Urinary Screening for Detection of Renal Abnormalities in Asymptomatic School Children, Sohag Governorate, Egypt

Background: Dipstick urine analysis is the most common method for screening children for detecting urinary abnormalities. This study is aimed to estimate the frequency of urinary problems among children aged 6-13 years from five primary schools in different parts of the Sohag Governorate, Egypt.

Study Design and Setting: Cross-sectional study carried out by the Pediatrics Department and Community Medicine Departments at Sohag University, Egypt.

Study Duration: Study was conducted during the academic year of Egypt 2014-2015.

Methods: Urine analysis was performed for 2850 asymptomatic school children [1800 (63%) males and 1050 (37%) females]. Out of which, 1736 (61%) children were from rural areas and 1114 (39%) children were from urban areas. Microscopic examinations were performed for the abnormal dipstick samples after two weeks. Urine culture and other investigations were done to determine the underlining urinary abnormities.

Results: The initial urinary screening by dipstick revealed 53 children (1.86%) had urine abnormities. Confirmatory test by complete microscopic examination of urine after 15 days showed that only 38 children (1.33%) still had urinary abnormalities. Twenty-one children (0.74%) had hematuria, three children (0.11%) had proteinuria and 14 children (0.49%) had pyuria. Urinary tract infections (UTIs) were diagnosed in 21 children (14 children with pyuria and seven children with hematuria) in whom further evaluation revealed UTIs. The most common bacteria in positive urine culture samples were gram-negative bacilli in 42.86% children.

Conclusion: Small number of asymptomatic renal abnormalities can be detected by dipstick urine screening. The common abnormalities were hematuria, UTIs and proteinuria. Hematuria and UTIs were more common in females than males. Further work is needed to determine value of early detection of renal disorders in childhood in preventing development of end-stage renal diseases.