Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan.
Department of Internal Medicine, Saiseikai Karatsu Hospital, 817 Motohata-machi, Karatsu-shi, 847-0852, Japan.
J Gastroenterol. 2019 Aug;54(8):699-707. doi: 10.1007/s00535-019-01559-9. Epub 2019 Feb 15.
To present the strategies and preliminary findings of the first 3 years after implementing a Helicobacter pylori screening and eradication program to prevent gastric cancer in Saga Prefecture.
A screening and treatment program to eradicate H. pylori from third-grade junior high students was started in Saga Prefecture in 2016, using local governmental grants. Screening was with urinary anti-H. pylori antibody tests, followed by H. pylori stool antigen tests for students who were antibody positive. Those positive on both tests underwent H. pylori eradication by triple therapy based on a potassium-competitive acid blocker.
From 2016 to 2018, the participation rate was 83.1% and the H. pylori infection rate was 3.1% (660/21,042). The participation rates were higher in 2017 (85.4%) and 2018 (85.9%) compared with 2016 (78.5%) (P < 0.0001), and the infection rate also decreased in a time-dependent manner (2016: 3.6%, 2017: 3.3%, 2018: 2.5%, P = 0.0001). In total, 501 students positive for H. pylori received eradication therapy (85.1% success) and adverse events occurred in 20 of these (4.0%). However, no serious complications occurred.
The H. pylori screening and eradication project for school students in Saga Prefecture has started successfully and we have seen both a steady increase in the participation rate and a steady decrease in the infection rate, without major safety concerns.
介绍在佐贺县实施幽门螺杆菌筛查和根除计划以预防胃癌的前 3 年的策略和初步结果。
2016 年，佐贺县利用地方政府拨款启动了一项针对三年级初中生的幽门螺杆菌筛查和治疗计划。筛查采用尿抗幽门螺杆菌抗体检测，对抗体阳性的学生进行幽门螺杆菌粪便抗原检测。对两项检测均阳性的学生采用基于钾竞争酸阻滞剂的三联疗法进行幽门螺杆菌根除。
2016 年至 2018 年，参与率为 83.1%，幽门螺杆菌感染率为 3.1%（21042 人中有 660 人）。与 2016 年（78.5%）相比，2017 年（85.4%）和 2018 年（85.9%）的参与率更高（P<0.0001），感染率也呈时间依赖性下降（2016 年：3.6%，2017 年：3.3%，2018 年：2.5%，P=0.0001）。共有 501 名幽门螺杆菌阳性的学生接受了根除治疗（成功率为 85.1%），其中 20 名发生不良反应（4.0%）。然而，没有发生严重的并发症。
佐贺县针对学生的幽门螺杆菌筛查和根除计划已成功启动，我们既看到了参与率的稳步上升，也看到了感染率的稳步下降，且没有重大安全问题。
