The epidemiology and factors associated with nocturnal enuresis among boarding and daytime school children in southeast of Turkey: a cross sectional study

Ali Gunes,Adem Akilli,Gulsen Gunes,Yasemin Acik

doi:10.1186/1471-2458-9-357

Abstract

BackgroundNocturnal enuresis is an important problem among young children living in Turkey. The purpose of this study was to determine the possible differences in the prevalence of enuresis between children in boarding school and daytime school and the association of enuresis with sociodemographic factors.MethodsThis was a cross-sectional survey. A total of 562 self-administered questionnaires were distrubuted to parents from two different types of schools. One of them was a day-time school and the other was a boarding school. To describe enuresis the ICD-10 definition of at least one wet night per month for three consecutive months was used. Chi-square test and a logistic regression model was used to identify significant predictive factors for enuresis.ResultsThe overall prevalence of nocturnal enuresis was 14.9%. The prevalence of nocturnal enuresis declined with age. Of the 6 year old children 33.3% still wetted their beds, while the ratio was 2.6% for 15 years-olds. There was no significant difference in prevalence of nocturnal enuresis between boys and girls (14.3% versus 16. 8%). Enuresis was reported as 18.5% among children attending day time school and among those 11.5% attending boarding school (p < 0.05). Prevalence of enuresis was increased in children living in villages, with low income and with positive family history (p < 0.05). After multivariate analysis, history of urinary tract infection (OR = 2.02), age (OR = 1.28), low monthly income (OR = 2.86) and family history of enuresis (OR = 3.64) were factors associated with enuresis. 46.4% of parents and 57.1% of enuretic children were significantly concerned about the impact of enuresis.ConclusionEnuresis was more frequent among children attending daytime school when compared to boarding school. Our findings suggest that nocturnal enuresis is a common problem among school children, especially with low income, smaller age, family history of enuresis and history of urinary tract infection. Enuresis is a pediatric public health problem and efforts at all levels should be made such as preventive, etiological and curative.

Highlights

Nocturnal enuresis is an important problem among young children living in Turkey
Primary nocturnal enuresis is bedwetting in a child aged 5 years or more who has never been dry for extended periods, while secondary nocturnal enuresis is the onset of wetting after a continuous dry period of more than 6-12 months[5]
There was no significant difference in prevalence of nocturnal enuresis between boys and girls [14.3% versus 16. 8%]

Summary

Introduction

Nocturnal enuresis is an important problem among young children living in Turkey. The purpose of this study was to determine the possible differences in the prevalence of enuresis between children in boarding school and daytime school and the association of enuresis with sociodemographic factors. Nocturnal enuresis can be defined as the involuntary passage of urine during sleep beyond the age of anticipated nightime bladder control, after 4-6 y of age [1,2]. According to International Children's Continence Society (ICCS),intermittent incontinence is urine leakage in discrete amounts. It can occur during the day and/or at night, and it is applicable to children who are at least 5 years old. Enuresis can be further categorized into primary nocturnal enuresis or secondary nocturnal enuresis. Primary nocturnal enuresis is bedwetting in a child aged 5 years or more who has never been dry for extended periods, while secondary nocturnal enuresis is the onset of wetting after a continuous dry period of more than 6-12 months[5]

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