Risk factors of pediatric urinary tract infections: an epidemiologic study

Abstract

Background: Urinary tract infection (UTI) is the second most prevalent pediatric infection, and if it is not recognized and treated properly, it can cause severe irreversible complications such as renal failure and hypertension. In this research, some of the risk factors of UTIs were compared in children with urinary tract infections.Methods: This is a cross-sectional study, with the urinary tract infection as the dependent variable and gender, circumcision status, history of urinary catheterization, family history, history of renal stone, hypercalciuria, constipation history, reflux, neurogenic bladder, phimosis, posterior urethral valves (PUV), ureteropelvic junction obstruction (UPJO), and ureterovesical junction obstruction (UVJO) as the independent variables. A total of 405 children were studied in this research. The data was collected using questionnaires, checklists, and examinations. Data analysis was also carried out using descriptive and analytical statistics method in SPSS.Results: This research revealed the prevalence of urinary tract infection among children with several risk factors, and the common factors were positive family history, history of urinary catheterization, constipation, and other non-anatomical disorders (history of renal stone and hypercalciuria. The most common risk factors regardless of gender and age were non-anatomic disorders that were observed in 147 cases (43.7%) (p-value<0.001). Among the non-anatomical factors, constipation was the most common factor observed in 66 cases (16.3%). A higher rate of urinary infection was observed in the uncircumcised male patients than the circumcised patients, and there was a significant relationship between circumcision and UTI.Conclusions: In this study, urinary tract infection staged a significant relationship with gender, circumcision status, urinary catheterization history, family history, renal stone history, hypercalciuria, history of constipation, reflux, neurogenic bladder, phimosis, PUV, UPJO, and UVJO.

Evaluating the Predictive Efficacy of Dipstick Urinalysis for Detecting Urinary Tract Infections in Febrile Children Under Five Years of Age at Federal Medical Centre, Owerri, Imo State, Nigeria

“…The low sensitivity of leucocyte esterase test could have been due to the low concentration of pyuria in majority of the study participants; similarly the low sensitivity of the nitrite observed in this study may have been due to the use of random urine specimen for analysis as long bladder incubation period is required for conversion of dietary nitrates to nitrites. This is similar to the report by Festo et al [29] in Tanzania as well as some Nigerian researchers 11,33,110 Contrarily, Hay et al [27] in the UK, Frederick et al [30] in Tanzania and Amajor et al [34] in Calabar Nigeria documented high sensitivity and specificity for both nitrite and leucocyte esterase. This supposes that the use of dipstick urinalysis (nitrite and leucocyte esterase) for screening of UTI in febrile under-five children could lead to missed cases of UTI due to the large number of false negatives, however it could be valuable in the exclusion of UTI due to the high specificity and negative predictive value.…”

“…Some Nigerian authors have also documented similar findings in their studies [28][29][30][31][32]. Urine Microscopy: Urine microscopy is important to ascertain whether there are white blood cells in the urine which is a sensitive indicator of inflammation associated with infection [33][34][35]. Pyuria is 73% sensitive and 81% specific for the diagnosis of UTI.…”

Evolution of Urinary Tract Infection Understanding: From Ancient Insights to Contemporary Perspectives

“…Dysfunctional Voiding Dysfunctional voiding in children due uncoordinated contraction of the urethral sphincter and detrusor muscle spasm result in incomplete bladder emptying increasing residual bladder urine which facilitates multiplication of uropathogens, possibly resulting in UTI. [62][63][64], in a urodynamic study involving 52 children with febrile UTI found uncoordinated voiding in 93% of the study population. However, in studies carried out by the American Academy of Pediatrics (AAP) among children less than six years with a first or second UTI and followed up for two years, [65] documented bowel and bladder dysfunction (BBD) in 54% of the 181 toilet trained children and 35% of those with BBD experienced recurrent UTIs.…”

“…The longer the duration of catheterization the higher the risk of UTI [62]. [44], in a study of 79 children with febrile UTI in Sri Lanka and Esteghamati [63] in Iran documented a significant association between urethral catheterization and UTI in their study subjects. In contrast, [61] in a prospective casecontrol study of 214 children aged two to twelve years did not observe a significant relationship between urethral catheterization and UTI, and this could be as a result of the fact that fewer participants had a history of urethral catheterization.…”