Urine Dipstick Research Articles

Evaluating the Predictive Efficacy of Dipstick Urinalysis for Detecting Urinary Tract Infections in Febrile Children Under Five Years of Age at Federal Medical Centre, Owerri, Imo State, Nigeria

This study aimed to assess the predictive efficacy of dipstick urinalysis in detecting urinary tract infections (UTI) among febrile children under five years of age at the Federal Medical Centre, Owerri, Imo State, Nigeria. The research involved a hospital-based descriptive cross-sectional study, analyzing the diagnostic performance of nitrite and leucocyte esterase tests on urine dipsticks. The results revealed low sensitivity but high specificity for both tests, suggesting their potential role in excluding UTI. The findings emphasize the importance of combining dipstick urinalysis with urine culture for accurate diagnosis in febrile children. Keywords: Urinary tract infections, Dipstick urinalysis, Febrile children, Nitrite, Leucocyte esterase, Diagnostic efficacy, Nigeria.

Evaluating the Predictive Efficacy of Dipstick Urinalysis for Detecting Urinary Tract Infections in Febrile Children Under Five Years of Age at Federal Medical Centre, Owerri, Imo State, Nigeria

This study aimed to assess the predictive efficacy of dipstick urinalysis in detecting urinary tract infections (UTI) among febrile children under five years of age at the Federal Medical Centre, Owerri, Imo State, Nigeria. The research involved a hospital-based descriptive cross-sectional study, analyzing the diagnostic performance of nitrite and leucocyte esterase tests on urine dipsticks. The results revealed low sensitivity but high specificity for both tests, suggesting their potential role in excluding UTI. The findings emphasize the importance of combining dipstick urinalysis with urine culture for accurate diagnosis in febrile children. Keywords: Urinary tract infections, Dipstick urinalysis, Febrile children, Nitrite, Leucocyte esterase, Diagnostic efficacy, Nigeria

Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department-A Diagnostic Accuracy Trial.

Urinary tract infections (UTIs) are a leading infectious cause of emergency department admission. Early UTI diagnosis is challenging, and a faster, preferably point-of-care urine analysis is necessary. We aimed to evaluate the diagnostic accuracy of urine flow cytometry (UFC) and urine dipstick analysis (UDA) in identifying bacteriuria and UTIs. This study included adults suspected of an infection admitted to three Danish emergency departments. UFC and UDA were the index tests, and urine culture and an expert panel diagnosis were the reference tests. We used logistic regression and receiver operator characteristics curves to find each test's optimal model and cut-off. We enrolled 966 patients and performed urine cultures on 786. Urine culture was positive in 337, and 200 patients were diagnosed with a UTI. The UFC model ruled out bacteriuria in 10.9% with a negative predictive value (NPV) of 94.6% and ruled out UTI in 38.6% with an NPV of 97.0%. UDA ruled out bacteriuria in 52.1% with an NPV of 79.2% and UTI in 52.8% with an NPV of 93.9%. Neither UFC nor UDA performed well in ruling out bacteriuria in our population. In contrast, both tests ruled out UTI safely and in clinically relevant numbers.

Microalbuminuria and Functional Iron Deficiency are Risk Factors for Hearing Loss in Adolescents.

