Community-based Helicobacter pylori screening and empiric eradication in health promotion program participants aged 50–69 Years in Chiayi county, Taiwan

Background Taiwan has launched community-based Helicobacter pylori ( H. pylori ) screening programs in select areas. However, in many parts of Taiwan, the most effective treatment strategies remain unclear. Methods In July 2023, H. pylori stool antigen (HpSA) screening for adults aged 50–69 years was added to the county-wide community-based health promotion program conducted by the Chiayi County Health Bureau. This single-center retrospective analysis included 531 HpSA-positive individuals who were evaluated at Chiayi Chang Gung Memorial Hospital between July 2023 and June 2024. Results Among the 5749 screened adults aged 50-69 years in Chiayi County, HpSA positivity was 25.6% (95% CI, 24.5–26.7). Of 1470 HpSA-positive individuals identified through screening, 531 (36.1%) were evaluated at the study hospital. Of them, 458 (86.3%) underwent endoscopy, which identified gastric ulcers in 24.5%, duodenal ulcers in 17.0%, and both in 6.6%. Rapid urease test and histological assessment were performed in 316 and 158 patients, respectively, yielding a positivity rate of 87.0% and 86.7% respectively. Among the 441 patients with available follow-up data, eradication rates were 94.7% (216/228) for those receiving 14-day clarithromycin-based triple therapy and 93.1% (149/160) for those receiving pooled 7–14-day concomitant therapy ( p = 0.508). Reverse hybrid therapy achieved a 100% eradication rate in 20 patients, without significant difference compared to triple therapy ( p = 0.293). Conclusion Among screened adults aged 50-69 years in Chiayi County, HpSA positivity was approximately 25.6%. Fourteen-day triple therapy, 7–14-day concomitant therapy and reverse hybrid therapy all achieved high eradication rates.