1. Some determinants
of urinary tract infection in children
from 2 months to 6 years old
In hai phong vietnam In 2008
Dang Van Chuc
Nguyen Ngoc Sang
Dang Viet Linh
2. 1. introduction
• Urinary Tract Infection (UTI):
- Renal Scarring=> anemia, hypertention (7-17%),
preclampsia, clampsia, renal failure and ended stage
renal diseases.
- Hospital based studies.
- Limited community based studies
Objective:
To determine some risk factors of UTI in children
from 2 month to 6 years old at some areas of Hai
Phong.
3. 2. Population and method
2.1. Population and research time.
- All children from 2 months to 6 years old at some areas of H
- Research time: 7/2006-10/2008.
-UTI criteria: Leucocyturia ≥ 30/mm3 and bacteriuria ≥ 105/m
2.2. Method
- Research area: 3 counties/districts representative of rural, u
coastal of HP.
- Study design: Descriptive and Cross-sectional study.
- Sample size: using the following formula:
4. 2 p1 p
n Z 1 / 2
d2
n: Sample Size
Z21-α/2 = (1,96)2 (Confidence degree 95%)
p = 0,04 (UTI incidence in children of HP in a commune from
Nguyen Ngoc Sang et al in 2005)
d: Expected accuracy = 20% of p
Applying to this formula , it needs about 4610 children for the study.
-Sampling procedure: Multistage sampling.
3 county/districts: Kien An (urban), Kien Thuy (coastal) and Thuy Ng
9 cummunes: Nam son, Trang Minh and Van au (Kien An), ai Ha, T
and Ngu oan(Kien Thuy), Phuc Le, Lap Le and Pha Le (Thuy Nguyen
5. - Data collection:
+ Determing UTI:
Clean morning midstream urine samples were used to scr
for urinary tract infection.
UTI was defined when having both
bacteriuria ≥105/ml and Leucocyturia ≥ 30/mm3.
+ Children’ parent interview:
On socio-economic conditions, children’s diseases and
history of children’diseases.
+ Physical examination:
Pediatricians directly examined children to find out childre
diseases then weigh and measure to estimate their nutritio
status.
6. Data analysis:
Using Epi-Info and SPSS version 13.0 to enter
and analyse data, calculate UTI incidence and determ
risk factors.
Dependent variables: 128 UTI cases, independent va
socio-economic and children’s diseases.
Risk factor: OR>1, 95% IC includes OR.
Multivariable analysis by using Logistics Regression
7. 3. results
3.1. Common information on children:
-There were 4631 children screened among them
boys were 2268 (49%); girls 2363 (51%);
rural children 1603 (34,6%); coastal children 1568
(33,9%); urban children 1460 (31,5%).
-128 children had both leucocyturia and bacteriuri
UTI incidence was 2.8%.
8. 3.2. Some determinants of UTI:
Table 1. The relationship of socio-economic condition and UTI.
OR OR
Risk Rate Bi Multi
Exposure n 95%CI 95%CI
factors % variable variabl
s es
Maternal < secondary* 105 3.1
1.7 1.1-2.7
education ≥ secondary 23 1.8
Paternal < secondary * 109 3.3
2.2 1.3-3.7
education ≥ secondary 19 1.5
Poverty* 29 5.8
Economy 2.5 1.6-3.8 2.9 1.3-6.5
Non poverty 99 2.4
Unsafe water 31 2.6
Water 0.9 0.6-1.3
Safe water 97 2.8
Ware of Unware of UTI 115 2.8
1.2 0.7-2.2
UTI Ware 13 2.3
Paternal Indirect paternal care
84 3.6
care of of child* 1.9 1.3-2.8
child Direct care 44 1.9
9. 3.2. Some determinants of UTI:
Table 2. The relationship of socio-economic condition and UTI (continu
OR OR
Risk Rate Bi Multi
Exposure n 95%CI 95%CI
factors % variable variable
s s
Maternal Indirect maternal
71 3.9 1.4-
care of care of child* 1.9
2.8
child Direct care 57 2.0
Stable 73 2.5 0.5-
House 0.7
Unatable 55 3.3 1.1
Unhygienic
58 2.3 0.4-
Lavatory lavatory 0.65
0.9
Hygienic lavatory 70 3.4
House’s < 20 m2 98 2.5 0.3-
0.5
square ≥ 20 m2 30 4.3 0.8
10. 3.2. Some determinants of UTI:
Table 3. The relationship of hygienic factors and UTI.
OR
OR
Risk Rate Bi 95%C
Exposure n 95%CI Multi
factors % variable I
variables
s
Hygiene Clean* 102 3.3
1.3-
after 1.9
Clean and 3.0
urination 26 1.8
washing
Yes* 23 5.8
1.5-
Diaper 2.4
3.8
No 105 2.5
Hygiene Clean * 99 3.2
1.1-
after 1.7
Clean and 2.6
stool 29 1.9
washing
11. 3.2. Some determinants of UTI:
Table 4. The relationship of hygienic factors and UTI (continued).
OR OR
Risk Rate Bi 95% Multi 95%C
Exposure n
factors % variable CI variable I
s s
Posterio-
123 2.9
Way of anterior*
1.1- 1.2-
washing Anterio- 2.6 1.9
6.3 3.9
after stool posterior, in 5 1.2
place
Kinder- Yes 94 2.6 0.5-
0.9
garten 1.1
No 34 3.3
Yes 16 2.5
0.5-
Preschool 0.8
1.4
No 112 2.8
12. 3.2. Some determinants of UTI:
Table 5. The relationship of children’s diseases and UTI.
OR
OR
Exposur Rate Multi 95%C
Risk factors n Bi 95%CI
e % variable I
variables
s
Yes * 49 3.5
Stunting 1.4 1.0-2.1
No 79 2.4
Yes * 41 4.0 1.1-
Low weight 1.6 1.1-2.4 1.7
No 87 2.4 3.3
Yes * 26 4.7
Wasting 1.97 1.3-3.3
No 102 2.5
Yes * 30 6.6 3.7- 3.7-
Phimosis 6.6 6.7
No 19 1.0 11.9 12.2
Yes * 44 4.6
Constipation 2.0 1.4-2.9
No 84 2.3
Yes * 81 3.3
Enuresis 1.5 1.1-2.3
No 45 2.1
13. 4. conclusion
- Family poverty
- Low weight malnutrition
- Phimosis in boys
- Parental Incorrect washing method for their child