Epidemiological urinalysis of children from kindergartens of Can Gio, Ho Chi Minh City - Vietnam

Abstract

BackgroundRecent studies on Vietnamese children have shown that kidney diseases are not detected early enough to prevent chronic renal failure. The dipstick test is a simple and useful tool for detecting urinary abnormalities, especially in isolated or remote areas of Vietnam, where children have limited access to health care.MethodsThis cross-sectional study was conducted in 2011 at seven kindergartens in Can Gio district, Ho Chi Minh City, Vietnam. Two thousand and twelve children, aged 3 to 5, were enrolled. Morning mid-stream urine samples were examined by dipstick. Children with abnormal findings were re-examined with a second dipstick and underwent further investigations.ResultsUrinalysis was available for 1,032 boys and 980 girls. Mean age was 4.4 ± 0.8 years. Urinary abnormalities were detected in 108 (5.5%) of the subjects. Among them, nitrituria and leucocyturia accounted for more than 50%. Positive fractions of proteinuria, hematuria, nitrituria, leucocyturia, and combined nitrituria and leucocyturia after two dipsticks were 0.1%, 0.1%, 2%, 1% and 0.3%, respectively. Abnormal findings were more common in girls than boys (p < 0.001), and higher in communes with very low (< 50 persons/km2) population density (14.3% vs 4.1%, p < 0.001). A renal ultrasound detected four cases of hydronephrosis and one case of duplication of ureter.ConclusionsThe prevalence of urinary abnormalities in asymptomatic children in South Vietnam demonstrates the need for hygiene education among parents. Training for dipstick usage for all medical staff at health stations, especially in remote areas and in places with very low population density, is also clearly necessary. Routine urinalysis can be set up if a close control is conducted at locations.

Risk Factors Associated With Abnormal Urinalysis in Children

“…Abnormal results were less common in the southern and southwestern regions of China, which had very high population densities. This is consistent with a previous report from Vietnam in which abnormal findings were more common in communities with a very low population density ( 16 ). Therefore, sex, age, guardian's educational level, and geographic location were revealed to be significantly associated with abnormal urinalysis.…”

“…The prevalence of abnormal urinalysis was estimated to be 4.3% in "healthy" children. In previous reports, the prevalence of abnormal results in children ranged from 0.5 to 5.5% (6,8,(15)(16)(17)(18)(19)(20)(21). Patterns of abnormalities were variable according to different countries, age groups or screening methods.…”

“…Most of the above studies screened school children by urine dipstick testing occult blood and protein. A recent investigation in Vietnam screened children aged 3–5 years old using a dipstick with 10 reagents ( 16 ). They reported that nitrituria (2%) and leukocyturia (1%) were more common.…”

“…Unfortunately, there is not enough information about target populations among children. In previous reports, urinary abnormalities have been detected to be more common among girls, children at certain ages or children with low socioeconomic status (6,15,16). However, a comprehensive investigation among children of all ages is still needed to identify children at high risk.…”

Caracterización clínico- epidemiológica del paciente con hematuria en el servicio de clínicas pediátricas. 2020.

“…Entre el 2 y 6% de los escolares tienen cantidades detectables de sangre en una muestra aislada de orina, (Len Aguilera & de la Mata Franco, 2015) en otros estudios en poblaciones en niños de edad escolar han demostrado que el promedio de la prevalencia de la hematuria microscópica detectada en una muestra simple de orina es de 3 a 4%. (Preciado, Cáceres, Beltrán & Ortiz, 2015;El Shafie, El Nemr, Bahbah, Shokry & Attia, 2014;Yamagata et al, 2008;Cho & Kim, 2007) La distribución por edad fue de 46,02% en el grupo de 5 a 10 años en nuestra investigación coincidiendo con estos estudios: sin embargo el estudio realizado por de la Rosa (de la Rosa Brito, Guzmán & Rodríguez 2018) en República Dominicana predominó la edad preescolar, así como lo encontrado por Dang y Tabada, (Dang et al, 2013;Tabada et al, 2017) Bignall y Dixon plantean que la hematuria es más frecuente en hembras que en varones, (Bignall & Dixon, 2018) esto no coincide con nuestro estudio en el que encontramos predominio del sexo masculino al igual que en un estudio realizado en el oeste de Arabia Saudita en adolescentes donde existió predominio del mismo sexo. (Hothan et al, 2016) La hematuria en el niño puede presentarse como un signo aislado o acompañada de otros síntomas los cuales pueden ser generales (fiebre, astenia, artralgias), renales (disuria, tenesmo, incontinencia urinaria, edema, HTA) o extrarrenales (artritis, púrpura).…”