Predictors of Urinary Tract Infection and Their Diagnostic Performances among Cameroonian Under-five

Abstract

Objective: Urinary tract infection (UTIs) in child is serious public health problem especially in developing countries. This aimed at identifying factors associated with urinary tract infection and determining their diagnosis performances as well as resulting algorithms among Cameroonian under-five. Methods: A descriptive and analytical cross sectional study took place from May 2013 to March 2014 at Pediatrics Department of the Bonassama District hospital in the town of Douala. Urine samples were collected dependent on the age of children and its aptitude to micturate. Ten microliters (10 µL) of urine specimen were cultured at 37°C for 24-48 hours. In addition, sociodemographic, anthropometric, clinic and biological information of each child were documented. Results: The prevalence of UTI was 32.2% (129/400) which was mainly caused by Escherichia coli (41.1%). A total of four risk factors for UTI were found after adjustment for all pertinent characteristics of children. These included female gender (ARR= 0.55; p= 0.0046), presence of fever (ARR = 1.83; p= 0.0426), trouble urine (ARR = 1.36; p= 0.0063) and presence of nitrites in urine (ARR = 1.09; p= 0.0001). Presence of nitrites was the most discriminant parameter based on specificity (98.1%), positive predictive value (95.4%) and negative predictive value (90.1%). The diagnosis performances have gradually improved with the increasing number of parameters. Conclusion: This study reported four factors associated with increased risk for UTI. This also outlined that the presence of nitrites in urine had best diagnosis performances and different predictors-based clinical algorithms could be helpful especially in the identification of UTI-negative children. J Microbiol Infect Dis 2019; 9(2):68-77.