Urinary abnormalities in asymptomatic school age children in public primary schools in abuja

Abstract

Background: Nitrituria and leucocyturia are indicative of urinary tract infection and a commonly missed condition in asymptomatic children. When left untreated could lead to long term consequences such as renal scaring, hypertension, altered renal function, and end stage renal disease. We conducted this study to determine the prevalence and risk factors for silent urinary tract infection among primary school children from public school in Abuja.

Materials and Methods: A descriptive cross sectional school-based study was conducted among apparently healthy, children from public primary schools in Gwagwalada Area Council of Federal Capital Territory, Abuja using a multi-staged sampling technique. Early morning urine was collected for presence of nitrites and leucocytes using urinary dipsticks. Urine microscopy was done for all subjects with positive results (nitrites and leucocytes) to confirm the presence of white blood cell count (pyuria), and urinalysis repeated 2 weeks later for persistent urinary abnormality. Bio-data was collected and socio economic class determined using Oyedeji et al classification.

Results: Of the 861 urine samples analysed, 215(25%)were from urban schools, and 646(75%) from rural schools. Three hundred and ninety-seven(46.1%)of the subjects were males, while 464(53.9%) were females, given a male to female ratio of 1:1.2. Their mean age was 9.5±2.1 years with a range of 6-12 years, and most 315(36.6%) were between 11-12 years. Nitrituria, leucocyturia, pyuria, nitrituria+leucocyturia, and nitrituria+leucocyturia+pyuria was seen in 23(2.7%), 29(3.4%), 26(3.0%), 18 (2.1%), and 5(0.6%) of the subjects respectively. Statistically significant association was seen between nitrituria with location of the school (x2=6.589, p=0.010), and social class (x2=9.065, p=0.011), and between leucocyturia, and nitrituria+leucocyturia with gender (x2=7.804, p= 0.005) and (x2=3.603, p=0.042) respectively.

Conclusion: There is high prevalence of nitrituria and leucocyturia among primary school pupils in this study, necessitating the need for regular routine urinary screening for early detection and treatment to prevent long term complications

Keywords: Nitrituria, leucocyturia, pyuria, primary school, children.