Intrafamilial Transmission Research Articles

Intrafamilial Transmission of HTLV-1 and HTLV-2 in Indigenous Peoples of the Brazilian Amazon: Molecular Characterization and Phylogenetic Analysis

Intrafamilial Transmission of HTLV-1 and HTLV-2 in Indigenous Peoples of the Brazilian Amazon: Molecular Characterization and Phylogenetic Analysis

Life-Threatening Conditions in Children with Bocavirus Infection-Case Series and Mini Review of the Literature.

In this study, we present four cases of Human Bocavirus (HBoV) infection in children aged between 1 month and 4 years. Among these cases, two siblings were hospitalized with similar symptoms. Among the four pediatric cases of patients with HBoV infection, three were associated with acute respiratory failure and spontaneous pneumothorax, and two of these presented with subcutaneous emphysema. The presented patients were young children, aged between 1 month and 4 years, two of whom were siblings, suggesting a possible intrafamilial transmission of HBoV1 infection. These cases highlight the importance of considering HBoV as a differential diagnosis in pediatric patients with respiratory and gastrointestinal symptoms. Early recognition and appropriate medical care are important in treating HBoV infection in young children.

INTRA-FAMILIAL TRANSMISSION OF HEPATITIS B VIRUS IN ADEN -YEMEN

Hepatitis B virus (HBV) is a major challenge to public health worldwide. Close contacts between susceptible family members and the index cases who live with HBV infection increase the rate intra-familial transmission of HBV. So our study aimed to determine the prevalence of HBV infection among family members of confirmed positive HBV patients and to identify the intra and extra-familial risk factors contributing for transmission of HBV infection among those members. Analytical cross-sectional study was conducted on 100 family members who belong to the 14 index cases were included in this study, the average was 7.1(100/14) members. HBsAg in both index cases and family members was determined by using ELISA kit. Analysis of the data was performed by using SPSS (Version 21), the quantitative data were expressed as mean values, (SD) because the data was normal distributed. The qualitative data was expressed as percentages and χ2 test was used for comparison of two variables to determine the p- value where <0.05 was considered statistically significant. They were 50 (50 %) males with a total mean± SD of age were 25±15.9 years. The overall prevalence of HBV infection was 19 (19. 0%). The highest rates were 41.2% in age group 30—39 years, 22% males, 26.7% married, 19.4% among those family members who were in close contact with female index cases and 40% father relatives. A statistically significance association between HBV infection and age group 30—39 years (p=0.011). There were no positive cases was found among those members who were vaccinated against HBV and no significant association between HBV infection and either intra or extra risk factors among family members. It can be concluded that Intra-familial transmission of HBV infection was high among family member in Yemen. The highest prevalence was found in age group 30-39 years, males, married and among those family members who were in close contact with female index cases. The most frequent relatives with HBV infection were fathers, while a negative HBV cases was observed among mothers and wives and vaccinated members. There were no significant association between HBV infection and either intra or extra risk factors among family members.

Nasal Staphylococcus aureus Carriage and Antimicrobial Resistance Profiles Among Community-Dwelling Adults in Jiangsu, China.

Persistent nasal carriage has beenassociated with Staphylococcus aureus infection. Previous S.aureus studies in Asia have primarily focused on clinical patients, providing limited information on persistent nasal carriage among the general adult population. This study examined 143healthy adults in a community in Jiangsu, China. Nasal swab samples were collected 10 times. The colonization status was identified using SPA typing. We also determined antimicrobial susceptibility, genotype, and genomic characteristics of S.aureus. The prevalence ofS.aureusnasal carriage among the community individuals was on average 16.78%. The carriage rates of methicillin-resistant S.aureus and multidrug-resistant S.aureus were 6.29% and 7.69%, respectively. We identified 8.39% persistent carriers, 39.16% intermittent carriers, and 52.45% noncarriers. Furthermore, family members displayed concordance in terms of genotype and genomic characteristics. Persistent nasal sampling captured intermittent carriers that were missed during short-term sampling, thus highlighting the necessity for regular community testing. SPA typing can serve as a rapid method for determining S.aureus colonization. The potential for intrafamilial transmission of S.aureus is evident, with persistent carriers being the most probable source of infection.

