Project HelIcobacter pylori
PROBLEM
In most African countries, 90% of the adult population risk to be infected with this bacteria. Infected individuals usually carry the infection indefinitely, unless they are treated with medications to eradicate the bacterium. One out of every six patients with H. Pylori infection will develop ulcers of the duodenum or stomach. From every 100.000 inhabitants at least 15.000 of them will develop ulcers.
This is becoming a major problem, because the costs of treating ulcers is so high, that only a few patients can afford to pay for the treatment and be helped. Accurate and simple tests for the detection of H. Pylori infection are available. They include one step H. Pylori-Saliva-Urease (HPU) tests. With the use of this test, it has become easy to test patients whether or not they are infected with this bacteria. If tested positive for this bacteria, the patient receives an eradication, with as result the disappearance of this bacteria. Once the bacteria has disappeared, it will not come back. For diagnosing and treating the patient the costs will not be in excess of € 60,-.
SOLUTION
The first step is a H. Pylori-Saliva-Urease (HPU) test. A simple immuno-chromatographic assay for rapid, qualitative detection of Urease and a possible H. Pylori infection, via endoscope biopsy or saliva.
Physicians currently diagnose H. Pylori infections with endoscopy, blood tests and breath tests. Endoscopy, the gold standard is invasive, expensive and can miss H. Pylori infections if a biopsy sample from one part of the stomach does not contain the bacteria. Blood tests detect antibodies to H. Pylori, but these antibodies can persist for up to a year after the bacteria are eradicated, making it impossible for physicians using blood tests to quickly determine if a patient’s treatment succeeded. Breath tests capitalize on the fact that H. Pylori contains abundant Urease and can rapidly metabolized urea, releasing CO2 and NH3. To perform the test, physicians have their patient swallow a capsule full of urea labeled with the radioactive isotope C14 or non radioactive C13. If the patient has a H. Pylori infection, the bacteria will metabolize the urea and soon the patient’s expired CO2 will have a higher than normal concentration of the (non) radioactive carbon isotope. To collect the labeled CO2, the patient breathes into a mylar balloon. The laboratory can quantitate the number of C14 counts with a liquid scintillation counter. Breath tests have their disadvantages in that the equipment is very expensive and not available in some locations. (The costs of an breath analyzer are approximately € 30.000,- in comparison to the costs of a single Urea breath test being € 20,-) For this reason we suggest to start a project in which we use the one step H. Pylori-Saliva-Urease (HPU) test. Followed by an confirmation on a centrally located breath analyzer.
Advantages of using this type of test:
1. Quick and Painless
2. Non-invasive
3. Minimal inconvenience for the patient
4. No bio-hazardous component
5. Low cost solution
Project
This is a new method intended to be used in Africa. We plan to start in a hospital or AMCU. Later we plan to expand to other hospitals, clinics and AMCU’s.
We will be giving several workshops during one week, and explain the pilot. For this workshop we will invite:
- physicians interested to use this method
- educate and train medical personnel that is going to perform the tests
Workshops will be given by medical experts with regard to detection and treatment of H. Pylori infections. After the workshop of a week the invited physicians and medical personnel will be trained on how to use the one step H. Pylori Saliva (HPU) test, for diagnosing the possible presence of Helicobacter Pylori in the stomach and the way it can be treated. They will be made aware of the importance of testing to find out the possible existence of H. Pylori and the way in which the H. Pylori infection can be treated..