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Recurrence of Helicobacter pylori Infection in Bolivian Children and Adults After a Population‐Based “Screen and Treat” Strategy
Author(s) -
Sivapalasingam Sumathi,
Rajasingham Anu,
Macy Jonathan T.,
Friedman Cindy R.,
Hoekstra Robert M.,
Ayers Tracy,
Gold Benjamin,
Quick Robert E.
Publication year - 2014
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12137
Subject(s) - medicine , helicobacter pylori , urea breath test , odds ratio , confidence interval , population , helicobacter pylori infection , pediatrics , environmental health
Background Strategies to prevent gastric cancer by decreasing H elicobacter pylori infections in high‐prevalence, low‐income countries could include a population‐based “screen and treat” eradication program. Methods We tested residents of two rural villages for H. pylori infection using urea breath test ( UBT ), treated infected persons using directly observed therapy ( DOT ), retested for cure, and retested after 1 year later for H. pylori infection. Findings We tested 1,065 (92%) of 1153 residents from two villages in rural Bolivia. Baseline H. pylori 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 H. pylori 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). Interpretation Children <10 years had high H. pylori recurrence rates following a population‐based screen and treat program; this H. pylori eradication strategy may not be feasible in high‐prevalence, low‐income settings.