Intra-Familial Cases of Hepatitis B Virus and Their Associated Risk Factors of Transmission in District Mardan, Khyber Pakhtunkhwa, Pakistan

Introduction: Hepatitis - B Virus is a prevalent viral hepatitis, with high morbidity, and mortality worldwide. It affects 2 billion people, especially those with limited healthcare access and low socioeconomic status. It causes liver problems which may be acute or chronic. HBV is transmitted from mother to fetus during pregnancy (vertical transmission) and also transmitted from infected individuals to others (horizontal transmission). In our society, the family living system is a joint system, many people live in a single house which results in the sharing of different personal items. So, there are high chances of intra-familial cases of HBV. This study aimed to find out the intra-familial cases of HBV infections and their associated risk factors of transmission within a family in District Mardan. Methodology: This was a descriptive cross-sectional study conducted in the Department of Pathology, Mardan Medical Complex, District Mardan, Khyber Pakhtunkhwa Pakistan. After ethical approval and informed consent from participants a total of 36 positive families of HBV were taken by using a non-probability convenience sampling method. Data was collected from positive individuals with the help of a pre-designed questionnaire. That data was analyzed through SPSS version 22. Results: Out of 36 families, 50% had no HBV-positive members, while 50% had positive individuals. There were 18 households (50%) with only one member positive for HBV, 12 families (33.3%) with two members, 4 families (11.1%) with three individuals, and 2 families (5.6%) with four members. There were three major risk factors present, which resulted in intra-family HBV transmission. There were 7 (19.4%) families where Vertical transmission was the main risk factor. 7 were (19.4%) due to the use of personal hygiene goods, whereas 4 families (11.1%) were due to unsafe sexual intercourse among couples (husband/wife). Conclusion: There was an equal chance of the hepatitis B virus to affect only one member of a family or have transmission to other members within a family. Multiple risk factors are involved in the transmission of HBV in a family but most of the cases were due to vertical transmission, use of personal hygienic items, and unsafe sexual intercourse between (couples)wife and husband in district Mardan, Pakistan. Key words: Hepatitis-B virus, Intra-familial, vertical transmission, Mardan, Risk factor

Silencing or silent transmission? An exploratory study on trauma communication in Kurdish refugee families.

Trauma communication in refugee families is increasingly recognized as an important relational dynamic influencing psychosocial well-being, yet studies exploring interactional dynamics and meaning making at play in intra-family trauma communication remain scarce. This article reports on a qualitative study with Kurdish refugee families including parents (N = 10) and children (N = 17) resettled in Belgium, aiming to explore practices on trauma communication within refugee family relationships. In a multiple-phased qualitative design, semi-structured family interviews and participant observation administered in the homes of the participant families are followed by parental interviews involving a tape-assisted recall procedure to investigate observed intergenerational trauma communication and parent-child interactions. Data analysis shows parents and children seldom explicitly talked about the families' lived experiences of trauma. This silence was especially related to parental wishes to avoid their children's future involvement in violence. However, findings also indicate how the intra-family transmission of memories of collective violence occurs in many subtle ways. Four modes of indirect trauma communication could be distinguished: (1) focusing on the repetition of violence in the present; (2) transmission of the collective trauma history; (3) family storytelling; and (4) interaction with meaningful objects of the past. These findings shed light onto the interwoven nature of personal-familial and collective trauma and loss and illuminate the meanings of silence and disclosure in the context of the Kurdish diaspora. In the final section, we discuss our findings and outline its clinical implications for family therapeutic practices in refugee trauma care.

