Prevalence of asymptomatic urinary tract infection among primary school children in Iraq [Hilla]

Urinary tract infections are common in infancy and childhood associated with potentially serious long term consequences of renal scarring, hypertension and chronic renal failure. To determine the prevalence of urinary tract infections among Iraqi children and some associated risk factors a cross-sectional study was conducted in Hilla province during the period from the 1st October 2001 through March 2002. Two stage-randomized samples, in the first stage a sample of schools was chosen. In the second stage 250 boys and 250 girls were chosen. The criteria used for enhanced urinalysis were Pyuria; presence of at least 10 white blood cells /mm3 by using a Neubaure counting chamber and /or Bacteriuria; presence of any bacteria /20 oil immersion field on gram stain smear. The questionnaire papers distributed to all those included in the sample. Chi-square test was used. The age range was 7-12 years. Mean +/- SD [9.36 +/- 1.39]. Prevalence of asymptomatic urinary tract infection was 6.6% but among girls was significantly higher than boys [11.2% Vs 2%] [P=0.00007]. The results of urinanylsis and cultures were positive in 28.6% of infected girls only, bacteriuria present in 46.42% of infected girls and in 80% of infected boys. Pyuria and bacteriuria present in 25% infected girls and in 20% infected boy [P>0.05].Urine culture showed E. coli in 57% of infected girls and 80% of infected boys. There was no significant difference between age groups [P>0.05]. Asymptomatic urinary tract infection is a hidden disease affecting young children and early adolescence, mainly girls 11.2%. Urine culture could be replaced by enhanced urinalysis as a screening test. We encourage the use of this test in school health program at least once per year