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KMID : 0371020000330030285
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Journal of Preventive Medicine and Public Health
2000 Volume.33 No. 3 p.285 ~ p.298
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Community-based Helicobacter pylori Screening and its Eff ects on Eradication in Patients with Dyspepsia
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Kim Seong-Ho
Hong Dae-Yong
Kang Pock-Soo
Lee Kyeong-Soo
Kim Suk-Bum
Kim Sang-Kyu
Suh Jeong-Ill
Kim Mi-Kyung
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Abstract
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Objectives : To investigate the positive rate of helicobavter pylori in patients with dyspepsia; medical compliance and relatde 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 Campylobavter-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 ll was favorable in terms of cost. Alternative lll 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.
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KEYWORD
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Helicobacter pylori, Dyspepsia, Eradication rate
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