Opportunistic screening using point-of-care testing leads to successful linkage to care of HBV-infected migrant populations in a low endemic country

Background and aimsIn low endemic countries, screening for hepatitis B surface antigen (HBsAg) in migrants is cost-effective in reducing the disease burden of hepatitis B virus (HBV) infections, but linkage to care (LTC) remains a challenge. This study aims to guide future screening initiatives, with 3 objectives: 1. to compare LTC between different ethnic groups screened for HBsAg with point-of-care testing (POCT) in an outreach setting; 2. to estimate the proportion of HBsAg seropositivity for ethnic minorities; and 3. to investigate the association between seropositivity and HBV risk factors. MethodsOpportunistic outreach screenings using finger prick HBsAg tests were performed at civic integration programmes between 11/2017 and 09/2022. If an individual tested positive, an appointment was given immediately at the outpatient hepatology clinic for follow-up and confirmation of HBsAg positivity in blood. Dedicated personnel contacted these individuals to motivate them for further LTC, which was defined as being assessed by a hepatologist, a blood test and an abdominal ultrasound. ResultsA total of 677 people from different ethnicities (Asian, Middle Eastern and African) were serologically screened using POCT. The observed positivity for HBsAg was 3.4 % (95% CI 2.17-5.05, 23/677). Apart from ethnicity and male sex, none of the surveyed HBV risk factors were associated with HBsAg seropositivity. All HBsAg positive individuals were linked to care and assessed by a hepatologist, despite the COVID-19 pandemic increase in time to follow-up of 82 days (95% CI 51–112 days) vs. 24 days (95% CI 5–43 days, p = 0.008)).Among HBV-infected patients, 31.8% (7/22), 100 % (22/22) and 26.1% (6/23) met the criteria for treatment indication, intrafamilial transmission risk and need for hepatocellular carcinoma surveillance, respectively. ConclusionThe proportion of HBsAg seropositivity in ethnic minorities was 3.4%. POCT and commitment of dedicated personnel can overcome previously identified barriers resulting in a 100% LTC.

High Ratio of Human T Cell Lymphotropic Virus Transmission and Prevalence of Human T Cell Lymphotropic Virus Type 1-Associated Diseases in Brazilian Family Groups Followed Up by the GIPH Cohort.

A silent spread of human T cell lymphotropic virus type 1 (HTLV-1) has been occurring for thousands of years, with a high prevalence in some regions due to the sexual and vertical transmission and formation of family clusters. The time from HTLV-1 infection until the onset of virus-associated diseases is extremely long, approximately one to three decades. In this study, we evaluated intrafamilial HTLV-1 transmission and associated diseases in 1,204 individuals enrolled and followed up by the GIPH cohort between 1997 and 2017. The family groups (n = 43) were composed of 279 individuals who were tested for HTLV-1/human T cell lymphotropic virus type 2 (HTLV-2) and were classified as two groups according to the index case: blood donor (blood donors referred to the GIPH cohort) and nondonor (individuals referred to the GIPH cohort by other health services). The observed rates of HTLV-1 transmission and associated diseases among the relatives were high. Of 236 family members and sexual partners tested for HTLV, 104 (44.1%) were confirmed as having HTLV infection, with 36.7% of relatives whose index case was blood donors and 56.9% of relatives with nondonor index cases. At least one case of HTLV-1-associated myelopathy was observed in 42.9% of the families with intrafamilial transmission of HTLV-1. Brazil is an endemic area for HTLV-1/2 and has implemented mandatory universal screening of blood donors for HTLV-1/2 since 1993. However, the lack of public health services offer diagnosis for HTLV to the general population and pregnant women in the country makes it difficult to identify infected people, and contributes to the silent spread of the virus.

