Predictors of urinary tract infection and their diagnostic performances among underfive admitted in District hospital in the town Douala

Abstract

Background: Urinary tract infections (UTIs) in child is a 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 underfive living in the town of Douala, Cameroon. Methods and materials: This cross-sectional study took place from May 2013 to March 2014 among children admitted at the Bonassama District hospital. Sociodemographic, anthropometric, clinic and biological information were documented from each child upon obtaining their parents/guardians’ consent. Results: The prevalence of UTI was 32.2% 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; 95%CI 1.01–1.10; 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 presence of at least one of the four predictors had better diagnosis performances than other defined algorithms. 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.