INTRODUCTIONHelicobacter pylori (H. pylori) infection have been reported to be the most common human infection, affecting about 50% of the global population (1–3). By the age of 5 years about 50% of children are infected and this rate has been reported to exceed 90% during adulthood (4). A recently hospital based study in Uganda among children aged 1 to 15 years found the prevalence to be 24.3% and this increased with increasing age (1). A previous study which was conducted in the Bugando Medical Center on Helicobacter pylori infection in children < 12 years of age reported a prevalence of 42.9%. It was clearly reported that the prevalence increased with increase in age (5). Treating all children could expose them to unnecessary antibiotics therapy hence promoting antimicrobial resistance (AMR) development. On the other hand invasive tests to establish causes of symptoms are not widely available in many settings in LMICs. The joint ESPGHAN/NASPGHAN guidelines recommend confirmation of H. pylori infection by invasive methods such as upper gastrointestinal endoscopy, thereafter provision of eradication therapy preferably proton pump inhibitor plus two antibiotics for 14 days to the H . pylori infected children who have gastric or duodenal ulceration or erosions. Confirmation of eradication is performed at least 4 weeks after completion of antibiotic treatment and 2 weeks after proton pump inhibitors (PPI ) cessation using the urea breath test or H. pylori stool antigen test (6).