Predictors of Urinary Tract Infection and Their Diagnostic Performances among Cameroonian Under-five

Year 2019, , 68 - 77, 15.06.2019

Dorgelesse Francine Kouemo Motse Guy Pascal Ngaba Loick Pradel Kojom Danielle Christiane Kedy Koum Cecile Ebongue Okalla Calixte İda Penda Evelyn Mah Andreas Chiabi Dieudonné Désiré Adiogo

https://doi.org/10.5799/jmid.574542

Cited By: 2

Abstract

ABSTRACT

Objective: Urinary tract infection (UTIs) in child is serious
public health problem especially in developing countries. This aimed at
identifying factors associated with urinary tract infection and determining
their diagnosis performances as well as resulting algorithms among Cameroonian
under-five.

Methods:
A descriptive and analytical cross sectional study took place from May 2013 to
March 2014 at Pediatrics Department of the Bonassama District hospital in the
town of Douala. Urine samples were collected dependent on the age of children
and its aptitude to micturate. Ten microliters (10 µL) of urine specimen were
cultured at 37°C for 24-48 hours. In addition, sociodemographic,
anthropometric, clinic and biological information of each child were
documented.

Results:
The prevalence of UTI was 32.2% (129/400) which was mainly caused by Escherichia coli (41.1%). A total of
four risk factors for UTI were found after adjustment for all pertinent
characteristics of children. These included female gender (ARR= 0.55; p= 0.0046),
presence of fever (ARR = 1.83; p= 0.0426), trouble urine (ARR = 1.36; p=
0.0063) and presence of nitrites in urine (ARR = 1.09; p= 0.0001). Presence of
nitrites was the most discriminant parameter based on specificity (98.1%),
positive predictive value (95.4%) and negative predictive value (90.1%). The
diagnosis performances have gradually improved with the increasing number of
parameters. 

Conclusion: This study reported four factors associated with
increased risk for UTI. This also outlined that the presence of nitrites in
urine had best diagnosis performances and different predictors-based clinical
algorithms could be helpful especially in the identification of UTI-negative
children.  J Microbiol Infect Dis 2019; 9(2):68-77.

Keywords

Under-five, urinary tract infection, predictors, predictive potential, Cameroon

References

• REFERENCES 1. Dibua UME, Onyemerela IS, Nweze EI. Frequency, urinalysis and susceptibility profile of pathogens causing urinary tract infections in Enugu State, southeast, Nigeria. Rev Inst Med Trop Sao Paulo 2014; 56(1):55-59. 2. Robinson JL, Finlay JC, Lang ME, Bortolusi R, and Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Community Paediatrics Committee. Urinary tract infections in infants and children: Diagnosis and management. Paediatr Child Health 2014; 19(6):315-319. 3. Williams GJ, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev 2006; (3):CD001534. 4. Festo E, Kidenya BR, Hokororo A et al. 2011. Predictors of Urinary tract infection among febrile children attending at Bugando Medical Centre Northwestern, Tanzania. Arch Clin Microbiol 2011; 5 (2): 1-7. 5. Msaki BP, Mshana SE, Hokororo A. Prevalence and predictors of urinary tract infection and severe malaria among febrile children attending Makongoro health centre in Mwanza city, North-Western Tanzania. Arch Public Health 2012; 70 (1):4. 6. Anígilájé EA, Bitto TT. Prevalence and predictors of urinary tract infections among children with cerebral palsy in Makurdi, Nigeria. Open J Pediatr 2013; 3: 350-357. 7. Gondim R, Azevedo R, Braga AANM, Veiga ML, Barroso Jr U. Risk factors for urinary tract infection in children with urinary urgency. Int Braz J Urol 2018; 44 (2): 378-83. 8. Akoachere J-FTK, Suylika Y, Akum N, Seraphine EN. Etiologic profile and antimicrobial susceptibility of community-acquired urinary tract infection in two Cameroonian towns. BMC Res Notes 2012; 5: 219-34. 9. Kouemo MDF. Profil de sensibilité des germes responsables d’infection du tractus génital chez des enfants de 5 ans à l’hôpital de District de Bonassama. Mémoire de Master II, Biologie Clinique, Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Cameroun: 75 p [French]. 10. Tchendjou Takam PY (2002). L’infection urinaire du nouveau-né et de l’enfant à l’hôpital général de Yaoundé: Aspects cliniques, biologiques, thérapeutiques et évolutifs (Thèse de Médecine). Yaoundé: Université de Yaoundé I. [French]. 11. Zhang J, Yu KF. What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 1998; 280(19):1690-1691. 12. Kamgain LM, Assam-Assam J-P, Kojom Foko LP, Kamga Fouamno HL. Prevalence of Malaria Infection and Reliability of ACCUCARE One Step Malaria Test® for Diagnosing Malaria in People Living with Human Immunodeficiency Virus Infection in Cameroon. Int J Trop Dis Health 2017; 21 (2): 1-10. 13. Saeed CH, AL-Otraqchi Kamal IB, Mansoor Isam Y. Prevalence of urinary tract infections and antibiotics susceptibility pattern among infants and young children in Erbil city. Zanco J Med Sci 2014; 19 (1): 915-22. 14. Schmiemann Gg, Kniehl E, Gebhardt K, Matejczyk MM, Hummers-Pradier E. The diagnosis of urinary tract infection. Dtsch Arztebl Int 2010; 107(21): 361-367. 15. Whiting P, Westwood M, Watt I, Cooper J, Kleijnen J. Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: A systematic review. BMC Pediatr 2005; 5(1):4. 16. Spencer JD, Schaderer AL, Becknell B, Watson J, Hains DS. The innate immune response during urinary tract infection and pyelonephritis. Pediatr Nephrol 2014; 29(7): 1139-1149. 17. WHO. World Malaria Report 2017. The World Health Organization, 2017, Geneva, Switzerland: 196 p. Available at URL: www.who.int accessed on 02 August 2018 18. Liao JC, Churchill BM. Pediatric urine testing. Pediatric Clinics of North America 2001; 48(6): 1425-1441. 19. Revollo JY, Lowder JC, Pierce AS, Twilla JD. Urine discoloration associated with Metronidazole: a rare occurrence. J Pharm Technol 2014; 30(2): 54-46. 20. Oyaert M, Meensel BV, Cartuyvels R, et al. Laboratory diagnosis of urinary tract infections: Towards a BILULU consensus guidelines. J Microbiol Methods 2018; 146: 92-99. 21. Tiso M, Schechter AN. Nitrate Reduction to Nitrite, Nitric Oxide and Ammonia by Gut Bacteria under Physiological Conditions. PLoS ONE 2015; 10(3): e0119712. 22. Konieczna I, Żarnowiec P, Kwinkowski M, et al. Bacterial Urease and its Role in Long-Lasting Human Diseases. Curr Protein Pept Sci 2012; 13(8): 789-806. 23. Franz M, Horl WH. Common errors in diagnosis and management of urinary tract infection. I: Pathophysiology and diagnostic technique. Nephrol Dial Transplant 1999; 14 (11): 2746-2753. 24. Godaly G, Ambite I, Svanborg C. Innate immunity and genetic determinants of urinary tract infection susceptibility. Curr Opin Infect Dis 2015; 28(1):88-96. 25. Koves B, Wullt B. The roles of the host and the pathogen in urinary tract infections. Eur Urol Suppl 2016; 15(4): 88-94.