Renal impairment and some systemic diseases are associated with hearing loss (HL) in adults. However, studies of these relationship in adolescents are rare. The objective of this study was to determine the association between HL and renal or systemic disease in adolescents. Subjects were extracted from the 5th Korea National Health and Nutrition Examination Survey from 2011 to 2012. We included adolescents aged 10-19 years old with normal tympanic membrane and those who underwent a physical and laboratory examination and pure tone audiometry. HL, high-frequency hearing loss (HFHL), albuminuria, impaired glomerular filtration rate, hypertension, diabetes, and obesity were evaluated based on the data. Individuals with microalbuminruia (MIA) exhibited higher prevalence of HL (p = 0.003) and HFHL (p = 0.012) than those without MIA. The prevalence of HL and HFHL appeared to increase according to the severity of albuminuria. Additionally, individuals with HL or HFHL showed lower transferrin saturation (TSAT) than individuals without HL (p = 0.002) or HFHL (p = 0.001). And, HFHL was associated with lower ferritin levels (p = 0.017). HL and HFHL were related to MIA (p = 0.004 and p = 0.022, respectively) and TSAT (p = 0.005 and p = 0.011, respectively) after controlling other factors. MIA and TSAT level were independently associated with the HL and HFHL. Since MIA can be easily detected by dipstick test and urine analysis, hearing evaluations for individuals with MIA might be helpful to identify hearing impairments earlier in adolescents. 3 (individual cross-sectional study) Laryngoscope, 134:3329-3334, 2024.

Evaluation of a urine dipstick protein to urine specific gravity ratio for the detection of proteinuria in dogs and cats.

The utility of urine dipsticks for the quantification of proteinuria is limited because of the influence of urine specific gravity (USG). To circumvent the need for urine protein creatinine ratios (UPCR) some have proposed a calculated dipstick urine protein to USG ratio (DUR) for the detection of proteinuria. However, the performance of DUR has not been evaluated in veterinary patients. Evaluate the correlation between DUR and UPCR, while also assessing the effect of urine characteristics on this relationship and evaluating the performance of DUR in detecting proteinuria. Urine samples from 308 dogs and 70 cats. Retrospective cohort study of urinalyses and UPCRs from dogs and cats collected between 2016 and 2021. Both canine and feline urine samples showed a positive moderate correlation between the UPCR and DUR. The correlation was not influenced by the presence of active urine sediment, glucosuria, or urine pH. In detecting canine urine samples with a UPCR >0.5, an optimal DUR of 1.4 had sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 89%, 83%, 96%, and 63%, respectively. In detecting feline urine samples with a UPCR >0.4, an optimal DUR of 2.1 had sensitivity, specificity, PPV, and NPV of 70%, 100%, 100%, and 75%, respectively. Use of the DUR can be a relatively reliable method for identification of proteinuria. However, given its poor NPV, the DUR cannot be recommended for exclusion of proteinuric patients.

522 - From urine dipstick to diagnosis: all proteinuria is not glomerular

522 - From urine dipstick to diagnosis: all proteinuria is not glomerular

Comparison of urine protein-creatinine ratio and urine dipstick test for significant proteinuria in preeclamptic women.

Assessing for significant proteinuria in pregnancy (SPIP) stands as a key indicator for diagnosing preeclampsia. However, the initial method typically employed for this assessment, the urine dipstick test, often yields inaccurate results. While a 24-h urine collection is considered the most reliable test, its implementation can lead to delays in diagnosis, potentially affecting both maternal and fetal well-being. The urine protein-creatinine (P/Cr) ratio can be used as an alternative to 24-h urine protein analysis, but its diagnostic accuracy has remained uncertain. There is a need to compare the diagnostic accuracy of urine P/Cr ratio and dipstick urinalysis for SPIP, especially in resource-poor settings. To determine and compare the diagnostic accuracy of urine P/Cr ratio and dipstick urinalysis in a spot urine specimen for the diagnosis of SPIP among women evaluated for preeclampsia using 24-h urine protein excretions as a gold standard. This is a comparative cross-sectional study. The study involved 82 singleton pregnant women evaluated for preeclampsia from 20 weeks of gestation who underwent dipstick and P/Cr ratio tests in the same urine sample. Women at risk of preeclampsia were given a specimen container for the collection of urine samples on an outpatient basis. Participants were trained and told to collect the urine sample 24 h prior to their next antenatal appointment. However, those on admission and evaluated for preeclampsia had their 24-h urine collected in the hospital. The outcome measures included sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio and accuracy for the two tests. Significant proteinuria was defined as a P/Cr ratio >0.27 or ⩾2+ of proteinuria on the dipstick test. Preeclampsia was confirmed in women with both high blood pressure and SPIP. The mean age of participants was 28.65 ± 5.76 years. Comparatively, the diagnostic accuracy (91.46% (95% CI = 83.29-96.59) vs 59.76% (95% CI = 48.34-70.44), p = 0.001), sensitivity (94.74% vs 70.00%, p = 0.021), specificity (84.00% vs 43.75%, p = 0.001), negative predictive value (87.50% vs 48.28%, p = 0.003) and positive predictive value (93.10% vs 66.04%, p = 0.001), respectively, were higher for the spot urine P/Cr ratio than dipstick test. In addition, the positive likelihood ratio and the negative likelihood ratio for spot urine P/Cr ratio versus dipstick test were (1.93 vs 1.24) and (0.07 vs 0.69), respectively. The spot urine P/Cr has superior diagnostic accuracy in the determination of significant proteinuria in pregnant women being evaluated for preeclampsia than the widely used dipstick test. A more robust multicenter study is needed to compare the diagnostic accuracy of spot urine PCR with the standard 24-h urine protein in low-income settings.

