Table 1.

Helicobacter pylori Noninvasive Tests and the Current Situation in Indonesia

Diagnostic test	Sensitivity14-16	Specificity14-16	Advantage	Disadvantage	Situation in Indonesia
UBT	95%	95%	High accuracy Detect current infection	Less reliable in patients with history of gastric resection or PPI consumption	13C-UBT and 14C-UBT remain restricted to 4 and 6 cities, respectively Expensive and uncovered by social insurance Ongoing validation
SAT	94%	92%	Inexpensive and not age dependent Novel monoclonal antibodies are not influenced by PPI ICA-based, does not require special equipment or experts	Inconsistent accuracy based on antigens Accuracy influenced by incubation time and stool condition	Most centers use ICA-based tests, but with low sensitivity Collecting stools is more difficult than collecting blood samples
Serology	90%	80%	Saves costs and reduces endoscopic workload	Less accurate in children Wide range of cutoff values Cannot distinguish between current and past infections Lower accuracy than ICA-based tests	Most widely used Validated for some kits
Urine test	93%	92%	Easy sampling method without special skills and tools Sampling cheaper than serum sampling	False negative results with low concentrations of IgG	Lower accuracy Requires more time to interpret Lack of availability

UBT, urea breath test; PPI, proton pump inhibitor; SAT, stool antigen test; ICA, immunochromatographic assay; IgG, immunoglobulin G.