Prevalence, pattern and determinants of urine abnormalities among school pupils in a semi-urban community
Background: Dipstick urinalysis is a semi-quantitative examination of the urine, which can be utilized as a screening and diagnostic tool in children. It is rapid, sensitive, easy to perform and affordable for the resource-poor environment.
Objectives: To describe the pattern of urinalysis findings using urinary dipsticks and the determinants of urine abnormality among pupils in primary schools in a semi-urban area.
Methods: Apparently healthy 387 pupils were recruited from 10 public and 5 private primary schools in Ikenne Local Government Area of Ogun State, Nigeria using multi-stage and proportionate sampling techniques. Data on demography, nutritional status and urinary examination were obtained using Interviewer-administered questionnaires, clinical examination and dipstick urinalysis respectively.
Results: Dipstick urinalysis revealed the following; urine pH and specific gravity were normal in 98.2% and 100.0% of the pupils respectively. Protein, leukocyte esterase, nitrite, bilirubin, urobilinogen, blood and ketones were detected in 18.1%, 15.8%, 14.2%, 3.3%, 2.1%, 0.8%, and 0.5% respectively. Glucose and ascorbic acid were generally absent in the urine samples. Female gender significantly contributed to the pattern of urinalysis (leukocyte esterase and nitrites). Proteinuria was most frequent among the underweight (38/70; 54.3%). Urine abnormalities were more prevalent among pupils in public schools compared with private schools though not statistically significant, and not influenced by gender.
Conclusion: Asymptomatic proteinuria and urinary tract infection are not uncommon among children. Female gender and socio-economic status play a role in the incidence of the conditions.
Simerville JA, Maxted WC, Pahira JJ. Urinalysis: A Comprehensive Review. Am Fam Physician 2005; 71: 1153-1162.
Farah H, Mohamad T, Bilal A, Ahmad S. Dipstick Urine Analysis Screening among Asymptomatic School Children. N Am J Med Sci 2011; 3(4): 179–184.
Harsh KM, Hetal NJ, Bhairavi MS. Urinary Tract Infection in Children: Clinical Aspects and Utility of Urine Dipstick Test. Int J Contemp Pediatr 2017; 4(3): 790-795.
Gorelick MH, Shaw KN. Screening Tests for Urinary Tract Infection in Children: A Meta-analysis. Pediatrics 1999; 104(5): 1-7.
Koshy SM, Garcia-Garcia G, Pamplona JS, Renoirte-Lopez K, Perez-Cotres G, Gutierrez M.G, et al. Screening for kidney disease in children on world kidney day in Jalisco, Mexico. Pediatr Nephrol 2009; 24; 1219-1925.
Koch VH, Zuccolotto SM: Urinary tract infection: a search for evidence. J Pediatr (Rio J) 2003; 79: 97–106.
Al-Hamid JN, Ahmad S, Azam G, Mehrdad S. Urinary Screening in Primary School Children in Yazd, Iran. Shiraz E-Medical Journal 2015; 16 (1): e23866.
Akor F, Okolo SN, Agaba EL, Okolo A. Urine examination findings in apparently new school entrants in Jos, Nigeria. South Afr J Child Health 2009; 2(3): 60-63.
Malla HA, Bhat AM, Shazia B, Fayaz AR, Saleem MN, Imtiyaz AW. Prevalence of Proteinuria in School Children (Aged 12–14 Years) in Kashmir Valley, India, Using Dipstick Method. Saudi J Kidney Dis Transpl 2016; 27(5): 1006-1010.
Abdulla AA, Azza AT, Awatif EE, Ali NE, Azza HA. Screening for urine abnormalities among preschool children in western Saudi Arabia. Saudi Med J 2014; 35(12): 1477-1481.
Thoraya AA, Toaimah AFH, Mohammad GA, Al-Maadid DA, Al-Bast HM, Hamad FA. Urinary screening for renal disease among apparently healthy school children in Qatar. J Trop Paediatr 2012: 58(1); 81-84.
Runsewe-Abiodun TI, Sholeye O, Alaje A, Olawale O. Odusan. Dietary pattern and nutritional status of pupils in primary schools in a semi-urban Local Government Area, Ogun State, Nigeria: a cross-sectional descriptive study. Niger J Nutri Sci 2018; 39(2): 129-140.
