APPSPGHAN 2022

Toshihiko Kakiuchi

Department of Pediatrics, Faculty of Medicine, Saga University

Japan

Dr. Toshihiko KAKIUCHI graduated from Jichi Medical School of medicine in year of 1999 and subsequently received further training in paediatrics gastroenterology and hepatology in The National Center for Child Health and Development, Tokyo, Japan, He is currently an associate professor of Paediatrics at Saga University, Japan.

Dr. KAKIUCHI research interests are in the field of Pediatric gastroenterology and Hepatology, Helicobacter pylori, New development of inspection equipment in the digestive field. He published widely in the field of pediatric gastroenterology and hepatology.

Strategies For Helicobacter Pylori Screening And Treatment In Junior High School Students To Eliminate Gastric Cancer

Endoscopy Symposium (Day 3)

15 October 2022 (0830-1000) @ Sipadan Hall 1

Background and aim:
Helicobacter pylori (H. pylori) eradication therapy for children is thought to be effective for decreasing the risk of developing stomach cancer. We set up an administrative project of screening examination and treatment of H. pylori infection for those who got consent for third graders of all junior high schools and special support schools (108 schools) in Saga prefecture since 2016. Screening test, eradication treatment and eradication judgement for H. pylori were decided to start with the public expenditure grant.

Methods:
First, urinary anti-H. pylori antibody test using immune chromatography was implemented at the same time as school urinalysis performed every spring in Japan. Then, H. pylori stool antigen test was carried out in students who tested positive on the urinary test individually at home. If the two tests were positive, H. pylori eradication therapy was performed without upper GI endoscopy examination. After therapy, the sterilization judgment was carried out by using 13C-urea breath test.

Results:
After explaining about the project for the many related organizations such as the prefectural governor, prefectural board of education committee, municipal cancer counselor from each administrative side or the medical side, that was started. As a result of the six years from the starting of the project, the examination consent rates for children were 88.2% and the infection rates for H. pylori was 2.3% in PP analysis. Regarding the infection rate, it was somewhat higher in the mountain area, but correlation with the municipal population in the prefecture, three-generation cohabitation rate, water supply penetration rate, and stomach cancer incidence was not recognized. H. pylori eradication therapy was used of triple therapy with a potassium-competitive acid blocker (P-CAB), amoxicillin and clarithromycin. A total of 833 students received eradication therapy. Eradication rates were 85.0% in PP analysis. Adverse effects associated with eradication therapy were observed in 46 of 717 subjects (6.4%).

Conclusion:
We could have made this project possible in the prefecture unit for the first time in Japan for thanks to the multidisciplinary collaborators. First-line triple therapy with a P-CAB for H. pylori eradication in children was found to be safe.

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