Point-of-care testing and antibiotics prescribing in out-of-hours general practice: a register-based study in Denmark

BackgroundPoint-of-care testing may reduce diagnostic uncertainty in case of suspicion of bacterial infection, thereby contributing to prudent antibiotic prescribing. We aimed to study variations in the use of point-of-care tests (C-reactive protein test, rapid streptococcal antigen detection test, and urine dipstick) among general practitioners (GPs) and the potential association between point-of-care testing and antibiotic prescribing in out-of-hours general practice.MethodsWe conducted a population-based observational register-based study, based on patient contacts with out-of-hours general practice in the Central Denmark Region in 2014–2017. The tendency of GPs to use point-of-care testing was calculated, and the association between the use of point-of-care testing and antibiotic prescribing was evaluated with the use of binomial regression.ResultsOut-of-hours general practice conducted 794,220 clinic consultations from 2014 to 2017, of which 16.1% resulted in an antibiotic prescription. The GP variation in the use of point-of-care testing was largest for C-reactive protein tests, with an observed variation (p90/p10 ratio) of 3.0; this means that the GPs in the 90th percentile used C-reactive protein tests three times as often as the GPs in the 10th percentile. The observed variation was 2.1 for rapid streptococcal antigen detection tests and 1.9 for urine dipsticks. The GPs who tended to use more point-of-care tests prescribed significantly more antibiotics than the GPs who tended to use fewer point-of-care tests. The GPs in the upper quintile of the tendency to use C-reactive protein test prescribed 22% more antibiotics than the GPs in the lowest quintile (21% for rapid streptococcal antigen detection tests and 8% for urine dipsticks). Up through the quintiles, this effect exhibited a positive linear dose–response correlation.ConclusionThe GPs varied in use of point-of-care testing. The GPs who tended to perform more point-of-care testing prescribed more antibiotics compared with the GPs who tended to perform fewer of these tests.

The COVID-19 Severity and Its Association with Intestinal Parasite Coinfection and Urine Biochemical Parameters among COVID-19-Confirmed Patients Admitted to Debre Markos University COVID-19 Center, Northwest Ethiopia.

