Detection of Urinary Tract Infections in 3- to 5-Year-Old Girls by Mothers Using a Nitrite Indicator Strip

Abstract

A program to detect urinary tract infections among 3- to 5-year-old girls was conducted in Madison-Dane County, Wisconsin using local pharmacies as the distribution site for test kits. Screening was conducted at home by mothers with a nitrite dip-strip on three consecutive first morning specimens. Twenty-one percent of the target population participated during a one-month study period. Eighteen cases were found among 1,573 participants (1.1%). In addition, 243 girls other than those in the target area or age group participated and yielded eight additional cases, for a total of 26 cases among 1,816 total participants. The rate of false-positive nitrite tests was 0.3%. Newspapers were the most effective means of alerting the public to the program. The only factors which were associated with less awareness or participation were low socioeconomic and rural residence. Past history of infection, minor urinary symptoms, and pyuria were common among the bacteriuric girls. Immunoglobulin-coated bacteria suggestive of tissue invasion were present in one third of the cases. Vesico-ureteral reflux was present in five and caliectasis in two of 23 girls studied. Despite the likelihood that some bacteriuric girls, particularly those infected with gram-positive organisms were not detected, screening at home appears to be a highly efficient method of detecting urinary tract infections in large populations of preschool children.