Prevalence of Helicobacter Pylori Infection Among Patients with Dyspepsia by Stool Antigen and Serology Tests

  • Mahsa Mirzaei 1. School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
  • Sattar Jafari 2. Department of gastroenterology and hepatology , zanjan university of medical scienes, Zanjan, Iran
  • Somayeh Abdollahi Sabet 3. Department. of Community Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
  • Saeed Mansouri 2. Department of gastroenterology and hepatology , zanjan university of medical scienes, Zanjan, Iran
Keywords: Helicobacter pylori, Dyspepsia, Serological Test, Stool Antigen Test


Background: Helicobacter pylori is the most common chronic bacterial infection globally and is the underlying cause of many disorders, including dyspepsia. Also, the prevalence of gastric cancer in Zanjan city is high. Therefore, this study investigates the prevalence of H. pylori infection in patients with dyspepsia by the H. pylori stool antigen (HpSA) test. Materials and Methods: This cross-sectional study was performed on patients over 18 years of age who were referred to Shafieieh Special Clinic in Zanjan with dyspepsia during 2019-2020. First, the HpSA test was examined for H. pylori infection. Since the results of two separate tests are needed to prove that H. pylori infection is negative, the serological test was used in the patients with HpSA negative results. Results: Based on the demographic information of the present study, most patients (70.1%) were under 40 years old, and most (55.1%) were women. Smoking, alcohol, drug, and non-steroidal anti-inflammatory drugs (NSAIDs) use in patients were 16.5%, 6.3%, 7.9%, and 39.4%, respectively. The highest and lowest symptoms were abdominal pain (44.9%) and burp (22%), respectively. Except for the relationship between positive serological results and age (P˂0.001), no significant relationship was found between other variables (P≥0.05). Based on the HpSA test, H. pylori infection was seen in 56.7% of patients. By the serological test, another 29 patients had H. pylori infection. Therefore, the total number of patients was 101, and the overall prevalence of H. pylori increased to 79.5%. Conclusion: The results of the present study showed that the overall prevalence of H. pylori infection was high compared to previous studies. Also, above the age of 40 years, female gender in HpSA test and male gender in serology test, higher education level, and the presence of risk factors (smoking, alcohol, and NSAIDs) have a higher positive test for H. pylori.


Baghestani AR, Pourhoseingholi MA, Ashtari S, Najafimehr H, Busani L, Zali MR. Trend of Gastric Cancer after Bayesian Correction of Misclassification Error in Neighboring Provinces of Iran. GMJ. 2019;8:1223.

Batebi S, Arani AM, Jafari M, Sadeghi A, Isfeedvajani MS, Emami MH. Validity and Reliability of the Persian Version of Leeds Dyspepsia Questionnaire. GMJ. 2019 31;8:1609.

PMid:34466536 PMCid:PMC8343703

Hooi JK, Lai WY, Ng WK, Suen MM, Underwood FE, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterol. 2017;153(2):420-9.


Amani M. prevalence of Helicobacter pylori infection in Iran. Institute of Gastroenterol Liv Dis.2018 ;13-6.

Pounder RE, Ng D. The prevalence of Helicobacter pylori infection in different countries. Alimen pharmacol ther. Supp. 1995;9(2):33-9.

Torres J, Leal-Herrera Y, Perez-Perez G, Gomez A, Camorlinga-Ponce M, Cedillo-Rivera R, et al. A community-based seroepidemiologic study of Helicobacter pylori infection in Mexico. l inf dis. 1998;178(4):1089-94.


Hunt RH, Sumanac K, Huang JQ. should we kill or should we save Helicobacter pylori?. Alimen pharmacol ther. Supp. 2001;15:51-9.


Nouraie M, Latifi‐Navid S, Rezvan H, Radmard AR, Maghsudlu M, Zaer‐Rezaii H, et al. Childhood hygienic practice and family education status determine the prevalence of Helicobacter pylori infection in Iran. Helicobacter. 2009;14(1):40-6.


Malekzadeh R, Sadjadi A, Riahi A. Review of Gastric cancer in Iran. Govaresh. 2008;13(2):107-12.

Azimi M, Zahedi MJ, Mehrabani M, Tajadini H, Zolala F, Baneshi MR, et al. Effects of Iranian Traditional Medicine Remedies (Apium Graveolence and Trachyspermum Copticum) on Modifying the Quality of Life in Patients with Functional Dyspepsia: A Double-Blind Randomized Clinical Trial. GMJ. 2017;6(2):102-9.

Tamadon MR. The treatment of Helicobacter pylori in chronic kidney disease patients. Front Biomed. 2016 9;1(1):e03.

Chorami M, Zojaji H, Naderi N, Moghimi-Dehkordi B, Mirsattari D, Shalmani HM. Evaluation of the benefit of addition of clidinium C to a Helicobacter pylori eradication regimen. Gastroenterol hepatol 2013;6(3):141.