Though most people with COVID-19 disease show asymptomatic to mild illness, a substantial number of patients are at high risk of developing severe disease and adverse outcomes with long COVID-19 and death. Even though some studies showed that previously existing infections with parasites amend the host's body defenses to increase resistance to infection with SARS-CoV-2, there is limited data in Ethiopia. This study is aimed at determining the COVID-19 disease severity and its association with intestinal parasite coinfection and urine biochemical parameters among COVID-19-confirmed patients admitted at Debre Markos University COVID-19 Center, 2021. A prospective cohort study was conducted on 136 RT-qPCR-confirmed COVID-19 patients admitted at Debre Markos University COVID-19 Center from January 1 to March 30, 2021. Sociodemographic and clinical data were collected by using standardized data collection forms. A urine biochemical test was performed using a dry urine dipstick kit and stool examination using direct wet mount microscopic examination and formalin-ether concentration method. The chi-square test, Fisher exact test, and ordinal logistic regression analysis were computed to assess association with outcome variables using Statistical Package for Social Science software (version 24). A total of 136 COVID-19-confirmed patients participated in this study. The median age of the participants was 48 years. The majority (86 (62.5%)) of them were male in sex. Of the 136 cases, 39 (28.7%) had died. Among the 136 patients, 22 (16.2%) were coinfected with intestinal parasites. COVID-19 patients who have intestinal parasite coinfection had lower odds of developing clinically severe COVID-19 compared to noninfected (AOR = 0.37; 95% CI = 0.147-0.944; P = 0.037). The majority (104 (76.5%)) of them have abnormal urine biochemical results. From the abnormal urine biochemical tests observed, the urine blood, glucose, and ketone tests were positive for 54 (39.7%), 36 (26.5%), and 30 (21.1%) patients, respectively. Among the 31 critical COVID-19 patients, 25 (80.6%) showed abnormal urine biochemical parameters. Age and comorbidity were significantly associated with COVID-19 severity (P < 0.05). Patients with old age and comorbidity had an increased risk of developing severe COVID-19 disease. Patients having SARS-CoV-2 and intestinal parasitic coinfections demonstrated mild COVID-19 disease severity. Abnormal urine biochemical results were common among critical COVID-19 patients. Thus, advanced study on the effect of the interaction among intestinal parasites on COVID-19 clinical severity and its mechanisms is essential.

The Value of Negative Urinary Dipstick Tests for Haematuria in Patients Undergoing Surveillance for Low-grade Ta Urothelial Cancer: A Two-stage Prospective Clinical Study in 524 Patients

Background and objectiveThe risk of first recurrence beyond 5 yr for patients with low-grade (LG) Ta non–muscle-invasive bladder cancer (NMIBC) is low enough to consider discontinuing cystoscopic surveillance at that point. However, a positive urinary dipstick test for haematuria (UDH) during and beyond the period of cystoscopic surveillance can disrupt plans to cease surveillance because the association between UDH positivity and recurrence in LG Ta NMIBC is unknown. In a two-stage study, we evaluated this association and explored the role of UDH negativity in predicting the absence of recurrence. MethodsBecause of previously demonstrated changes in recurrence patterns over time, two prospective cohorts were assessed: an “exploratory” cohort (January 2007–March 2008) and a “validation” cohort (November 2017–August 2018). UDH was performed before flexible cystoscopy. Patient, operative, and surveillance data have been recorded prospectively using standard pro forma sheets since 1978 in our institution. Only patients with primary LG Ta pTa NMIBC were included for analysis. Key findings and limitationsWe assessed 231 patients in the exploratory group and 293 in the validation group. The proportion of smokers (67% vs 70%; p = 0.5) and mean follow-up (72.2 vs 79.9 mo; p = 0.2) were similar between the groups. The recurrence rate was higher in the exploratory group (19% vs 11%; p = 0.009), as was the UDH positivity rate (37% vs 11%; p < 0.001). The specificity and negative predictive value were 64% and 83% in the exploratory group, and 90% and 90%, respectively, in the validation group. These values increased further for the subgroup with solitary primary tumours the subgroup without recurrence for 3 yr. Conclusions and clinical implicationsUDH negativity has a high probability of being associated with the absence of recurrence in small LG Ta NMIBC and could be an inexpensive adjunct during surveillance. Ongoing validation, which started in 2019, is being performed in a now-nationalised Scottish protocol in which UDH replaces cystoscopy in years 2 and 4 for patients in the low-risk group. Patient summaryWe investigated the accuracy of a dipstick test for blood in the urine for patients undergoing surveillance for low-grade noninvasive bladder cancer. We found that a negative dipstick test result was highly associated with the absence of tumour recurrence, particularly for patients with the lowest risk. These findings have been introduced into a national protocol designed to reduce the frequency of telescopic inspection of the bladder during surveillance to reduce the burden for patients.

