Prevalence of Urinary Tract Infections and Associated Factors Among Under-Five Children with Congenital Anomalies of the Kidney and Urinary Tract in Hospitalized Patients in Addis Ababa

Abstract

Background: - Among the most prevalent birth defects in newborns are congenital anomalies of the kidney and urinary tract (CAKUT). Urinary tract infection (UTI) is one of the most common bacterial infections in children, and it is more common in kidney and urinary tract abnormalities. The purpose of this study was to assess the prevalence of urinary tract infections and its determinants among 0-59-month-old children with congenital anomalies of the kidney and urinary tract in Addis Ababa. Methods: A health institution-based retrospective cross-sectional study was employed on 389 medical records of children with CAKUT at Tikur Anbesa and Menelik II Specialized Hospitals from March 1 to April 10, 2023, among those admitted between January 1, 2018, and December 31, 2022. The study hospitals were purposively selected, and each study participant was recruited by a systematic random sampling technique. Sociodemographic, clinical, and laboratory characteristics were reviewed using a structured data extraction sheet. The data were entered and cleaned using Kobo-toolbox statistical software and subsequently transferred to SPSS version 25 for further analysis. Binary logistic regression analysis was used to evaluate the associations of variables with a P value of 0.05 and a confidence interval of 95%. Results. The majority of the study participants (336 [86.4%]) were males. A total of 194 (49.8%) children were older than 25 months, with a mean age of 24.2 (±13.4) months. A total of 117 (30.1%) (95% CI=25.4-35.2) study participants were positive for urinary tract infection (UTI). Escherichia coli was the most frequently isolated bacteria followed by Klebsiella pneumonia, Enterobacter spp, and Staphylococci spp. Factors associated with UTI among CAKUT children were found to be being female (AOR = 4.3, 95% CI = (1.4–13.07), children having Posterior Ureteral Valve (AOR = 4.8, 95% CI = (2.32–9.93), duration of hospitalization (>4 days) (AOR = 3.08, 95% CI = (1.52-6.24), and children having fever (AOR = 5.8, 95% CI = (2.81–11.97). Conclusion In this study, almost 1/3 of the children developed UTIs, and female sex, longer hospitalization, PUV, and fever were found to be independent risk factors for the occurrence of UTIs.