Temporal trends and correlates of Helicobacter pylori prevalence in children undergoing upper gastrointestinal endoscopy

• We observed a nearly 50% decline in H. pylori prevalence over a 10-year period, from 47.9% in 2010 to 23.4% in 2020 among symptomatic children, with the most pronounced decline in school-aged children and adolescents. • In this cohort, precancerous lesions were uncommon (gastric atrophy 2.3%, intestinal metaplasia 1.38%) and, although H. pylori infection was nearly twofold higher in children with these lesions, they were not independently associated with H. pylori infection.