P10 New rash in a child of skin of colour

Abstract A 7 year old Nigerian girl was referred by Haematology to the Paediatric Dermatology team with “suspected eczema”. She had known sickle cell disease, for which she was on hydroxycarbamide, Mum reported an 8 month history of a new rash with no systemic features. She had marked indurated plaques on face, forehead and forearms which were associated with scarring and hyperpigmentation. She had a number of investigation including negative urine dipstick. ANA was positive with elevated RO and RNP antibodies. Inflammatory markers were normal. Skin biopsy results were consistent with discoid lupus erythematosus. Stringent photo protection and sun blocking creams were advised. She was commenced on potent topical steroids and hydroxychloroquine which is first line systemic treatment. Within 4 weeks of commencing hydroxychloroquine there was significant flattening of the plaques. She was referred to Paediatric Rheumatology for assessment, given her high risk features. Clinical features of DLE in children are similar to adult DLE in presentation and chronic course. However it is rare in children with less than 2% of patients developing DLE before 10 years of age. DLE tends to be more common and severe in skin of colour. There are complications of scarring and pigmentation. It is important to be aware of the psychological impact on both parent and child’s quality of life. There is high risk of transition to SLE in children with DLE and hence screening bloods and early referral to Rheumatology should be considered.

Utility of dipstick urinalysis in the diagnosis of urinary tract infections among outpatients in Mwanza and Dar es Salaam regions in Tanzania

Abstract Background Globally, urinary tract infections (UTIs) are the leading cause of hospital visits, especially among women. In many developing countries, especially in lower health facilities, the dipstick urinalysis is the most commonly requested test, as urine culture is not routinely performed. The dipstick test can potentially reduce the number of patients who could be treated with empirical antibiotics and reduce the burden of antibiotic resistance. The current study determined the utility of dipstick urinalysis in diagnosing UTIs using urine culture as a gold standard method. Methods A cross-sectional study was conducted between July and November 2021. The study involved 1327 outpatients attending lower health centres in Mwanza (n = 678) and Dar es Salaam (n = 649) regions. The samples were subjected to dipstick urinalysis (nitrite and leucocytes) and quantitative bacterial culture. Results Of all 1326 patient samples, 808(60.9%) and 48(3.6%) were positive for urinary leucocyte and nitrite, respectively, while significant urine culture was found in 364(27.4%). leucocyte test correctly diagnosed UTI in 283 (77.75%) and nitrite test in 36 (9.89%). The leucocytes and nitrites, in combination, exhibited a sensitivity of 79.40% and NPV of 85.24% but a lower specificity of 44.96% and a lower PPV of 35.29%. Urinary leucocyte test had a higher discrimination ability to detect urinary tract infection than urinary nitrite test (AUC = 0.073, 95% CI 0.043–0.103, p &lt; 0.001); likewise, combined results of urinary nitrite and leucocytes tests had higher discrimination ability to detect UTI than nitrite only (AUC = − 0.079, 95% CI − 0.107–0.050, p &lt; 0.001). Conclusions In settings where culture is available, dipstick urinalysis can be a helpful screening method for reducing unnecessary urine cultures and related expenses because of its higher negative predictive value. In most low-resource settings where patients' diagnosis solely depends on clinical diagnosis and culture is not easily available, urine dipstick can decrease the risk of overuse of antibiotics. However, the combined (leucocytes and nitrites) dipstick urinalysis has a rather low positive predictive value, with approximately one-third of cases giving positive test results being truly UTI, subjecting over 65% of cases to unnecessary antibiotic treatment.

