Helicobacter pylori Screening and Eradication in Junior High School Students in Yokosuka, Japan: Prevalence, Eradication Rates, and Challenges

Yoshika Saito; Hiroaki Saito; Tomoki Matsuda; Yoshitaka Nishikawa; Taiga Uchiyama; Chihiro Matsumoto; Masaharu Tsubokura; Chihiro Endo; Mikio Matsuoka; Koki Mitsuya; Yasuhiro Mizuno

doi:10.1111/jgh.70067

Helicobacter pylori Screening and Eradication in Junior High School Students in Yokosuka, Japan: Prevalence, Eradication Rates, and Challenges

J Gastroenterol Hepatol. 2025 Oct;40(10):2499-2506. doi: 10.1111/jgh.70067. Epub 2025 Sep 3.

Authors

Yoshika Saito¹, Hiroaki Saito^{1

2

3}, Tomoki Matsuda¹, Yoshitaka Nishikawa^{4

5}, Taiga Uchiyama², Chihiro Matsumoto², Masaharu Tsubokura², Chihiro Endo^{6

7}, Mikio Matsuoka^{6

8}, Koki Mitsuya^{6

9}, Yasuhiro Mizuno^{6

10}

Affiliations

¹ Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
² Department of Radiation Health Management, Fukushima Medical University, Fukushima, Fukushima, Japan.
³ Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan.
⁴ Department of Health Informatics, Kyoto University School of Public Health, Yoshidakonoecho, Sakyo-ku, Kyoto, Japan.
⁵ Takemi Program in International Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.
⁶ Yokosuka Medical Association, Yokosuka, Kanagawa, Japan.
⁷ Endo Ichogekaiin, Yokosuka, Kanagawa, Japan.
⁸ Chuou Naika clinic, Yokosuka, Kanagawa, Japan.
⁹ Mitsuya Naika, Yokosuka, Kanagawa, Japan.
¹⁰ Ma-ru Clinic Yokosuka, Yokosuka, Kanagawa, Japan.

Abstract

Background: Helicobacter pylori infection increases the risk of developing gastric cancer. Early eradication is effective in reducing the risk. An increasing number of Japanese municipalities are implementing school-based H. pylori screening programs. This study examined an administrative initiative targeting junior high school students to reveal the challenges in enhancing child-centered screening efforts.

Materials and methods: This study examined a 2019-2021 population-based H. pylori screening program that targeted second-year junior high school students in Yokosuka City, Japan. The program used a two-tiered approach: initial urine antibody testing, followed by urea breath tests for confirmation. Students with confirmed infections received eradication therapy, and the outcomes were monitored through follow-up testing. Data on participation rates, treatment efficacy, side effects, and family infection surveys were analyzed.

Results: Between 2019 and 2021, 6270 students in Yokosuka City participated in H. pylori screening, with a confirmed infection rate of 1.2%. First-line eradication therapy achieved a 52.9% success rate, which increased to 94.7% after the second-line treatment. Mild side effects, mainly diarrhea, were reported in 27.0% of the first-line and 22.0% of the second-line cases. Family surveys showed that 48.5% of the infected students had H. pylori-positive relatives, underscoring the importance of addressing familial transmission alongside treatment efforts.

Conclusions: H. pylori has low prevalence among Japanese junior high school students in an urban area, with modest eradication success. The low participation and dropout rates highlight the need for improved strategies to boost engagement and ensure comprehensive screening and treatment for better program outcomes.

Keywords: Adolescents; Eradication; H. Pylori; Public Health; Screening; Test and Treat.

MeSH terms

Adolescent
Anti-Bacterial Agents / therapeutic use
Breath Tests
Disease Eradication* / statistics & numerical data
Female
Helicobacter Infections* / diagnosis
Helicobacter Infections* / drug therapy
Helicobacter Infections* / epidemiology
Helicobacter pylori* / immunology
Helicobacter pylori* / isolation & purification
Humans
Japan / epidemiology
Male
Mass Screening* / methods
Prevalence
School Health Services
Schools
Students* / statistics & numerical data
Treatment Outcome

Substances

Anti-Bacterial Agents