Significance of Stool Antigen Testing for Helicobacter pylori Detection in Humans

Authors

DOI:

https://doi.org/10.24086/cuesj.v9n2y2025.pp68-73

Keywords:

Detection, Helicobacter pylori, stool, antigen test, Erbil

Abstract

Helicobacteriosis, a globally prevalent bacterial infection caused by Helicobacter pylori, affects more than half of the world’s population. H. pylori, a Group 1 carcinogen, is a widespread pathogen associated with gastric cancer and peptic ulcers. Due to its high prevalence, carcinogenic classification, and increasing antimicrobial resistance, H. pylori remain a major global health concern. This study examined the frequency of H. pylori infection in a specific population, revealing an overall prevalence of 20.5%, with a higher infection rate among females (23.7%) than males (17.8%). The 11–20-year age group had the highest infection rate (28.6%), while the 1–10-year group had the lowest (11.5%). However, statistical analysis (Chi-square test, “P” = 0.921) indicated no significant age-related differences, suggesting a relatively uniform distribution across age groups. Similarly, rural residents exhibited a slightly higher infection rate (22.3%) than urban dwellers (18.5%). However, the difference was not statistically significant (P = 0.593), suggesting that the location of habitation had little to no influence on infection risk. Monthly variations in prevalence were noted, with peaks in September (24.3%) and December (21.6%), whereas August recorded the lowest rate (16.7%). However, statistical analysis (P = 0.982) revealed no significant seasonal trend, suggesting that temporal factors did not substantially influence infection rates in this study. Overall, the findings indicate a moderate prevalence of H. pylori infection with no significant variations across age, location, or season, pointing to a relatively uniform distribution within the studied population. Further investigations are warranted to elucidate the underlying risk factors and transmission dynamics.

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Author Biographies

Dhary A. Almashhadany, Department of Medical Laboratory Science, Knowledge University, Erbil, 44001, Iraq

Dhary A. Almashhadany is a professor  at the Department of Medical Laboratory Science, Knowledge University, Erbil, 44001, Iraq. His research interest are Public Health, Food Safety, Bacteriology

Salah M. Al-bader, Department of Community Health Nursing, College of Health Technology, Cihan University- Erbil, Kurdistan Region, Iraq

Salah. M. Al-bader is a professor at the Department of Community Health Nursing, College of Health Technology, Cihan University- Erbil, Kurdistan Region, Iraq. His research interest is community health.

Sarwan W. Bradosty, Department of Community Health Nursing, College of Health Technology, Cihan University- Erbil, Kurdistan Region, Iraq

Sarwan W. Bradosty is a lecturer at the Department of Community Health Nursing, College of Health Technology, Cihan University- Erbil, Kurdistan Region, Iraq. His research interest is community health.

References

1. S. M. Alexander, R. J. Retnakumar, D. Chouhan, T. N. B. Devi, S. Dharmaseelan, K. Devadas, N. Thapa, J. P. Tamang, S. C. Lamtha, and S. Chattopadhyay, “Helicobacter pylori in human stomach: the inconsistencies in clinical outcomes and the probable causes,” Frontiers in Microbiology, vol. 17, p. 713955, 2021. DOI: https://doi.org/10.3389/fmicb.2021.713955

2. A. Salahi-Niri, A. Nabavi-Rad, T. M. Monaghan, T. Rokkas, M. Doulberis, A. Sadeghi, M. R. Zali, Y. Yamaoka, E. Tacconelli, and A. Yadegar, “Global prevalence of Helicobacter pylori antibiotic resistance among children in the world health organization regions between 2000 and 2023: a systematic review and meta-analysis,” BMC Medicine, vol. 22, p. 598, 2024. doi: 10.1186/s12916-024-03816-y. DOI: https://doi.org/10.1186/s12916-024-03816-y

3. H.-J. Chen, Y.-T. Si, L. Luan, J.-X. Lai, J.-L. Wang, Y.-R. Tang, and L. Wang, “Current rates of Helicobacter pylori infection and antibiotic resistance in the eastern coast of China: a single center study,” Frontiers in Cellular and Infection Microbiology, vol. 15, p. 1561778, 2025. doi: 10.3389/fcimb.2025.1561778. DOI: https://doi.org/10.3389/fcimb.2025.1561778

4. D. A. Almashhadany, “Epidemiology of Helicobacter pylori among humans in Erbil Governorate/Kurdistan Region/Iraq,” World Journal of Pharmacy and Pharmaceutical Sciences, vol. 9, no. 11, pp. 435–447, 2020. doi: 10.20959/wjpps202011-17728.

