Population screening program decreases H. pylori seroprevalence rates
MedWire News: Study findings show that a significant decline in Helicobacter pylori seroprevalence rates can be achieved with a voluntary “screen-treat-retest-and-retreat” program for young adults in the general population.
“Although the low prevalence of H. pylori infection may limit the cost efficiency of the program, the intervention is expected to reduce the burden of H. pylori-associated diseases,” say Anniina Salomaa–Räsänen (University of Helsinki, Finland) and co-authors.
For the program, individuals randomly selected from the general population in Vammala, Finland, were invited by mail to the local health center for a blood test. All samples were screened for H. pylori using serology, and those who tested positive were treated (for 2 weeks in the initial pilot study and 1 week in the others) and the cure was verified by serology. If required, patients were given optional salvage treatment.
The program was first tested as a pilot study among 594 inhabitants aged 15-75 years during 1994, and then again in 1996 (3326 individuals aged 15-40 years) and 1997-2000 (716 individuals aged 15 years and 584 aged 45 years).
Eradication rates were 93.8%, 82.2%, and 77.6% in participants enrolled in the 1994, 1996, and 1997-2000 studies, respectively.
Results of the 1994 pilot study showed that seroprevalence rates significantly increased with age (5-year age groups), from 4.5% in 15-year olds to 73.7% in those aged 75 years. Similar disparities in seroprevalence were seen in the 1996 study and in the 1997-2000 study, where rates were significantly higher among those aged 45 years compared with individuals aged 15 years (27.4% vs 3.2%).
The team observed that H. pylori seroprevalence rates decreased between 1994 and 2000, decreasing from 36% to 14% in the pilot study, from 12% to 4% in the 1996 study, and from 3% to 2% and 12% to 4% among participants aged 15 and 45 years, respectively, who took part in the 1997-2000 study.
Salomaa–Räsänen and colleagues also found that H. pylori infection was independently associated with crowded households during childhood, low maternal education, current smoking and alcohol consumption, unfavorable housing conditions, and sick leave due to dyspepsia.
“It will be seen in the future how much our intervention has affected the incidence and health costs of dyspepsia, peptic ulcer disease, and gastric cancer,” write the authors in the journal Helicobacter.
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By Ingrid Grasmo