Journal of the Formosan Medical Association = Taiwan yi zhi · 2026
Community-based Helicobacter pylori screening and empiric eradication in health promotion program participants aged 50-69 Years in Chiayi county, Taiwan.
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Ding Yuan-Jie, Wen Hsiu-Ping, Chen Wei-Ming, Tung Wei-Ling, Hsieh Yung-Yu, Chen Yi-Hsing, Chang Kao-Chi, Chao Wen-Hua, Cheng Hung-Hsia, Chang Te-Sheng
Аннотация
BACKGROUND: Taiwan has launched community-based Helicobacter pylori (H. pylori) screening programs in select areas. However, in many parts of Taiwan, the most effective treatment strategies remain unclear.
METHODS: In July 2023, H. pylori stool antigen (HpSA) screening for adults aged 50-69 years was added to the county-wide community-based health promotion program conducted by the Chiayi County Health Bureau. This single-center retrospective analysis included 531 HpSA-positive individuals who were evaluated at Chiayi Chang Gung Memorial Hospital between July 2023 and June 2024.
RESULTS: Among the 5749 screened adults aged 50-69 years in Chiayi County, HpSA positivity was 25.6% (95% CI, 24.5-26.7). Of 1470 HpSA-positive individuals identified through screening, 531 (36.1%) were evaluated at the study hospital. Of them, 458 (86.3%) underwent endoscopy, which identified gastric ulcers in 24.5%, duodenal ulcers in 17.0%, and both in 6.6%. Rapid urease test and histological assessment were performed in 316 and 158 patients, respectively, yielding a positivity rate of 87.0% and 86.7% respectively. Among the 441 patients with available follow-up data, eradication rates were 94.7% (216/228) for those receiving 14-day clarithromycin-based triple therapy and 93.1% (149/160) for those receiving pooled 7-14-day concomitant therapy (p = 0.508). Reverse hybrid therapy achieved a 100% eradication rate in 20 patients, without significant difference compared to triple therapy (p = 0.293).
CONCLUSION: Among screened adults aged 50-69 years in Chiayi County, HpSA positivity was approximately 25.6%. Fourteen-day triple therapy, 7-14-day concomitant therapy and reverse hybrid therapy all achieved high eradication rates.
METHODS: In July 2023, H. pylori stool antigen (HpSA) screening for adults aged 50-69 years was added to the county-wide community-based health promotion program conducted by the Chiayi County Health Bureau. This single-center retrospective analysis included 531 HpSA-positive individuals who were evaluated at Chiayi Chang Gung Memorial Hospital between July 2023 and June 2024.
RESULTS: Among the 5749 screened adults aged 50-69 years in Chiayi County, HpSA positivity was 25.6% (95% CI, 24.5-26.7). Of 1470 HpSA-positive individuals identified through screening, 531 (36.1%) were evaluated at the study hospital. Of them, 458 (86.3%) underwent endoscopy, which identified gastric ulcers in 24.5%, duodenal ulcers in 17.0%, and both in 6.6%. Rapid urease test and histological assessment were performed in 316 and 158 patients, respectively, yielding a positivity rate of 87.0% and 86.7% respectively. Among the 441 patients with available follow-up data, eradication rates were 94.7% (216/228) for those receiving 14-day clarithromycin-based triple therapy and 93.1% (149/160) for those receiving pooled 7-14-day concomitant therapy (p = 0.508). Reverse hybrid therapy achieved a 100% eradication rate in 20 patients, without significant difference compared to triple therapy (p = 0.293).
CONCLUSION: Among screened adults aged 50-69 years in Chiayi County, HpSA positivity was approximately 25.6%. Fourteen-day triple therapy, 7-14-day concomitant therapy and reverse hybrid therapy all achieved high eradication rates.