5. W. Farooqi, R. S. Ahmed, J. M. Asfari, S. M. Alotaibi, L. F. Bander, S. S. Almutiri, A. A. Almasood, N. M. Alsaggaf, and H. S. Alsugair, “Knowledge, attitudes, and treatment protocols for Helicobacter pylori infection among general practitioners in primary healthcare centers in Riyadh, Saudi Arabia,” Cureus, vol. 17, no. 6, p. e85492, 2025. doi: 10.7759/cureus.85492. DOI: https://doi.org/10.7759/cureus.85492

6. O. Sjomina, J. Pavlova, Y. Niv, and M. Leja, “Epidemiology of Helicobacter pylori infection,” Helicobacter, vol. 23, Suppl. 1, p. e12514, 2018. doi: 10.1111/hel.12514. DOI: https://doi.org/10.1111/hel.12514

7. S. E. Mousavi, M. Ilaghi, I. E. Vahed, and S. A. Nejadghaderi, “Epidemiology and socioeconomic correlates of gastric cancer in Asia: results from the GLOBOCAN 2020 data and projections from 2020 to 2040,” Scientific Reports, vol. 15, p. 6529, 2025. doi: 10.1038/s41598-025-90064-6. DOI: https://doi.org/10.1038/s41598-025-90064-6

8. K. B. Said, K. F. Alshammari, S. Moussa, R. M. E. Ahmed, A. H. Aljadani, N. B. Albalawi, L. Al-Hujaili, R. Alharbi, A. A. Alotaibi, F. M. Alshammary, F. R. Alfouzan, Z. A. Albayih, B. I. Alkharisi, G. N. Alsdairi, and S. H. Alshubrami, “Clinical pathologic profiles of Helicobacter pylori reveal age-specific peaking with concomitant chronic gastric inflammation, robust immunity, and tissue alterations implying potential predisposition to malignancy in Ha’il, Saudi Arabia,” Journal of Clinical Medicine, vol. 14, no. 8, p. 2643, 2025. doi: 10.3390/jcm14082643. DOI: https://doi.org/10.3390/jcm14082643

9. P. Malfertheiner, F. Megraud, T. Rokkas, J. P. Gisbert, J. M. Liou, C. Schulz, A. Gasbarrini, R. H. Hunt, M. Leja, C. O’Morain, M. Rugge, S. Suerbaum, H. Tilg, K. Sugano, and E. M. El-Omar, “Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report,” Gut, 2022. doi: 10.1136/gutjnl-2022-327745. DOI: https://doi.org/10.1136/gutjnl-2022-327745

10. D. A. Almashhadany, S. M. Mayas, and N. L. Ali, “Isolation and identification of Helicobacter pylori from raw chicken meat in Dhamar Governorate, Yemen,” Italian Journal of Food Safety, vol. 11, article 10220, 2022. doi: 10.4081/ijfs.2022.10220. DOI: https://doi.org/10.4081/ijfs.2022.10220

11. A. Ali and K. I. AlHussaini, “Helicobacter pylori: a contemporary perspective on pathogenesis, diagnosis and treatment strategies,” Microorganisms, vol. 12, no. 1, p. 222, 2024. doi: 10.3390/microorganisms12010222. DOI: https://doi.org/10.3390/microorganisms12010222

12. A. Al-Hinai, M. Rizvi, S. A. Al-Busafi, M. Kashoob, Z. Al-Muharrmi, A. Al-Darmaki, and Z. Al-Jabri, “Antibiotic resistance and genetic determinants of Helicobacter pylori in Oman: insights from phenotypic and whole-genome analysis,” International Journal of Molecular Sciences, vol. 26, no. 12, p. 5628, 2025. doi: 10.3390/ijms26125628. DOI: https://doi.org/10.3390/ijms26125628

13. C. Jiang, L. Zhu, W. Yang, Z. Yu, W. Yang, X. Jin, and Y. Shao, “Evaluating the relationship between familial poverty, Helicobacter pylori seropositivity, and all-cause mortality in the general US population,” Frontiers in Public Health, vol. 13, p. 1578257, 2025. doi: 10.3389/fpubh.2025.1578257. DOI: https://doi.org/10.3389/fpubh.2025.1578257

14. M. Zamani, A. Vahedi, Z. Maghdouri, and J. Shokri-Shirvani, “Role of food in environmental transmission of Helicobacter pylori,” Caspian Journal of Internal Medicine, vol. 8, pp. 146–152, 2017.

