Recurrence of Helicobacter pylori Infection in Bolivian Children and Adults After a Population‐Based "Screen and Treat" Strategy. Issue 5 (16th May 2014)

• Record Type: Journal Article
• Authors: Sivapalasingam, Sumathi; Rajasingham, Anu; Macy, Jonathan T.; Friedman, Cindy R.; Hoekstra, Robert M.; Ayers, Tracy; Gold, Benjamin; Quick, Robert E.
• Is Part Of: Helicobacter. Volume 19:Issue 5(2014:Oct.)
• Page Start: 343
• Page End: 348
• Publication Date: 2014-05-16
• Subjects: Helicobacter -- Periodicals; Helicobacter infections -- Periodicals; Stomach -- Diseases -- Periodicals; 616.3301405
• DOI: 10.1111/hel.12137
• Languages: English
• ISSNs: 1083-4389

Abstract

<abstract abstract-type="main" id="hel12137-abs-0001"> <title>Abstract</title> <sec id="hel12137-sec-0001" sec-type="section"> <title>Background</title> <p>Strategies to prevent gastric cancer by decreasing <italic>Helicobacter pylori</italic> infections in high‐prevalence, low‐income countries could include a population‐based "screen and treat" eradication program.</p> </sec> <sec id="hel12137-sec-0002" sec-type="section"> <title>Methods</title> <p>We tested residents of two rural villages for <italic>H. pylori</italic> infection using urea breath test (UBT), treated infected persons using directly observed therapy (DOT), retested for cure, and retested after 1 year later for <italic>H. pylori</italic> infection.</p> </sec> <sec id="hel12137-sec-0003" sec-type="section"> <title>Findings</title> <p>We tested 1, 065 (92%) of 1153 residents from two villages in rural Bolivia. Baseline <italic>H. pylori</italic> prevalence was 80% (95% confidence interval [CI]: 78–84). Age‐specific cure rates were similar (≥92%) after DOT. Among those cured, 12% (95% CI: 8–15) had recurrent infection. Age‐specific annual <italic>H. pylori</italic> recurrence rates for combined villages were 20% (95% CI: 10–29) in persons <5 years, 20% (95% CI: 10–29) in 5–9 years, 8% (95% CI: 1–15) in 10–14 years, and 8% (95% CI: 4–12) in persons ≥15 years. Compared with the referent population, those ≥15 years, recurrent infections were significantly more likely in children <5 years (odds ratios [OR] 2.7, 95% CI: 1.2–5.8) and 5–9 years (OR 2.7, 95% CI: 1.4–5.1).</p> </sec> <sec id="hel12137-sec-0004" sec-type="section"> <title>Interpretation</title> <p>Children <10 years had high <italic>H. pylori</italic> recurrence rates following a population‐based screen and treat program; this <italic>H. pylori</italic> eradication strategy may not be feasible in high‐prevalence, low‐income settings.</p> </sec> </abstract>