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.
Highlights
Recent studies on Vietnamese children have shown that kidney diseases are not detected early enough to prevent chronic renal failure
Children who were not included in this screening (“Missing Children”) were mainly 3 years of age, and this was the case across all communes
Setting up a microbiology laboratory in Can Gio was deemed necessary in order to confirm diagnoses and to improve the treatment of urinary tract infection (UTI) in children. This is why we have introduced a new protocol at the Can Gio District Hospital requesting a dipstick for each child presenting with fever and without any evidence of an infection focus; if leukocyturia and/or nitrituria is found, a urinary culture should be performed to search for bacteria
Summary
Recent studies on Vietnamese children have shown that kidney diseases are not detected early enough to prevent chronic renal failure. A retrospective study carried out by Mong Hiep et al, from 2001 to 2005, in two departments of pediatric nephrology and in four departments of adult nephrology in Ho Chi Minh City (HCMC), reviewed 310 children aged less than enough to prevent complications. This was evidenced by a median age at diagnosis that was much higher in the Vietnamese series (14 yrs) than in Belgian children (3 yrs). In Vietnam, where the health system is different from those in developed countries, little is known about urinary abnormalities in asymptomatic children, especially in isolated or remote areas of Vietnam, such as Can Gio district
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