Intra-family transmission of large family values

The article reveals the specifics of transmitting the norms of large families from generation to generation. Based on empirical data, it was possible to assess the degree of influence of the experience of the parent families of survey participants and their spouses, as well as the actual number of children of respondents on the number of children they advise their children to have. An analysis of the structure of parental families showed that the majority of respondents’ families are hereditarily small, and every fourth refuses to continue the tradition of large families in their own reproductive family. A comparative analysis of the desired and actual number of children in the families of respondents showed that the existing need for children is realized on average by only two-thirds. In connection with this, even full acceptance of the norm of children transmitted by parents will be insufficient to achieve the level of simple reproduction of the population. This justifies the need to implement targeted, scientifically based measures to support families with children, which reduce the influence of negative factors that prevent the birth of more children, and increase the importance of the opposite ones, which contribute to having a larger number of children.

Role of Extended Family for Intrafamilial Transmission of Helicobacter pylori Infection in Bulgarian Children

Helicobacter pylori infection is one of the most common chronic bacterial infections worldwide. The infection is usually acquired during the first years of childhood and transmission from infected mother is considered an important epidemiological factor. The aim of this study was to assess the H. pylori positivity in Bulgarian symptomatic children in association with the presence or absence of family anamnesis of gastroduodenal diseases among their parents, siblings and grandparents. H. pylori infection was evaluated in 362 children in two groups: 181 children with family anamnesis of gastroduodenal diseases and 181 children without family anamnesis. All patients underwent esophagogastroduodenoscopy and gastric biopsy samples for microbiological examination for H. pylori were taken. H. pylori infection among children with family history of gastroduodenal diseases was significantly more frequent (69.1%) compared with the group of patients without a family anamnesis (21.0%, p <0.0001). In addition to the significance of the infected parents (69.4%) and siblings (52.0%), infected grandparents were also associated with high prevalence of the infection (77.8%, 21/27 cases) in the children. In conclusion, H. pylori infection among children with family history of gastroduodenal disease was 3.3-fold higher than that in the group without family anamnesis. The significance of the grandparents in the extended family households should be considered.

Genetic typing and intrafamilial transmission of human T-lymphotropic virus type 1 in non-endemic areas of China.

The origin and intrafamilial transmission of Human T-Lymphotropic Virus Type 1 (HTLV-1) in non-endemic populations such as China is still unknown. In this study, donors from blood banks/centers in China (including 28 provinces and Shenzhen city) during 2019 and 2021 were screened for HTLV-1/2 antibody, and all the reactive samples were tested using a line immunoassay (LIA) and quantitative polymerase chain reaction (qPCR). Samples that can be detected using qPCR were amplified and sequenced for the long terminal repeat (LTR) region. The positive donors were contacted to identify their relatives. As a result, 4,451,883 blood donors were totally tested, and 50 of them were confirmed to be HTLV-1/2 positive. Viral LTR sequences genotyped from 26 HTLV-1 carriers demonstrated that all had the HTLV-1a genotype, of which Transcontinental and Japanese subgroups accounted for half each. There were 17 family members of 11 index donors detected, and the HTLV-1 infection rate in the spouses of male index donors (83.3%, 5/6) was significantly higher than that in the husbands of female index donors (0.0%, 0/4). However, 7 children of HTLV-1 positive women were tested and found negative. Therefore, our findings indicated that HTLV-1 is spreading silently from high-endemic to low-endemic areas in China. To prevent further HTLV-1/2 transmission, an efficient HTLV-1/2 screening strategy and counseling of the virus carriers are essential.

A household survey of intrafamily norovirus transmission.

Norovirus (NoV) is a leading cause of epidemic and sporadic gastroenteritis in people of all ages. Humans are the primary source of NoV and household contact is one of the risk factors for NoV transmission. However, the mechanisms underlying person-to-person NoV transmission are poorly understood. Here we conducted a survey to profile the frequency and characteristics of intrafamily NoV transmission. Stool samples were collected every week from three households between 2016 and 2020; the total number of samples was 1105. The detection of NoV and the genotyping were performed by reverse transcription-polymerase chain reaction targeting the capsid region and direct sequencing methods. NoV was detected in 3.4% of all samples. Eight NoV genotypes were identified. The most common genotype was GII.17, followed in order by GII.6, GI.6, GII.4, GI.3, and GI.2/GI.8/GI.9. Most NoV-positive samples were obtained from asymptomatic individuals. The highest number of NoV transmissions was found in household 3 (6 infections), followed by household 2 (2 infections), while household 1 had no NoV transmission, suggesting that asymptomatic NoV carriers play a major role in infection as NoV reservoirs in the households. Further clarification of the mode of infection will contribute to improved understanding and an appropriate prevention.

