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Tshibangu-Kabamba E, Phuc BH, Tuan VP, Fauzia KA, Kabongo-Tshibaka A, Kayiba NK, Rosas-Aguirre A, Devleesschauwer B, Cimuanga-Mukanya A, Ngoma Kisoko PDJ, Matsumoto T, Akada J, Disashi GT, Mumba Ngoyi D, Kido Y, Speybroeck N, Yamaoka Y. Assessment of the diagnostic accuracy and relevance of a novel ELISA system developed for seroepidemiologic surveys of Helicobacter pylori infection in African settings. PLoS Negl Trop Dis 2021; 15:e0009763. [PMID: 34499649 PMCID: PMC8455143 DOI: 10.1371/journal.pntd.0009763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 09/21/2021] [Accepted: 08/25/2021] [Indexed: 01/18/2023] Open
Abstract
Beside diagnostic uncertainties due to the lack of a perfect gold standard test for Helicobacter pylori infection, the diagnosis and the prevalence estimation for this infection encounter particular challenges in Africa including limited diagnostic tools and specific genetic background. We developed and evaluated the accuracy of an enzyme-linked immunosorbent assay (ELISA) system tailored for H. pylori genetics in Africa (HpAfr-ELISA). Strains belonging to main genetic populations infecting Africans were exploited as sources for whole-cell antigens to establish in-house the ELISA system. A phase II unmatched case-control study explored the diagnostic accuracy of the HpAfr-ELISA using a training set of samples collected from dyspeptic patients from Kinshasa, the Democratic Republic of Congo (DRC) who had been tested with invasive standard tests (i.e., histology, culture, and rapid urease test) in 2017. Then the assay was cross-validated through a community-based survey assessing the prevalence of H. pylori and associated factors in 425 adults from Mbujimayi, DRC in 2018. Bayesian inferences were used to deal with statistical uncertainties of estimates (true prevalence, sensitivity, and specificity) in the study population. At its optimal cut-off-value 20.2 U/mL, the assay achieved an estimated sensitivity of 97.6% (95% credible interval [95%CrI]: 89.2; 99.9%) and specificity of 90.5% (95%CrI: 78.6; 98.5). Consistent outcomes obtained at repeated tests attested the robustness of the assay (negative and positive agreements always > 70%). The true prevalence of H. pylori was estimated 53.8% [95%CrI: 42.8; 62.7%]. Increasing age (adjusted odds ratio [aOR] > 1.0 [95% confidence interval (CI): > 1.0; 1.1]; p<0.001), overcrowding households (aOR = 3.2 [95%CI: 2.0; 5.1]; p<0.001), and non-optimal hand hygiene (aOR = 4.5 [95%CI: 2.0; 11.4]; p = 0.001) were independently associated with the H. pylori-seropositivity. The novel ELISA system has demonstrated good diagnostic accuracy and potential usefulness for management and mitigation strategies for H. pylori infection in African settings.
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Affiliation(s)
- Evariste Tshibangu-Kabamba
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Department of Internal Medicine, Faculty of Medicine, University of Mbujimayi, Mbujimayi, DR Congo
- Research Center for Infectious Diseases Sciences & Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Bui Hoang Phuc
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Vo Phuoc Tuan
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Department of Endoscopy, Cho Ray Hospital, Cho Ray, Vietnam
| | - Kartika Afrida Fauzia
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Nadine Kalenda Kayiba
- Research Institute of Health and Society (IRSS), Université catholoique de Louvain, Brussels, Belgium
- Department of Public Health, Faculty of Medicine, University of Mbujimayi, Mbujimayi, DR Congo
| | - Angel Rosas-Aguirre
- Research Institute of Health and Society (IRSS), Université catholoique de Louvain, Brussels, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Alain Cimuanga-Mukanya
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Department of Internal Medicine, Faculty of Medicine, University of Mbujimayi, Mbujimayi, DR Congo
| | - Patrick de Jésus Ngoma Kisoko
- Department of Gastroenterology and Hepatology, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo
- Department of Gastroenterology and Hepatology, General Referential Hospital of Bukavu, Bukavu, DR Congo
| | - Takashi Matsumoto
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Junko Akada
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Ghislain Tumba Disashi
- Department of Internal Medicine, Faculty of Medicine, University of Mbujimayi, Mbujimayi, DR Congo
| | - Dieudonné Mumba Ngoyi
- Department of Parasitology, National Institute of Biomedical Research, Kinshasa, DR Congo
| | - Yasutoshi Kido
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Research Center for Infectious Diseases Sciences & Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Niko Speybroeck
- Research Institute of Health and Society (IRSS), Université catholoique de Louvain, Brussels, Belgium
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
- Department of Medicine, Gastroenterology section, Baylor College of Medicine, Houston, Texas, United States of America
- Global Oita Medical Advanced Research Center for Health, Oita University, Yufu, Japan
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