Comparing the Cost-Effectiveness of the Carbon-Urea Breath Test and Histology for the Detection of Helicobacter pylori.

Fawzia Peer


Approximately 4000 patients are diagnosed annually with Helicobacter pylori (H pylori) infection at King Edward VIII Hospital, KwaZulu-Natal, South Africa. The current method employed for the detection of H pylori is the histological analysis of a biopsy specimen taken at endoscopy.

Recently, in South Africa, health budgets devolved from central to provincial governments making each institution responsible for its own budget. This required some changes in strategy in order to find a more cost-effective means of diagnosis without compromising service delivery.

This study was undertaken to evaluate and compare the Carbon-14 Urea Breath Test (14C-UBT) with histology for the detection of H pylori in terms of cost-effectiveness. Fifty-two patients, aged between 18-80 years, clinically diagnosed with gastritis and referred for endoscopy were studied. Each patient was assessed by endoscopy with biopsy for histology and a 14C-UBT.

The sensitivity and specificity of the 14C-UBT were determined so as to ensure reliability of the 14C-UBT when compared to histology for the detection of H pylori. The sensitivity of the 14C-UBT was calculated to be 82% and the specificity 70%.

The provincial public sector cost of the 14C-UBT was calculated to be R135,42 and of the histology inclusive of a biopsy taken on endoscopy was R308,33. The findings of this study clearly indicate that the 14C-UBT provide a more cost-effective option as compared to histology for the detection of H pylori infection.


Radiography education; research; H pylori infection

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The South African Radiographer | ISSN 0258 0241

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