positivity was assessed among 656 symptomatic children in 2010-2017. Overall infection prevalence was 24.5% and a significantly higher rate was detected in girls (28.5%) compared to boys (20.0%). Moreover, in children with duodenal ulcer, prevalence was higher (47.4%) compared with the rest (23.9%). On the contrary, the infection was detected 1.9-fold less frequently in patients with GERD (14.5%) compared with the other (27.0%) patients and 2.1-fold less often in the presence of duodenogastric reflux (bile) reflux (13.0%) compared with the absence of the reflux (27.0%). No significant difference was observed between the younger (aged ≤7 years, 20.0%) and the older (aged 8-18 years, 25.5%) patients. infection rate in Bulgarian pediatric patients between 2010 and 2017 was 2.5-fold lower than that in 1996-2006. In conclusion, infection is still an important concern for Bulgarian children, although having decreased by about 1.8%/yearly over 21 years. This study reveals the importance of diagnostics even in the youngest symptomatic children and demonstrates an inverse association between either GERD or bile reflux and infection.
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