{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T14:03:05Z","timestamp":1726495385878},"reference-count":0,"publisher":"Hindawi Limited","issue":"12","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Canadian Journal of Gastroenterology"],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:p>BACKGROUND:<jats:italic>Helicobacter pylori<\/jats:italic>infection occurs more frequently in Arctic Aboriginal settings than elsewhere in North America and Europe. Research aimed at reducing health risks from<jats:italic>H pylori<\/jats:italic>infection has been conducted in the Aboriginal community of Aklavik, Northwest Territories.<\/jats:p><jats:p>OBJECTIVE: To compare the effectiveness of the Canadian standard therapy with an alternative therapy for eliminating<jats:italic>H pylori<\/jats:italic>infection in Aklavik.<\/jats:p><jats:p>METHODS: Treatment-naive<jats:italic>H pylori<\/jats:italic>-positive individuals were randomly assigned to a 10-day regimen (oral twice-daily doses) with rabeprazole (20 mg): standard triple therapy (proton pump inhibitor, added clarithromycin [500 mg] and amoxicillin [1 g] [PPI-CA]); sequential therapy (ST) added amoxicillin (1 g) on days 1 to 5, and metronidazole (500 mg) and clarithromycin (500 mg) on days 6 to 10. Participants with clarithromycin-resistant<jats:italic>H pylori<\/jats:italic>were randomly assigned to ST or quadruple therapy. Treatment effectiveness was estimated as per cent (95% CI) with a negative urea breath test at least 10 weeks after treatment.<\/jats:p><jats:p>RESULTS: Of 104 (53 PPI-CA, 51 ST) randomized participants, 89 (49 PPI-CA, 40 ST) had post-treatment results. Per-protocol treatment effectiveness was 59% (95% CI 45% to 73%) for PPI-CA and 73% (95% CI 58% to 87%) for ST. Based on intention to treat, effectiveness was 55% (95% CI 41% to 69%) for PPI-CA and 57% (95% CI 43% to 71%) for ST. Of 77 participants (43 PPI-CA, 34 ST) with 100% adherence, effectiveness was 63% (95% CI 43% to 82%) for PPI-CA and 81% (95% CI 63% to 99%) for ST.<\/jats:p><jats:p>CONCLUSIONS: While additional evidence is needed to confirm that ST is more effective for Arctic Aboriginal communities than the Canadian standard<jats:italic>H pylori<\/jats:italic>treatment, these results show standard PPI-CA treatment to be inadequate for communities such as Aklavik.<\/jats:p>","DOI":"10.1155\/2013\/143047","type":"journal-article","created":{"date-parts":[[2016,3,15]],"date-time":"2016-03-15T07:49:51Z","timestamp":1458028191000},"page":"701-706","source":"Crossref","is-referenced-by-count":19,"title":["A Randomized Controlled Trial Comparing Sequential with Triple Therapy for<i>Helicobacter pylori<\/i>in an Aboriginal Community in the Canadian North"],"prefix":"10.1155","volume":"27","author":[{"given":"Amy L","family":"Morse","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen J","family":"Goodman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Munday","sequence":"additional","affiliation":[{"name":"Susie Husky Health Centre, Aklavik, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiu-Ju","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Morse","sequence":"additional","affiliation":[{"name":"Stanton Territorial Hospital, Yellowknife, Northwest Territories, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Keelan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Division of Medical Laboratory Science, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janis","family":"Geary","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sander Veldhuyzen","family":"van Zanten","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"CAN Help Working Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"98","container-title":["Canadian Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/2013\/143047.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/2013\/143047.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T06:40:10Z","timestamp":1471934410000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/cjgh\/2013\/143047\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013]]},"references-count":0,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2013]]}},"alternative-id":["143047"],"URL":"https:\/\/doi.org\/10.1155\/2013\/143047","relation":{},"ISSN":["0835-7900"],"issn-type":[{"value":"0835-7900","type":"print"}],"subject":[],"published":{"date-parts":[[2013]]}}}