Нарушения опорно-двигательного аппарата у водолазного состава военно-морского флота

Aim. To study the features of the pathogenesis and clinical picture of musculoskeletal disorders in various categories of military personnel of the Navy (Navy) and pensioners of the Ministry of Defense of the Russian Federation (MOD) based on a set of clinical, instrumental and laboratory data. Design. Prospective observational study. Materials and methods. An examination was carried out and the medical documentation was studied of 98 military personnel of the Navy and pensioners of the Defense Ministry in the following groups: I — military personnel of the Navy without a history of exposure to hyperbaria, II — military personnel belonging to deep-sea divers with moderate work experience, III — military personnel belonging to deep-sea divers with significant work experience, IV — pensioners of the Ministry of Defense, whose professional activity was related to work on deep-sea vehicles (aquanauts), V — pensioners of the Ministry of Defense without a history of exposure to hyperbaria. The patients underwent a detailed laboratory and instrumental study of bone tissue metabolism, including digital radiography, osteodensitometry, magnetic resonance imaging (MRI) and computed tomography. Results. Significant osteo-articular changes of the type of dysbaric osteonecrosis were noted among Navy diving personnel, most pronounced among retired Navy personnel – aquanauts. Conclusion. Osteoarticular changes in Navy diving personnel are of a specific dysbarogenic nature, polyetiological, localized in large joints and diaphyses of adjacent bones and become significant as the length of service, the severity of the work performed and occupational risks in hyperbaric conditions increase. Digital radiography and MRI are recognized as the optimal methods for diagnosing dysbaric osteonecrosis and “dysbarogenic osteoarthropathy”. As a rapid diagnostic method, it is advisable to use innovative urine test strips that allow determining the threshold concentrations of bone resorption markers — β-crosslaps and α-crosslaps. Keywords: diving personnel of the Navy, aquanauts, dysbaric osteonecrosis and "dysbarogenic osteoarthropathy", etiology, pathogenesis, clinical picture, diagnosis.

Urine osmolality assessment through the integration of urea hydrolysis and impedance measurement.

We present the development and validation of an impedance-based urine osmometer for accurate and portable measurement of urine osmolality. The urine osmolality of a urine sample can be estimated by determining the concentrations of the conductive solutes and urea, which make up approximately 94% of the urine composition. Our method utilizes impedance measurements to determine the conductive solutes and urea after hydrolysis with urease enzyme. We built an impedance model using sodium chloride (NaCl) and urea at various known concentrations. In this work, we validated the accuracy of the impedance-based urine osmometer by developing a proof-of-concept first prototype and an integrated urine dipstick second prototype, where both prototypes exhibit an average accuracy of 95.5 ± 2.4% and 89.9 ± 9.1%, respectively in comparison to a clinical freezing point osmometer in the hospital laboratory. While the integrated dipstick design exhibited a slightly lower accuracy than the first prototype, it eliminated the need for pre-mixing or manual pipetting. Impedance calibration curves for conductive and non-conductive solutes consistently yielded results for NaCl but underscored challenges in achieving uniform urease enzyme coating on the dipstick. We also investigated the impact of storing urine at room temperature for 24 hours, demonstrating negligible differences in osmolality values. Overall, our impedance-based urine osmometer presents a promising tool for point-of-care urine osmolality measurements, addressing the demand for a portable, accurate, and user-friendly device with potential applications in clinical and home settings.

Can the urine dipstick test be used as a proteinuria screening test?

Can the urine dipstick test be used as a proteinuria screening test?

A Novel Acetone Sensor for Body Fluids.

