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Korean Journal of Preventive Medicine 2000;33(3): 285-298.
Community-based Helicobacter pylori Screening and its Effects on Eradication in Patients with Dyspepsia.
Seong Ho Kim, Dae Yong Hong, Pock Soo Kang, Seok Beom Kim, Kyeong Soo Lee, Sang Kyu Kim, Jeong Ill Suh, Mee Kyung Kim
1Department of Preventive Medicine, College of Medicine, Gyeongsang National University.
2Department of Preventive Medicine and Public Health, College of Medicine, Yeungnam University.
3Department of Internal Medicine, College of Medicine, Dongguk University.
4Kyongju Health Center.
ABSTRACT
CONCLUSIONS: To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. METHODS: A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. RESULTS: Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.7%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). CONCLUSIONS: When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.
Key words: Helicobacter pylori; Dyspepsia; Eradication rate
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