15. D. A. Almashhadany, S. M. Mayas, H. I. Mohammed, A. A. Hassan, and I. U. H. Khan, “Population- and gender-based investigation for prevalence of Helicobacter pylori in Dhamar, Yemen,” Canadian Journal of Gastroenterology and Hepatology, 2023, article 3800810. doi: 10.1155/2023/3800810. DOI: https://doi.org/10.1155/2023/3800810

16. L. Xie, G. W. Liu, Y. N. Liu, P. Y. Li, X. N. Hu, X. Y. He, R. B. Huan, T. L. Zhao, and H. J. Guo, “Prevalence of Helicobacter pylori infection in China from 2014–2023: a systematic review and meta-analysis,” World Journal of Gastroenterology, vol. 30, no. 43, pp. 4636–4656, 2024. doi: 10.3748/wjg.v30.i43.4636. DOI: https://doi.org/10.3748/wjg.v30.i43.4636

17. Y. Duan, Y. Xu, Y. Dou, and D. Xu, “Helicobacter pylori and gastric cancer: mechanisms and new perspectives,” Journal of Hematology & Oncology, vol. 18, p. 10, 2025. doi: 10.1186/s13045-024-01654-2. DOI: https://doi.org/10.1186/s13045-024-01654-2

18. J. Gong, Q. Wang, X. Chen, and J. Lu, “Helicobacter pylori vaccine: mechanism of pathogenesis, immune evasion and analysis of vaccine types,” Vaccines, vol. 13, no. 5, p. 526, 2025. doi: 10.3390/vaccines13050526. DOI: https://doi.org/10.3390/vaccines13050526

19. E. B. Tibasima, P. K. Kumbakulu, L. P. Chirac, O. Ramazani, T. B. Patrick, K. K. Olga, G. K. Shamavu, P. N. Prudence, and B. Mseza, “Prevalence, associated factors, and clinical outcomes of Helicobacter pylori infection in pediatric populations in a war-torn urban environment in Eastern Democratic Republic of Congo: a mixed methods study,” BMC Pediatrics, vol. 25, no. 1, p. 257, 2025. doi: 10.1186/s12887-025-05588-7. DOI: https://doi.org/10.1186/s12887-025-05588-7

20. S. Pu, Z. Zhuang, N. Liu, Q. Luo, and D. Zhang, “Research progress on the relationship between Helicobacter pylori infection and iron deficiency anemia,” Frontiers in Microbiology, vol. 16, p. 1552630, 2025. doi: 10.3389/fmicb.2025.1552630. DOI: https://doi.org/10.3389/fmicb.2025.1552630

21. J. G. Kusters, A. H. van Vliet, and E. J. Kuipers, “Pathogenesis of Helicobacter pylori infection,” Clinical Microbiology Reviews, vol. 19, no. 3, pp. 449–490, 2006, doi: 10.1128/CMR.00054-05. DOI: https://doi.org/10.1128/CMR.00054-05

22. J. Hind, A. Bilal, I. Rania, N. Walid, and M. Sara, “Assessment of Helicobacter pylori infection in Lebanon: Endoscopic and histopathological findings,” Journal of Infection and Public Health, vol. 18, no. 3, p. 102656, Mar. 2025, doi: 10.1016/j.jiph.2025.102656. DOI: https://doi.org/10.1016/j.jiph.2025.102656