Epidemiological and molecular evidence of intrafamilial transmission through sexual and vertical routes in Bahia, the state with the highest prevalence of HTLV-1 in Brazil.

Familial clustering of HTLV-1 and related diseases has been reported in Brazil. However, intrafamilial transmission of HTLV-1 based on molecular analysis has been studied only in a few communities of Japanese immigrants and African-Brazilians. To investigate the familial clustering of HTLV-1 infection and to determine the likely routes of transmission through epidemiological and genetic analyzes. Medical records of 1,759 HTLV-1+ patients from de the Center for HTLV in Salvador, Brazil, were evaluated to identify first-degree relatives previously tested for HTLV-1. Familial clustering was assumed if more than one member of the same family was HTLV-1+. LTR regions of HTLV-1 sequences were analyzed for the presence of intrafamilial polymorphisms. Family pedigrees were constructed and analyzed to infer the likely transmission routes of HTLV-1. In 154 patients at least one other family member had tested positive for HTLV-1 (a total of 182 first-degree relatives). Of the 91 couples (182 individuals), 51.6% were breastfed, and 67.4% reported never using a condom. Of the 42 mother-child pairs, 23.8% had a child aged 13 years or younger; all mothers reported breastfeeding their babies. Pedigrees of families with 4 or more members suggests that vertical transmission is a likely mode of transmission in three families. Three families may have had both vertical and sexual transmission routes for HTLV-1. The genetic signatures of the LTR region of 8 families revealed 3 families with evidence of vertical transmission, another 3 families (spouses) with sexual transmission, and one family with both transmission routes. HTLV-1 sequences belonged to Cosmopolitan subtype HTLV-1a Transcontinental subgroup A. Sexual and vertical transmission routes contribute to the intrafamilial spread of HTLV-1 in the state of Bahia.

Does the Misuse of Oral Hygiene Facilitate the Spread of COVID-19 Among Cohabiting Individuals? A Cross-sectional Study

Background: Despite all the available guidelines for coronavirus disease 2019 (COVID-19), less emphasis has been placed on oral care to reduce the viral load in the mouth and saliva. Objectives: This study aimed to investigate oral hygiene habits and infection control behaviors and their relationship with household transmission rates in patients with COVID-19. Methods: In this analytical cross-sectional study, 179 patients with COVID-19 were investigated through continuous sampling in 2021 - 2022. The data collection tool was a 3-section questionnaire, including (1) social and clinical information about the individual infected with COVID-19, preliminary information about family members and transfer to another person in the family, (2) oral hygiene habits during quarantine, and (3) infection control behaviors. The collected data were analyzed using independent t-test, ANOVA, Spearman's correlation, and chi-square test in SPSS version 24. Results: The rate of household disease transmission was 61.5%. There was no significant relationship between oral hygiene habits and the household transmission of COVID-19 (P = 0.108); however, the use of a shared toothbrush container and a toothpaste tube among family members was significantly related to the rate of household transmission (P = 0.042 and P > 0.001, respectively). Conclusions: No relationship was found between oral hygiene habits and the intra-familial transmission of COVID-19; however, oral hygiene habits were influential in contracting a more severe type of disease and hospitalization rate. Using shared toothbrush containers and toothpaste tubes by the family members increased the probability of household transmission of COVID-19.

