50% of humans worldwide and can be diagnosed by both invasive and noninvasive methods. 


to compare the diagnostic accuracy of noninvasive tests such as serology and stool antigen test in symptomatic patients and observing the relation of these tests to hematological parameter.

Materials and Methods

One hundred and fifteen blood and stool samples were taken from patients with dyspeptic symptoms from primary health care center of Shahid baxtyar clinic in Sulaimani (Iraq) in a period from June to December 2015, and analyzed for detection of Helicobacter pylori infection by different methods. 


The most attending group that have Helicobacter pylori infection were adult female with age group 26-35 years. Different percentage was recorded for each diagnostic maethod, 76.52% for rapid test, 62.60% for stool Ag, 67.82% for IgM and 86.96 % was recorded for IgG ELISA test. Serum ferritn was assessed for all patients and it was observed that 78 (67.82%) showed low serum ferritin level that includes all cases of positive stool Antigen.


H. pylori can be detected by all non invasive methods with predominent of serodiagnostic test and most of positive cases had iron deficiency anemia with low serum ferritin level. 


Helicobacter pylori, Non invasive methods, ELISA test, Stool Ag.


1. Kahraman P. Elmas, Kılbaş İ , Çiftci H. İhsan. Test Preferences for the Diagnosis of Helicobacter pylori Infection in Developing Countries: a Systematic Review a Systematic Review. Ann Clin Cytol Pathol. 2018; 4(7): 1121.

2. Chen C , Mao Y , Du J , Xu Y , Zhuand Z , Cao H. Helicobacter pylori infection associated with an increased risk of colorectal adenomatous polyps in the Chinese population. Gastroenterology 2019;19:14.

3. Khedmat H , Afshar K.Reza ,  Agah S, Taheri S. Helicobacter pylori Infection in the general population: A Middle Eastern perspective.Caspian J Intern Med. 2013; 4(4): 745–753.

4. Best L, Takwoingi Y, Seladurai A.Sulman, Candhi A, Low B, et al. Non-invasive diagnostic tests for Helicobacter pylori infection (Review). Cochrane Database of Systematic Reviews.2018;Issue 3. 

5. Talebi A. and Abadi B. Diagnosis of Helicobacter pylori Using Invasive and Noninvasive Approaches.Journal of Pathogens. 2018; Article ID 9064952, 13. https://doi.org/10.1155/2018/9064952. 

6. Ali Habib S.Hamed, Murad A.Hussam, Amir M.Elamir, Halawa F. Taher. Effect of sequential versus standard Helicobacter pylori eradication therapy on the associated iron deficiency anemia in children. Indian J Pharmacol. 2013; 45(5): 470–473. 

7. DuBois S, Kearney DJ. Iron-deficiency anemia and Helicobacter pylori infection: a review of the evidence.Am J Gastroenterol.2005;100(2):453–9.

8. Taye B, Enquselassie F, Tsegaye A, Amberbir A, Medhin G , Fogarty A et al. Effect of early and current Helicobacter pylori infection on the risk of anaemia in 6.5-year-old Ethiopian children. BMC Infectious Diseases 2015; 15(1):270-8.

9. Iannone A , Giorgio F , Russo F , Riezzo G , Girardi B , Pricci M, .et al. New fecal test for non-invasive Helicobacter pylori detection: A diagnostic accuracy study. World J Gastroenterol.2018; 24(27): 3021-3029. 

10. Salih A. Barik. Helicobacter pylori Infection in Developing Countries: The Burden for How Long. Saudi J Gastroenterol. 2009; 15(3): 201–207.

11. Sabbi T, Angelis D.Paola, Colistro F , Oglio D.Luigi , Castro M. Efficacy of Noninvasive Tests in the Diagnosis of Helicobacter pylori Infection in Pediatric Patients. Arch Pediatr Adolesc Med.  2005;159(3):238-241. 

12. Mohammed O. Mohammed. Correlation of Endoscopic Findings with Various Helicobacter pylori Tests .International Journal of Clinical Medicine.(2014) ; 5:1180-8.

13. Omosor K.I, Omosor O.H, Adejumo B.I.G, Ibeh I.N, Dimkpa U. Comparative Evaluation of Stool Antigen Immunoassay and Blood Antibody Test Methods for the Screening of Helicobacter Pylori Infection in Asymptomatic Adult Population in Delta State, Nigeria. J Mol Microbiol. 2008; 2(1):3-9.

14. Alsaimary I , Al-Sadoon M , Jassim A, Hamadi S. Clinical Findings and Prevalence of Helicobacter Pylori in Patients with Gastritis B in Al-Basrah Governorate Oman Med J.2014; 24(3): 208–211.

15.Alagarsamy R and Purushothaman R. A Study clinical findings and prevalence of H.pylori in patients with gastritis. Tech Journal of Surgery. 2015; 4 (2) :36-39.

16.Thankachan P , Muthayya S , Sierksma A , Eilander A ,Thomas T , Duchateau GS, et al .Helicobacter pylori infection does not influence the efficacy of iron and vitamin B(12) fortification in marginally nourished Indian children.Eur J Clin Nutr.2010 ;(10):1101-7.

17. 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(46): 17618–17625.

18. Jamieson JA and Kuhnlein HV . The paradox of anemia with high meat intake: a review of the multifactorial etiology of anemia in the Inuit of North America,” NutritionEtiology Reviews. 2008; 66(5):256–271.

19. Eusebi LH, Zagari RM, Bazzoli F. Epidemiology of Helicobacter pylori infection .Helicobacter. 2006 ;9(1):1-5.

20 . Zuberi BF, Afsar S, Qadeer R, Baloch I, Quraishy MS, Kumar A, et al. Ferritin, vitamin B12 and helicobacter pylori infection: a study in patients who underwent upper GI endoscopy at civil hospital karachi.J Coll Physicians Surg Pak. 2007;17(9):546-9.

21. Windle HJ, Kelleher D, Crabtree JE. Childhood Helicobacter pylori infection and growth impairment in developing countries: a vicious cycle. Pediatrics. 2007;119: E754–759.

22. Maria D, Queiroz M , Paul RH, Ian R. Sanderson, Henry J. Windle, Marjorie M, et al. Iron Status and Helicobacter pylori Infection in Symptomatic Children: An International Multi-Centered Study. PLOS ONE 2013; 8 (7): 68833.

23. Hoseinzadeh M , Khosravi A, Sayemiri K, Rasoli H. Mohammad, Mohaveri A. The antibody titers to Helicobacter pylori in 7- 12 year old iron deficiency anemic children, in Ilam. J Res Med Sci. 2010; 15(6): 324–330. 

24. Rajendiran S , Zachariah B, Hamide A . Increased Protein Carbonylation and Decreased Antioxidant Status in Anemic H. Pylori Infected Patients: Effect of Treatment.Gastroenterol.2014; 95(159): 110-119.

25. Shih Y. Hsiang , Kuo C. Fu, Sophie S, Wang W, Liu Y, Meng W, et al.Helicobacter pylori Infection and Anemia in Taiwanese Adults. Gastroenterology Research and Practice.2013;2(1):211-215.

26. Perez GI, Rothenbacher D, Brenner H. Epidemiology of Helicobacter pylori infection. Helicobacter 2014;9:1S–6S.

27. Chiu H, Chiang T, Yen M. Amy , Hsia C, Hiu Y. Sherry, Chen S Yuan Fann, et al . Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions. BMJ . 2013; 3(10): e003989. 


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