23. Z. Q. Zhang, J. Y. Li, H. Wang, C. Y. Fu, Y. L. Li, Q. Guo, Y. W. Bao, J. Wu, J. C. Liao, Y. Q. Song, D. X. Li, and X. H. Zhu, “Global, regional and national burden of respiratory infections among children and adolescents under 19 years of age from 1990 to 2021 and projected trends to 2040,” Egyptian Journal of Bronchology, vol. 19, p. 66, 2025, doi: 10.1186/s43168-025-00428-9. DOI: https://doi.org/10.1186/s43168-025-00428-9

24. D. A. Almashhadany, M. D. Alewi, A. T. Mohammed, and M. A. Zainel, “Overview of laboratory diagnosis of human Helicobacteriosis,” Global Journal of Public Health Medicine, vol. 6, pp. 976–987, 2024, doi: 10.37557/gjphm.v6i1.242. DOI: https://doi.org/10.37557/gjphm.v6i1.242

25. G. La Placa, M. Covino, M. Candelli, A. Gasbarrini, F. Franceschi, and G. Merra, “Relationship between human microbiome and Helicobacter pylori,” Microbiology Research, vol. 16, no. 1, p. 24, 2025, doi: 10.3390/microbiolres16010024. DOI: https://doi.org/10.3390/microbiolres16010024

26. B. Marshall and P. C. Adams, “Helicobacter pylori: A Nobel pursuit?,” Canadian Journal of Gastroenterology, vol. 22, no. 11, pp. 895–896, Nov. 2008, doi: 10.1155/2008/459810. DOI: https://doi.org/10.1155/2008/459810

27. M. Yi, S. Chen, X. Yi, F. Zhang, X. Zhou, M. Zeng, and H. Song, “Helicobacter pylori infection process: from the molecular world to clinical treatment,” Frontiers in Microbiology, vol. 16, p. 1541140, 2025, doi: 10.3389/fmicb.2025.1541140. DOI: https://doi.org/10.3389/fmicb.2025.1541140

28. A. Elbehiry, E. Marzouk, M. Aldubaib, A. Abalkhail, S. Anagreyyah, N. Anajirih, A. M. Almuzaini, M. Rawway, A. Alfadhel, A. Draz, and A. Abu-Okail, “Helicobacter pylori infection: current status and future prospects on diagnostic, therapeutic and control challenges,” Antibiotics (Basel), vol. 12, p. 191, 2023. DOI: https://doi.org/10.3390/antibiotics12020191

29. A. Elbehiry, E. Marzouk, A. Abalkhail, W. Sindi, Y. Alzahrani, S. Alhifani, T. Alshehri, N. A. Anajirih, T. ALMutairi, A. Alsaedi, F. Alzaben, A. Alqrni, A. Draz, A. M. Almuzaini, S. N. Aljarallah, A. Almujaidel, and A. Abu-Okail, “Pivotal role of Helicobacter pylori virulence genes in pathogenicity and vaccine development,” Frontiers in Medicine, vol. 11, p. 1523991, 2025, doi: 10.3389/fmed.2024.1523991. DOI: https://doi.org/10.3389/fmed.2024.1523991

30. P. Bawali, A. Brahma, S. R. Rana, A. Pal, and A. Bhattacharyya, “Helicobacter pylori infection and inflammatory events: the extracellular vesicle-connect in driving gastrointestinal tract cancers,” Frontiers in Medicine, vol. 11, p. 1444242, 2024, doi: 10.3389/fmed.2024.1444242. DOI: https://doi.org/10.3389/fmed.2024.1444242

31. B. G. Zhou, X. Jiang, Y. B. Ding, Q. She, and Y. Y. Li, “Vonoprazan-amoxicillin dual therapy versus bismuth-containing quadruple therapy for Helicobacter pylori eradication: A systematic review and meta-analysis,” Helicobacter, vol. 29, no. 1, p. e13040, Jan.–Feb. 2024, doi: 10.1111/hel.13040. DOI: https://doi.org/10.1111/hel.13040

32. C. Almarmouri, M. I. El-Gamal, M. Haider, M. Hamad, S. Qumar, M. Sebastian, R. Ghemrawi, J. S. Muhammad, C. Burucoa, and G. Khoder, “Anti-urease therapy: a targeted approach to mitigating antibiotic resistance in Helicobacter pylori while preserving the gut microflora,” Gut Pathogens, vol. 17, p. 37, 2025, doi: 10.1186/s13099-025-00708-1. DOI: https://doi.org/10.1186/s13099-025-00708-1

