Global whole family based-Helicobacter pylori eradication strategy to prevent its related diseases and gastric cancer

Table 1 Traditional and suggested Helicobacter pylori infection management strategies¹

Name of strategies	Character of the strategies and their applications
1 Test and treat1	Recommended for young patients with uninvestigated dyspepsia, but not applicable to patients with alarm symptoms or older patients
	Cost-effective or suitable only for low infection rate areas or counties
	Not suitable for high infection- and gastric cancer-prevalent areas
	Targeting H. pylori-infected individual, community or population-based
2 Screen and treat1	Recommended for patients with family history of gastric cancer, having alarm symptoms
	May not be cost-effective for low infection rate areas or counties
	Suitable for high infection- or gastric cancer-prevalent areas
	Targeting H. pylori-infected individual-, community- or population-based
3 Whole family-based	High-risk population-oriented, good patient-family compliance
	Screen, identify, treat and follow up on all H. pylori-infected individuals in the entire family
	Practical or suitable for both high and low H. pylori-infected areas or countries
	Targeting all H. pylori-infected individuals in a whole family, no need to differentiate high- or low-infection rate areas or populations, whole family-based

¹Management strategies is based upon: Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report[1]; Helicobacter pylori management in ASEAN: The Bangkok consensus report[9]; Fifth Chinese national consensus report on the management of Helicobacter pylori infection[10]; Guidelines for the management of Helicobacter pylori infection in Japan: 2016 revised edition[12]. H. pylori: Helicobacter pylori.

Table 2 Common Helicobacter pylori intra-familial transmission routes¹ and their prevention

Common routes	Infection routes	Prevention
1 Oral-oral	Sharing food from same dish, chewing food, feeding, wet kissing, consuming contaminated meat, milk, vegetable, water or food, poor hygiene practice	Avoid using same dish, consume healthy and safe food
2 Shared utensils	Sharing food ware, dental equipment, etc	Clean food ware and using safe dental equipment
3 Fecal-oral	Consuming fecal contaminated water or food, such as well water, untreated water, etc	Consume only safe food and water
4 Outside family	Iatrogenic contamination, intimate contact with H. pylori-infected persons or utensils	Sterilize iatrogenic equipment and avoid intimate contact with H. pylori-infected persons and suspected utensils

¹For common Helicobacter pylori intra-familial transmission routes[14,16-22]. H. pylori: Helicobacter pylori.