Global whole family based-Helicobacter pylori eradication strategy to prevent its related diseases and gastric cancer

Abstract

Helicobacter pylori (H. pylori) infects approximately 50% of the world population. The multiple gastrointestinal and extra-gastrointestinal diseases caused by H. pylori infection pose a major healthcare threat to families and societies; it is also a heavy economic and healthcare burden for countries that having high infection rates. Eradication of H. pylori is recommended for all infected individuals. Traditionally, “test and treat” and "screen and treat" strategies are available for various infected populations. However, clinical practice has noticed that these strategies have some shortfalls and may need refinement, mostly due to the fact that they are not easily manageable, and are affected by patient compliance, selection of treatment population and cost-benefit estimations. Furthermore, it is difficult to control infections from the source, therefore, development of additional, compensative strategies are encouraged to solve the above problems and facilitate bacteria eradication. H. pylori infection is a family-based disease, but few studies have been performed in a whole family-based approach to curb its intra-familial transmission and the development of related diseases. In this work, a third, novel whole family-based H. pylori eradication strategy is introduced. This approach screens, identifies, treats and follows up on all H. pylori-infected individuals in entire families to control H. pylori infection among family members, and reduce its long-term complications. This strategy is high-risk population-oriented, and able to reduce H. pylori spread among family members. It also has good patient-family compliance and, importantly, is practical for both high and low H. pylori-infected communities. Future efforts in these areas will be critical to initiate and establish healthcare policies and management strategies to reduce H. pylori-induced disease burden for society.

Keywords: Helicobacter pylori; Intra-familial infection; Gastrointestinal disease; Gastric cancer

Core tip: Helicobacter pylori (H. pylori) infection is an infectious and family-based disease. In additional to “test and treat” and "screen and treat" strategies, this work introduces a novel, “whole family-based H. pylori eradication strategy” to screen, identify, treat and follow up on all H. pylori-infected family members within a family unit. This “whole family- or household-based strategy” is high-risk population-oriented, and will be able to reduce H. pylori spreading among family members with good patient-family compliance. Importantly, this strategy is practical for both high and low H. pylori-infected communities.