33. A. Yarahmadi and H. Afkhami, “Potential relationship between Helicobacter pylori infection and autoimmune disorders: A narrative review,” Microbial Pathogenesis, vol. 205, p. 107572, Aug. 2025, doi: 10.1016/j.micpath.2025.107572. DOI: https://doi.org/10.1016/j.micpath.2025.107572

34. O. M. Al-Fakhrany and E. Elekhnawy, “Helicobacter pylori in the post-antibiotics era: from virulence factors to new drug targets and therapeutic agents,” Archives of Microbiology, vol. 205, p. 301, 2023, doi: 10.1007/s00203-023-03639-0. DOI: https://doi.org/10.1007/s00203-023-03639-0

35. Y. Raza, M. Mubarak, M. Y. Memon, and M. S. Alsulaimi, “Update on molecular pathogenesis of Helicobacter pylori-induced gastric cancer,” World Journal of Gastrointestinal Pathophysiology, vol. 16, no. 2, p. 107052, Jun. 2025, doi: 10.4291/wjgp.v16.i2.107052. DOI: https://doi.org/10.4291/wjgp.v16.i2.107052

36. M. Öztekin, B. Yılmaz, D. Ağagündüz, and R. Capasso, “Overview of Helicobacter pylori infection: Clinical features, treatment, and nutritional aspects,” Diseases, vol. 9, no. 4, p. 66, Sep. 2021, doi: 10.3390/diseases9040066. DOI: https://doi.org/10.3390/diseases9040066

37. D. L. Mebuge, R. J. Noel, and B. D. Gold, “Helicobacter pylori in children: An individualized approach to a worldwide disease,” Current Treatment Options in Pediatrics, vol. 11, p. 13, 2025, doi: 10.1007/s40746-025-00328-6. DOI: https://doi.org/10.1007/s40746-025-00328-6

38. D. A. Almashhadany, L. Q. Ismael, and A. M. Zaki, “Seroprevalence of Helicobacter pylori among humans at Erbil Governorate, Kurdistan Region, Iraq,” Research Journal of Life Sciences, Bioinformatics, Pharmaceutical and Chemical Sciences (RJLBPCS), vol. 4, no. 2, p. 268, 2018, doi: 10.26479/2018.0402.20. DOI: https://doi.org/10.26479/2018.0402.20

39. D. A. Almashhadany and S. M. Mayass, “Prevalence of Helicobacter pylori in humans in Dhamar Governorate, Yemen,” Journal of Medical and Pharmaceutical Sciences, vol. 2, no. 1, Mar. 2018, doi: 10.26389/AJSRP.S101217. DOI: https://doi.org/10.26389/AJSRP.S101217

40. D. A. Almashhadany, “Application of stool antigen test for monitoring Helicobacter pylori among humans in Erbil Governorate, Kurdistan Region, Iraq,” International Journal of Pharmacy and Pharmaceutical Sciences, vol. 10, pp. 49–53, 2018, doi: 10.22159/ijpps.2018v10i11.28872. DOI: https://doi.org/10.22159/ijpps.2018v10i11.28872

41. S. J. V. Veen, E. I. Levy, K. Huysentruyt, and Y. Vandenplas, “Clinical dilemmas for the diagnosis and treatment of Helicobacter pylori infection in children: From guideline to practice,” Pediatric Gastroenterology, Hepatology & Nutrition, vol. 27, no. 5, pp. 267–273, Sep. 2024, doi: 10.5223/pghn.2024.27.5.267. DOI: https://doi.org/10.5223/pghn.2024.27.5.267

42. D. Majumdar and S. Looi, “Helicobacter pylori infection and peptic ulcers,” Medicine, vol. 52, no. 3, pp. 152–160, Mar. 2024, doi: 10.1016/j.mpmed.2023.12.006. DOI: https://doi.org/10.1016/j.mpmed.2023.12.006

43. S. H. Muhi, F. B. Abed, N. H. Bedair, S. R. Jaafar, S. M. Ibrahim, D. A. Mohammed, O. A. Mahmoud, R. H. Ali, M. A. Hameed, and L. M. Edan, “Review on Helicobacter pylori associated diseases,” Baghdad Journal of Biochemistry and Applied Biological Sciences, vol. 5, no. 3, pp. 134–143, 2024, doi: bjbabs.v5i3.307. DOI: https://doi.org/10.47419/bjbabs.v5i3.307