Exploring risk factors and transmission dynamics of Hepatitis B infection among Indian families: Implications and perspective

IntroductionHepatitis B virus (HBV) is global health problem. Family members of HBV infected people are considered as high-risk groups due to frequent household transmission of HBV among contacts of HBsAg carriers. The present study aimed to investigate the intrafamilial transmission of HBV among family members of HBV-infected persons and to identify the risk factors for viral transmission in these setting. Methods361 index cases and their 1083 family contacts were tested for markers of Hepatitis B, viz. HBsAg and HBcAb using commercial ELISA. The demographic details and risk factors for acquiring HBV infection among the family members were recorded using a structured questionnaire. ResultsThe median (IQR) age of index cases and family members was 37 (27 − 48) and 26 (14 − 38) years, respectively. Among the screened family members, 9.23% (n = 100) members were positive for HBsAg and 32.75% (n = 355) were positive for HBcAb. At least one member of the family was affected in 229/361 (63.43%) index cases. Significantly lower percent of household contacts (9.23%, n = 100)were vaccinated against HBV.HBV transmission risk was significantly higher in families with more than four members(p < 0.0001). Multinomial logistics regression analysis for familial risk factors for transmission of HBV such asclose contact with carrier (aOR overt: 1.172, aOR occult: 1.173), sharing of bed/bedding (aOR overt: 1.258, aOR occult:1.264), personal hygiene items (aOR overt:1.260, aOR occult: 1.451), and eating in common utensils (aOR overt: 2.182, aOR occult: 1.307)were significantly associated with the transmission of HBV (p < 0.05). DiscussionClose contact with carrier, sharing of bed/bedding or personal hygiene items and eating in common utensils were significantly associated with the transmission of HBV. Increasing awareness about Hepatitis B infection and vaccination of family members in close contact with carrier is essential to prevent Hepatitis B transmission.

Intrafamilial transmission risk factors and preventive measures followed by household contacts of hepatitis C patients

Background Hepatitis C virus (HCV) infection is the most challenging public health problem in Egypt where the prevalence is the highest in the world. Intrafamilial transmission of hepatitis C occurring between patients infected with HCV and their household members sharing the same house and living conditions. Preventive measures of hepatitis C are considered the first line of defense against HCV infection. Aim assess the intrafamilial transmission risk factors and preventive measures followed by household contacts of hepatitis C patients. Design A descriptive cross sectional research design was utilized. Setting The study was conducted at outpatient clinics of Liver Institute at Kafer-Elsheikh Governorate. Sample A simple random sample of 365 household contacts of hepatitis C patients was recruited for the current study. Tool Data was collected through one tool: A structured Interviewing Questionnaire for household contacts of hepatitis C patients which included three parts; part I-(a) Demographic data, (b) Medical history of household contacts, Part II (a) Household contacts knowledge about HCV (b) Hepatitis C risk factors, Part III: Preventive measures followed by household contact of hepatitis C patient: This part is self-reported practices. Results The study revealed that;56.7% of household contacts were males, 72.1% of them were living in rural areas, 75.60% were married, with a mean age ±SD 36.73±9.18 years old.44.1% obtained secondary education, 30.7% were employees, among this group hypertension and diabetes were the main chronic illness. 49.90% had moderate level of general knowledge about HCV infection, 71.50% had low level of knowledge about hepatitis C risk factors and 90.00% had a low level of preventive measures (self-reported practices) regarding HCV. There was no correlation between household contacts knowledge about HCV risk factors and their preventive measures(r=0.031 and P=0.549). Conclusion Almost half of household contacts mentioned that they knew intrafamilial risk factors while about half of this group have a misconception about intrafamilial risk factors, while majority of them stated that they knew sharing scissors and clippers as the main intrafamilial risk factors and less than one-fourth of them knew direct contact with infected blood and sharing of special equitoothbrushesth brushes. Household contacts applied some preventive measures such as; Cover the wound with a piece of cloth or gauze, disinfect the site with alcohol or antiseptic solution and frequent and proper hand washing. Recommendations Routine health assessment of household contacts knowledge regarding intrafamilial risk factors and preventive measures therefore health education sessions should be conducted to raise their awareness regarding HCV infection and further research should be conducted on larger samples of contacts.

