Système gastro-intestinal et digestif

Abstrait

Screening and Treatment for Helicobacter pylori Infection in Teenagers in Japan

Taiji Akamatsu, Hiroyuki Uehara , Takumaro Okamura , Yugo Iwaya, Tomoaki Suga

To elucidate the prevalence and effect of H. pylori infection in Japanese teenagers, we underwent an examination and treatment of it in one high school health screening between 2007 and 2015. The study subjects were students ages 16 to 17. Students who tested positive on this screening using urine-based rapid test kits (RUPIRAN®) examination visited Shinshu University Hospital and underwent esophagogastroduodenoscopy (EGD) and were taken biopsy samples to determine their H. pylori status using culture and histology. Cure of H. pylori infections was determined by urea breath test. For 9 years, 4,297 of 4,312 students (99.7%) received a screening examination for H. pylori infection. One hundred and sixty-two of 4,297 students (3.8%) were positive for H. pylori. Ninety-three of these 162 with H. pylori-positive students visited our hospital, and 91 underwent EGD and 78 (85.7%) were confirmed to be H. pylori infected. The most common endoscopic findings for H. pylori infection were nodular gastritis (80.8%) and closed-type atrophic gastritis (61.5%). A scar from duodenal ulcer was recognized in 6 of them (7.7%), and intestinal metaplasia was histologically present in two. All 78 students with H. pylori infection and their parents agreed to receive eradication therapy using regimens according to the susceptibility of H. pylori. Finally, all except 3 were successfully cured of H. pylori infection. Remaining 3 students have not yet been assessed the decision of H. pylori infection. If this procedure were to be introduced into nationwide health screening at Japanese high schools, we calculated that the cost of the prevention of a gastric cancer would be 495,958 yen (4,508.71dollars) for each person. The low rate of prevalence of H. pylori infection in present Japanese teenagers would make it possible to perform the screening examination and treatment for this infection in nationwide health screening of high school students in the way that is practical and feasible.