Runsewe-Abiodun TI, Sholeye O, Alaje A, Olawale O. Odusan. Over-nutrition among primary school pupils in a semi-urban Local Government Area, South Western Nigeria. Annals of Health Research 2018; 4 (1): 23-33.
W.H.O Simplified Tables 2007. www.who.int/child growth/standards (accessed 3/01/2019)
Patil PM, Hipparagi SB, Sinha KS, Sorangavi VM. Asymptomatic Proteinuria and Haematuria in School Going Children. J Krishna Institute Med Sci University 2013; 2: 105-108.
Oviasu E, Oviasu SV. Urinary abnormalities in asymptomatic adolescent Nigerians West Afr J Med 1994;13: 152-155.
Ramage IJ, Chapman JP, Hollman AS, Elabassi M, McColl JH, Beattie TJ. Accuracy of clean-catch urine collection in infancy. J Pediatr 1999; 135: 765–767.
Moxey-Mims M. Haematuria and proteinuria. In: Kher KK, Schnaper HW, Makker SP (editors). Clinical Paediatric Nephrology. 2nd edition, Abingdon, United Kingdom. Informa Healthcare; 2007: 129–139.
Kass EH. Bacteriuria and the diagnosis of infections of the urinary tract. Arch Int Med 1957; 100: 709–714.
Coulthard MG, Kalra M, Lambert HJ, Nelson A, Smith T, Perry JD. Redefining urinary tract infections by bacterial colony counts. Pediatrics 2010; 125: 335–341.
Guy M, Newall R, Borzomato J, Kalra PA, Price C. Use of a first-line urine protein-to-creatinine ratio strip test on random urines to rule out proteinuria in patients with chronic kidney disease. Nephrol Dial Transplant 2009; 24: 1189-1193.
Finnell SM, Carroll AE, Downs SM: Subcommittee on Urinary Tract Infection. Technical report—Diagnosis and management of an initial UTI in febrile infants and young children. Pediatrics 2011; 128: e749–e770.
Roberts KB, Downs SM, Finnell SM, Hellerstein S, Shortliffe LD, Wald ER, et al. Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 2011; 128: 595–610.
Downs SM. Technical report: urinary tract infections in febrile infants and young children. The Urinary Tract Subcommittee of the American Academy of Pediatrics Committee on Quality Improvement. Pediatrics 1999; 103: e54: 1-60.
Stamm WE. Urinary tract infections, pyelonephritis and prostatitis. In: Face A, Breaunwald E, Kasper DL, et al., (Editors). Harrison’s Principles of Internal Medicine .17th edition. New York; McGraw Hill; 2008: 1741-1830.
Kaplan RE, Springate JE, Feld LG: Screening dipstick urinalysis: a time to change. Pediatrics 1997; 100: 919–21.
Ahmed SM, Avasara AK. Urinary tract infections (UTI) among adolescent girls in rural Karimnagar District, AP K.A.P. STUDY. Indian J Pre Soc Med 2008; 39: 12-15.
Elegbe IA, Elegbe I, Amusan K. Screening for urinary tract infections in asymptomatic elementary school children in Ile-Ife, Nigeria. J Trop Paediatr 1987; 33: 249-253.
Zainal D, Baba A, Mustaffa BE. Screening proteinuria and haematuria in Malaysian children. Southeast Asian J Trop Med Public Health. 1995; 26(4): 785–788.
Bakr A, Sarhan A, Hammad A, Ragab M, Salama O.S, Al-Husseini S, et al. Asymptomatic urinary abnormalities among primary school children in Egypt. World J Pediatr 2007; 3(3): 214–217.
Tong S, Gui-lan P, Hui-fen Z, Zong-qin H, Ji-Yong Z, Zhen-zhen W, et al. Urine routine screening of 34455 school children in Xiamen city. J Child Health Care 2009; 1.
Rao J, Zhou L, Shen Q, Sun L, Fang XY, Liu HM, et al. School urinalysis screening in Shanghai. World J Pediatr 2006; 3: 195–198.
Agbre-Yace ML, Oyenusi EE, Oduwole AO, Ake MD, Abodo JR. Prevalence of Diabetes mellitus among children and adolescents in the district of Abidjan in Cote d'Ivoire: a population-based study. J Diabetes Metab Disord. 2016; 15: 38.
Urakami T, Yoda M, Yoshida K, Mine Y, Aoki M, Suzuki J. Renal glucosuria in school children: clinical characteristics. Paediatr Int 2018; 60(1): 35-40.
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