Ketones are well-known biomarkers of fat oxidation produced in the liver as a result of lipolysis. These biomarkers include acetoacetic acid and β-hydroxybutyric acid in the blood/urine and acetone in our breath and skin. Monitoring ketone production in the body is essential for people who use caloric intake deficit to reduce body weight or use ketogenic diets for wellness or therapeutic treatments. Current methods to monitor ketones include urine dipsticks, capillary blood monitors, and breath analyzers. However, these existing methods have certain disadvantages that preclude them from being used more widely. In this work, we introduce a novel acetone sensor device that can detect acetone levels in breath and overcome the drawbacks of existing sensing approaches. The critical element of the device is a robust sensor with the capability to measure acetone using a complementary metal oxide semiconductor (CMOS) chip and convenient data analysis from a red, green, and blue deconvolution imaging approach. The acetone sensor device demonstrated sensitivity of detection in the micromolar-concentration range, selectivity for detection of acetone in breath, and a lifetime stability of at least one month. The sensor device utility was probed with real tests on breath samples using an established blood ketone reference method.

Barriers, enablers, benefits, and drawbacks to point-of-care testing: a survey of the general practice out-of-hours service in Scotland.

The general practice out-of-hours (GPOOH) service is under pressure to treat more patients in less time, while reducing referrals and minimising diagnostic errors. Point-of-care (POC) testing involves rapid clinical tests that can be used to generate results during the consultation, and has the potential to facilitate managing these competing demands safely. To describe current availability of POC tests in GPOOH in Scotland, and identify barriers, enablers, benefits, and drawbacks to its use. Cross-sectional mixed-methods study, which surveyed opinions of clinicians working in the GPOOH service in NHS Scotland. An electronic questionnaire was developed, designed, piloted, and distributed to clinicians, which had closed questions and areas for free text. In total, 142 responses were received. Urine dipstick testing (99.2%), pregnancy tests (98.5%), oxygen saturation (97.7%), and blood glucose testing (93.9%), were the only POC tests commonly available in GPOOH in NHS Scotland. There was strongest support for the provision of POC tests, particularly C-reactive protein (CRP; 79.4%), strep A (76.0%), and D-dimer (75.2%). Responders felt that POC tests would improve confidence (92.3%) and safety (89.8%) surrounding clinical decision making, improve patient satisfaction (80.6%), and reduce hospital and secondary care referrals (77.5%). Barriers to POC test use were availability of the test kits and machines (94.5%), training requirements on how to use the machine (71.1%) and interpret results (56.3%), and time to do the test (62.0%). Few POC tests are in regular use in GPOOH in Scotland. GPOOH clinicians are supportive of using POC testing. They identified a number of benefits to its use, with very few drawbacks. Increased provision of POC testing in GPOOH in NHS Scotland should be considered urgently.

Prevalence of Schistosomiasis and Soil-Transmitted Helminthiasis and Their Risk Factors: A Cross-Sectional Study in Itilima District, North-Western Tanzania.

Schistosomiasis and soil-transmitted helminthiasis remain a public health concern in Tanzania. This study investigated the prevalence and intensities of Schistosoma haematobium, S. mansoni, and soil-transmitted helminths and associated factors in Itilima district, north-western Tanzania. A cross-sectional survey was conducted between August and September 2020 among 3779 primary schoolchildren in 62 primary schools and 1122 adults in 19 villages. Urine samples were obtained from each participant and examined visually for the presence of macrohaematuria, microhaematuria, and S. haematobium eggs using a urine dipstick and urine filtration test. A single stool sample was obtained from each participant and screened for S. mansoni and soil-transmitted helminths using the Kato Katz and formalin-ether concentration techniques. A questionnaire was administered to schoolchildren to elucidate the risk factors for schistosomiasis. The overall prevalence of S. haematobium in adults was 8.1% (95% confidence interval (CI), 6.6-9.8%). In total, 3779 schoolchildren had complete results from urine testing, and the overall prevalence of S. haematobium was 10.1% (95% CI, 9.1-11.1%). The prevalence of S. mansoni and soil-transmitted helminths was relatively low among both children and adults compared to S. haematobium. Factors associated with S. haematobium infection among schoolchildren were the mother's occupation, children aged 11-15 years, and water contact behaviour. The odds of having schistosomiasis infection among children aged 11-15 are 40% higher than those aged 5-10 (95% confidence interval (CI), 10-80%, p = 0.04). Children of parents who are livestock keepers have 12.3 times higher odds of having infection compared to those who have small-scale businesses (95% CI, 1.0-5.4, p = 0.03). Children who are in contact with infested water more than three times a week have 2.1 times higher odds of having an infection compared to those who do not (95% CI, 2.1; 1.6-2.8, p < 0.001). The findings provide updated geographical information on prevalence, yielding insights into the planning and implementation of mass drug administration in rural Tanzania.

