Abstract

Objective Helicobacter pylori infection is a common chronic infection that is closely associated with gastric cancer, known to be decreasing worldwide. We set up an administrative project of screening examination for H. pylori infection in junior high school students in Akita prefecture in order to investigate the current prevalence of H. pylori infection in childhood in an area where the incidence of gastric cancer is particularly high. Subjects and methods All students in their second or third year of junior high school (13 to 15 year old) in two cities in Akita prefecture were recruited. First, urine-based enzyme-linked immunosorbent assay and/or stool antigen tests and/or serum antibody test for detection of H. pylori infection was performed. Then 13C-urea breath test (13C-UBT) was carried out in students who tested positive with one of three tests. Written informed consent was obtained from all participants and their parents. Results A total of 2715 students were included in the H. pylori screening study from April 2015 to March 2017. Of these, 2619 students (96.5%) agreed to participate and underwent a screening examination. We administered urine-based immunochromatography for all students (n=2,619), the stool antigen test for 677 students and serum antibody test for 830 students. Of these, 126 (4.7% 126/2619) tested positive by urine-based immunochromatography, 23 (3.3% 23/677) tested positive by stool antigen test, and 50 (6.0% 50/830) tested positive by serum antibody test. 163 students were positive in the three primary tests (urine-based immunochromatography positive and/or stool antigen enzyme-linked immunosorbent assay positive and/or serum antibody test positive). Finally, 138 (5.2% 138/2619) tested positive for H. pylori on 13C-UBT. Conclusions The current prevalence of H. pylori infection among students was low even in an area of Japan with a high incidence of gastric cancer.

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