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Patients with concordant diagnostic results were included. Demographic characteristics, symptoms, endoscopic and histopathological features were analyzed. Temporal trends in\n                    <jats:italic>H. pylori<\/jats:italic>\n                    prevalence were assessed, and factors associated with\n                    <jats:italic>H. pylori<\/jats:italic>\n                    were evaluated using multivariate logistic regression analyses.\u00a0Among 1300 eligible patients, 335 (25.8%) were\n                    <jats:italic>H. pylori<\/jats:italic>\n                    \u2013positive. The prevalence of\n                    <jats:italic>H. pylori<\/jats:italic>\n                    declined significantly over the study period, decreasing from 47.9% in 2010 to 23.4% in 2020.\n                    <jats:italic>H. pylori<\/jats:italic>\n                    positivity was associated with older age and lower height Z-score. Dyspepsia and refractory iron deficiency anemia, endoscopically antral nodularity, pangastritis, and duodenal ulcer were more frequent in\n                    <jats:italic>H. pylori<\/jats:italic>\n                    \u2013positive patients and remained independently associated with\n                    <jats:italic>H. pylori<\/jats:italic>\n                    infection. Although\n                    <jats:italic>H. pylori<\/jats:italic>\n                    infection was more frequent in patients with glandular atrophy and intestinal metaplasia, no independent association was found between the lesions and\n                    <jats:italic>H. pylori<\/jats:italic>\n                    after multivariate adjustment.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    :\u00a0In symptomatic children who underwent endoscopy, a nearly 50% decline in\n                    <jats:italic>H. pylori<\/jats:italic>\n                    prevalence was observed over a 10-year period. The infection was associated with impaired linear growth, refractory iron deficiency anemia, dyspeptic symptoms, and characteristic endoscopic findings; this underlines the continued clinical importance of\n                    <jats:italic>H. pylori<\/jats:italic>\n                    infection in pediatric practice.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td align=\"left\" colspan=\"2\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\" colspan=\"2\">\n                              \u2022\n                              <jats:italic>Helicobacter pylori infection is commonly acquired in childhood.<\/jats:italic>\n                              \u2022\n                              <jats:italic>The decline in H. pylori prevalence in children is less consistent compared to adults, and its clinical associations remain controversial.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\" colspan=\"2\">\n                              <jats:bold>What is New:<\/jats:bold>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\" colspan=\"2\">\n                              \u2022\n                              <jats:italic>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.<\/jats:italic>\n                              \u2022\n                              <jats:italic>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.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-026-06908-4","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T13:27:20Z","timestamp":1775741240000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal trends and correlates of Helicobacter pylori prevalence in children undergoing upper gastrointestinal endoscopy"],"prefix":"10.1007","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8753-5208","authenticated-orcid":false,"given":"Kadir","family":"I\u015f\u0131k","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-3826","authenticated-orcid":false,"given":"Burcu","family":"Volkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4427-0569","authenticated-orcid":false,"given":"Deniz","family":"Ertem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"6908_CR1","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1038\/nrmicro3016","volume":"11","author":"NR Salama","year":"2013","unstructured":"Salama NR, Hartung ML, Muller A (2013) Life in the human stomach: persistence strategies of the bacterial pathogen Helicobacter pylori. 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