Aledavood SA, Ghavam-Nasiri MR, Ghaffarzadegan K, Raziee HR, Saboori G, Anvari K, et al. Hepatitis-C Infection Incidence Among the non-Hodgkin's B-cell Lymphoma Patients in the Northeast of Iran. Iran J can prev. 2014;7(3):147-51.

Yoshii S, Mabe K, Watano K, Ohno M, Matsumoto M, Ono S, et al. Validity of endoscopic features for the diagnosis of Helicobacter pylori infection status based on the Kyoto classification of gastritis. Digest Endoscop. 2020;32(1):74-83.


Elsiddig YM, Sameir RM, Mohammed HE, Alshaikh TE, Arabi OH, Malik MI, et al. Assessment of Serological Tests for Diagnosis of H. pylori Infection among Dyspeptic Patients, Gezira State, Sud. Assess. 2019;3(11):1-6.

Thapa S, Thapa J, Karki B, Khadka D, Thapa AB. Noninvasive diagnosis of Helicobacter pylori among patients with dyspepsia. Nep J Med Sci. 2020;5(1):28-34

Darvish S, Khataminejad MR. Comparison of the invasive pathological method and serological diagnosis of Helicobacter pylori in patients at Taleghani hospital in Chalous from 2014-2015. Iran J Med Microbiol. 2016;10(3):61-7.

Aje AO, Otegbayo JA, Odaibo GN, Bojuwoye BJ. Comparative study of stool antigen test and serology for among nigerian dyspeptic patients-a pilot study. Niger J clin prac 2010;13(2):120-4.

Shrestha S, Paudel P, Pradhan GB, Shrestha L, Bhattachan CL. Prevalence study of H. pylori infection in dyspeptic patients coming to Nepal Medical College Teaching Hospital, Jorpati, Kathmandu. Nepal Med Coll J. 2012;14(3):229-33.

Alyahawi A, Alkaf A, Alzaghrori S. Prevalence of helicobacter pylori among asymptomatic populations in Sana'a, Yemen. Uni J Pharma Res 2018;3(3):31-35.

Shi R, Xu S, Zhang H, Ding Y, Sun G, Huang X, et al. Prevalence and risk factors for Helicobacter pylori infection in Chinese populations. Helicobacter. 2008;13(2):157-65.


Aguemon BD, Struelens MJ, Massougbodji A, Ouendo EM. Prevalence and risk-factors for Helicobacter pylori infection in urban and rural Beninese populations. Clini microbiol inf. 2005;11(8):611-7.


Abebaw W, Kibret M, Abera B. Prevalence and Risk Factors of H. pylorifrom Dyspeptic Patients in Northwest Ethiopia: A Hospital Based Cross-sectional Study. Asia Pac J Can Prev. 2014;15(11):4459-63.


Dilnessa T, Amentie M. Prevalence of Helicobacter pylori and risk factors among dyspepsia and non-dyspepsia adults at Assosa General Hospital, West Ethiopia: A comparative study. Ethiopian J HeaL Develop. 2017;31(1):4-12.

Umoru BI, Ndububa DA, Adekanle O, Ijarotimi O, Adeniran AA. Correlation between Gastric mucosal histology and Faecal antigen test for the detection of Helicobacter pylori infection among dyspeptic patients in a tertiary hospital in south-west Nigeria. Afr. J. Med. Med. Sci. 2017:46.

Azizi G, Nasiri M, Sadria R, Javanbakht MH, Kalvandi M, Khannazer N, et al. Diagnosis of Helicobacter pylori Infection in Children and Adult by Serological Test and Stool Antigen Test. Alborz UniverS Med J. 2013;2(4):191-6.

Siavoshi F, Malekzadeh R, Daneshmand M, Ashktorab H. Helicobacter pylori endemic and gastric disease. Digest dis sci. 2005;50(11):2075-80.


Sotoudehmanesh R, Malekzadeh R, Vahedi H, Dariani NE, Asgari AA, Massarrat S. Second-line Helicobacter pylori eradication with a furazolidone-based regimen in patients who have failed a metronidazole-based regimen. Digestion. 2001;64(4):222-5.


Tameshkel FS, Niya MH, Kheyri Z, Azizi D, Roozafzai F, Khorrami S. The evaluation of diagnostic and predictive values of Helicobacter pylori stool antigen test in Iranian patients with dyspepsia. Iran J Pathol. 2018;13(1):38.

How to Cite
Mirzaei, M., Jafari, S., Abdollahi Sabet, S., & Mansouri, S. (2021). Prevalence of Helicobacter Pylori Infection Among Patients with Dyspepsia by Stool Antigen and Serology Tests . Galen Medical Journal, 10, e2134.
Original Article