Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2020; 26(10): 995-1004
Published online Mar 14, 2020. doi: 10.3748/wjg.v26.i10.995
Global whole family based-Helicobacter pylori eradication strategy to prevent its related diseases and gastric cancer
Song-Ze Ding
Song-Ze Ding, Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, and Henan University School of Medicine, Zhengzhou 450003, Henan Province, China
Author contributions: Ding SZ designed the overall concept and outline of the manuscript; completed the writing, editing the manuscript, illustrations, and review of literature.
Supported by grants to SZD from Henan Provincial Government-Science and Technology Bureau, No. 142300410050; Henan Provincial Government-Health and Family Planning Commission, No. 20170123; Henan Provincial Innovative Talents Projects of 2016 and 2017; National Natural Science Foundation of China, No. U1604174.
Conflict-of-interest statement: The author declares no conflicts of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Song-Ze Ding, MD, PhD, Chief Doctor, Full Professor, Department of Gastroenterology and Hepatology, Henan Provincial People’s Hospital, Zhengzhou University, No. 7 Wei Wu Road, Jin Shui District, Zhengzhou 450003, Henan Province, China. dingsongze@hotmail.com
Received: November 14, 2019
Peer-review started: November 14, 2019
First decision: December 4, 2019
Revised: December 14, 2019
Accepted: February 12, 2020
Article in press: February 12, 2020
Published online: March 14, 2020

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.