RESUMO
Disorders affecting the urinary tract represent an important group of diseases which cause notable morbidity and mortality among children. Little, however, is known about the pattern and determinants of their occurrence among Egyptian children. The aim of this study was to describe the epidemiologic characteristics and relative importance of this group of diseases among a group of Egyptian children below 12 years of age. The study was carried out over a period of six months [October 1[st], 1999 to end of March 2000]. It was designed as a hospital-based matched case control study. All patients presenting to Alexandria University Children's Hospital with any disorder of the urinary system were investigated. Diseases of kidney and urinary system were responsible for 6% of all hospital attendance during the study period. Almost one fourth of all cases were below 1 year of age. Approximately 60% were males with a male to female ratio of 1.6:1. Renal problems among children were associated with poor paternal and maternal education, low socioeconomic condition and drinking untreated water [OR = 1.8, 1.6, 1.6 and 2.4 respectively]. The most commonly encountered conditions were renal impairment [33.7%], nephrotic syndrome [24.4%], acute glomerulonephritis [19.7%] and urinary tract infections [UTI] [17%]. After controlling for possible confounders in Stepwise Multiple Logistic Regression, renal impairment was associated with sepsis, congenital anomalies and lack of medical care. As regards nephrotic syndrome, the number of males was almost twice that of females and approximately 75% of cases were above four years. Nephrotic syndrome was associated with residence in industrial areas. Glomerulonephritis was associated with presence of streptococcal sore throat or skin infection, low maternal education, high crowding index [>2 persons/room], insufficient income and low socio-economic condition. UTI was associated with urinary catheterization, anatomic abnormalities of urinary tract and systemic diseases [nephrotic syndrome and leukemia]. Diseases of the kidney and urinary tract represent a significant cause of morbidity among children. Urinary tract diseases were associated with low socioeconomic conditions, poor parental education and drinking untreated water. Early detection, prompt and adequate management of conditions that predispose to functional renal failure, especially dehydration and sepsis is recommended. Circumcision of young boys is a protective maneuver. If catheterization is indicated it should be conducted under strictly aseptic conditions