44. A. Astúa, M. C. Estevez, M. J. Ramírez-Lázaro, X. Calvet, S. Lario, and L. M. Lechuga, “Identification and ultrasensitive quantification of H. pylori infections on gastric and stool human samples with a photonic label-free nanobiosensor,” Biosensors and Bioelectronics, vol. 281, p. 117459, Aug. 2025, doi: 10.1016/j.bios.2025.117459. DOI: https://doi.org/10.1016/j.bios.2025.117459

45. K. Namakin and F. B. Nejad, “Prevalence of Helicobacter pylori infection in asymptomatic children in Birjand, Eastern Iran,” Journal of Pediatric Perspectives, vol. 2, no. 4.2, pp. 55–63, 2014, doi: 10.22038/ijp.2014.3438.

46. A. M. Telmesani, “Helicobacter pylori: prevalence and relationship with abdominal pain in school children in Makkah City, western Saudi Arabia,” Saudi Journal of Gastroenterology, vol. 15, no. 2, pp. 100–103, Apr. 2009, doi: 10.4103/1319-3767.45359. DOI: https://doi.org/10.4103/1319-3767.45359

47. A. Elmas and M. Akçam, “Trend of Helicobacter pylori infection in childhood: A single-center experience,” Turkish Archives of Pediatrics, Mar. 2024, doi: 10.5152/TurkArchPediatr.2024.23312. DOI: https://doi.org/10.5152/TurkArchPediatr.2024.23312

48. H. W. Moon, S. Y. Lee, M. Hur, and Y. M. Yun, “Characteristics of Helicobacter pylori-seropositive subjects according to the stool antigen test findings: a prospective study,” Korean Journal of Internal Medicine, vol. 33, no. 5, pp. 893–901, Sep. 2018, doi: 10.3904/kjim.2016.353. DOI: https://doi.org/10.3904/kjim.2016.353

49. M. El-Shabrawi, N. A. El-Aziz, T. Z. El-Adly, F. Hassanin, A. Eskander, M. Abou-Zekri, H. Mansour, and S. Meshaal, “Stool antigen detection versus 13C-urea breath test for non-invasive diagnosis of pediatric Helicobacter pylori infection in a limited resource setting,” Archives of Medical Science, vol. 14, no. 1, pp. 69–73, Jan. 2018, doi: 10.5114/aoms.2016.61031. DOI: https://doi.org/10.5114/aoms.2016.61031

50. Y. Qiao, Y. Zhou, L. Zhao, S. Yang, X. Zhang, and S. Liu, “Sex differences in Helicobacter pylori infection and recurrence rate among 81,754 Chinese adults: a cross-sectional study,” BMC Gastroenterology, vol. 24, p. 305, 2024, doi: 10.1186/s12876-024-03404-7. DOI: https://doi.org/10.1186/s12876-024-03404-7

51. S. Al-Sinani, S. W. Sharef, K. Al-Naamani, and H. Al-Sharji, “Helicobacter pylori infection in Omani children,” Helicobacter, vol. 19, no. 4, pp. 306–311, Aug. 2014, doi: 10.1111/hel.12134. DOI: https://doi.org/10.1111/hel.12134

52. Y. A. Awuku, D. L. Simpong, I. K. Alhassan, D. A. Tuoyire, T. Afaa, and P. Adu, “Prevalence of Helicobacter pylori infection among children living in a rural setting in Sub-Saharan Africa,” BMC Public Health, vol. 17, p. 360, Apr. 2017, doi: 10.1186/s12889-017-4274-z. DOI: https://doi.org/10.1186/s12889-017-4274-z

Published

2025-10-15

How to Cite

1.
Almashhadany DA, Al-bader SM, Bradosty SW. Significance of Stool Antigen Testing for Helicobacter pylori Detection in Humans. Cihan U Erbil SCI J [Internet]. 2025 Oct. 15 [cited 2026 Jun. 23];9(2):68-73. Available from: https://journals.cihanuniversity.edu.iq/index.php/cuesj/article/view/1601

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