Review for 10.1186/1471-230X-10-114 (2010)

Reviewer's report
Title:Helicobacter pylori infection and gastroduodenal diseases in Vietnam : a
cross-sectional, hospital-based study
Version: 1Date:11 July 2010
Reviewer: Deniz Ertem
Reviewer's report:
TITLE: Helicobacter pylori infection and gastroduodenal diseases in Vietnam : a
cross-sectional, hospital-based study
The purpose of this population-based study was to investigate H.pylori
associated gastroduodenal disease in Vietnamese population. Patients were
recruited from two different cities where the age standardized incidence rate of
gastric cancer was different. Hence, the authors tried to analyze the reason of
this discrepancy in the rate of gastric cancer and the contribution of the virulence
factors of H.pylori to this discrepancy.
Overall, this is a well written and informative manuscript; there are some points
which need clarification
Major Compulsory Revisions:
1. In methods section, determination of H.pylori infection status ------ it has been
stated that to increase the diagnostic accuracy five different diagnostic methods
were combined. Since these diagnostic tests have different sensitivity and
specificity, accepting at least one positive test (i.e. a positive ELISA test
confirmed the H.pylori infection in this study) for the definition of H.pylori might be
misleading. A positive serum or urine test for H.pylori can not be equalized to a
positive H.pylori culture or a positive histopathology. Hence it would be more
obvious if the authors give us the data regarding the results of different
diagnostic methods, used for the definition of H.pylori infection in this study.
2. The number of patients having PU was 38 in the study group (27 Hanoi, 11 Ho
Chi Minh). Since DU, compared to GU, is less closely related to gastric cancer, it
would better to give the number of patients having DU, GU and GDU in two
different cities in order to argue their hypothesis.
3. I wonder whether there was a difference between the two populations
regarding the presence of intestinal metaplasia.
4. The results explained within the text (result section, H.pylori-chronic gastritis)
regarding the antrum-corpus-pan gastritis may be given in a table and it would be
helpful to give the difference, (if there is any) between the two cities.
5. The result section, page 14, the last sentence “These results suggested that
H. pylori virulence factors might contribute to the difference in the prevalence of
PU between Hanoi and Ho Chi Minh.” is not a result sentence (it might be
transferred to discussion)
6. I wonder whether there was a difference between the patients having DU and
GU regarding the H.pylori virulence factors.
7. Discussion section (page 15, the first paragraph) ---- “H. pylori is probably a
very important cause of PU in Vietnam, as PU was observed in approximately
21% of infected patients, while it was virtually absent in non-infected subjects.
Given the high prevalence of H. pylori infection in Vietnam and the high risk of
PU among the infected population, H. pylori testing might be a good and
economic approach for screening out patients before referring them for
endoscopic examination, which is much more expensive and invasive.”
Which test could be used for H.pylori screening? This recommendation could not
be deduced from this study because this study was not designed to analyze the
sensitivity or specificity of diagnostic tests for H.pylori and H.pylori associated
PU.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.