Familial Monkeypox Virus Infection Involving 2 Young Children

We report intrafamilial transmission of monkeypox virus to all members of a family (father, mother, and 2 children). Case reports in young children have been extremely rare during the 2022 mpox outbreak. Their clinical signs were mild, and clinical diagnosis would be difficult without knowledge of the father's monkeypox virus infection.

Intense intrafamilial transmission of HBV in a rural area in Egypt is a probable cause of non-response to vaccination: A cross-sectional-seroprevalence-community-study.

Intense intrafamilial transmission of HBV in a rural area in Egypt is a probable cause of non-response to vaccination: A cross-sectional-seroprevalence-community-study.

Intra-Familial Transmission Patterns of COVID-19 Infection among the Rural Residents of Ahmedabad, Gujarat, during an Epidemic of SARS-CoV-2 in India.

We are yet to completely understand the transmission dynamics of coronavirus disease 2019 (COVID-19), a highly infectious disease, and research exploring the same is currently lacking. Hence, a community-based cross-sectional study was conducted to assess the intra-familial transmission pattern of COVID-19 among the rural residents of Ahmedabad, Gujarat, in relation to possible determinants, with a special focus on the viral load as an important factor. This cross-sectional study included visiting 195 families. We interviewed families with at least one case of COVID-19 infection. We recorded information about sociodemographic profiles and secondary transmission of cases. Out of the 195 families, 114 confirmed having at least one infected case within the family. Approximately 38.6% (44/114) of the index cases were asymptomatic, which was much higher than the low viral load index cases. Index cases with high, moderate, and low viral loads had transmitted the infection with an average of 3.3, 1.5, 0.4 secondary cases per index case, respectively. Approximately one-third of the COVID-19 cases were asymptomatic, and the affected individuals were capable of transmitting the disease within families. Moreover, index cases with a higher viral load had a higher transmission potential to generate more secondary cases, as compared to those with a low viral load.

Low compliance to post-screening recommendations in a family-based Helicobacter pylori screening and treatment program: A prospective cohort study.

Intra-family transmission is an important Helicobacter pylori (H.pylori) infection route. Family-based screening and treatment of H.pylori is a promising strategy. However, limited data are available on patient compliance with post-screening recommendations for such a strategy. A prospective cohort study of families from six regions in Shandong, China, from July 2021 to February 2022 was conducted. Demographic characteristics, prior testing, and treatment for H.pylori, prior gastroscopy, symptoms, and family history were collected. Infection status of participants was determined using the 13 C-urea breath test. Infected participants were recommended to undergo eradication treatment, confirmation testing, and gastroscopy per expert consensus. Participants were monitored for 6 months to record recommendation compliance in a real-world setting. Logistic regression models were used to analyze the factors influencing compliance with the recommendations. The study included 1173 individuals from 386 families with the overall infection rate of 36.7%. The recommendation compliance for eradication treatment, confirmation testing, and gastroscopy was 69.3% (271/391), 32.5% (88/271), and 6.1% (19/309), respectively. Factors that increased the risk of lower compliance were male sex (odds ratio [OR], 1.917, 95% confidence interval [CI], 1.233-2.981), and living in a non-urban area (OR, 1.954, 95% CI, 1.241-3.074), for treatment recommendations; having more than one infected family member (OR, 2.138, 95% CI, 1.237-3.698), and a lower family income (¥100,000-¥300,000 per year, OR, 7.247, 95% CI, 1.788-29.363; or <¥100,000 per year, OR, 7.294, 95% CI, 1.832-29.042), for confirmation testing recommendations; and being asymptomatic (OR, 3.009, 95% CI, 1.105-8.196), for gastroscopy recommendations. Post-screening recommendation compliance for this family-based H. pylori screening and treatment program was unsatisfactory. Further studies focusing on pre-screening education are warranted to improve compliance.