Proteinuria screening and risk of bone fracture: a retrospective cohort study using a nationwide population-based database.

Proteinuria is associated with an increased risk of kidney function deterioration, cardiovascular disease, or cancer. Previous reports suggesting an association between kidney dysfunction and bone fracture may be confounded by concomitant proteinuria and were inconsistent regarding the association between proteinuria and bone fracture. Therefore, we aimed to evaluate the association using a large administrative claims database in Japan. Using the DeSC database, we retrospectively identified individuals with laboratory data including urine dipstick test between August 2014 and February 2021. We evaluated the association between proteinuria and vertebral or hip fracture using multivariable Cox regression analyses adjusted for various background factors including kidney function. We also performed subgroup analyses stratified by sex and kidney function and sensitivity analyses with Fine & Gray models considering death as a competing risk. We identified 603766 individuals and observed 21195 fractures. With reference to the negative proteinuria group, the hazard ratio for hip or vertebral fracture was 1.10 [95% confidence interval (CI), 1.05-1.14] and 1.16 (95%CI, 1.11-1.22) in the trace and positive proteinuria group, respectively, in the Cox regression analysis. The subgroup analyses showed similar trends. The Fine & Gray model showed a subdistribution hazard ratio of 1.09 (95%CI, 1.05-1.14) in the trace proteinuria group and 1.15 (95% CI, 1.10-1.20) in the positive proteinuria group. Proteinuria was associated with an increased risk of developing hip or vertebral fractures after adjustment for kidney function. Our results highlight the clinical importance of checking proteinuria for predicting bone fractures.

Diagnostic Value of Dipstick Test (Leukocyte Esterase and Nitrite) in Diagnosis of Urinary Tract Infection

Background: The accurate UTI diagnosis is crucial in the laboratory. Objective: The objective was to assess the sensitivity and specificity of the nitrite test, leukocyte esterase, both nitrite and leukocyte esterase, and urine microscopy in UTI diagnosis. Methodology: This was a cross-sectional study in which 100 adult patients, who were suspected to have UTI and did not receive antibiotics for at least 1 week, were included in this study performed in Shahabuddin Medical College and Hospital, Gulshan-2, Dhaka. Urine samples were collected and sent to laboratory for urine analysis and urine culture. Nitrite and leukocyte esterase dipsticks tests were done as well. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were measured for nitrite, leukocyte esterase, both nitrite and leukocyte esterase. Results: According to the results of the urine dipstick test, microscopy, and urine culture, nitrite was positive in 17.0% of the cases, leukocyte esterase was positive in 53.0% of the cases, both nitrite and leukocyte esterase were positive in 17.0% of the cases, urine microscopy was positive in 71.0% of the cases, and urine culture was positive in 41.0% of the cases. In the detection of urinary tract infections, the sensitivity, specificity, PPV, and NPV of leukocyte esterase were 87.8%, 71.2%, 67.9%, and 89.4% respectively, using urine culture as the gold standard test. Based on urine culture as gold standard test, the sensitivity, specificity, PPV, and NPV of both nitrite and leukocyte esterase were 34.1%, 94.9%, 82.4%, and 67.5% respectively, in detecting urinary tract infections. Conclusions: Efficacy of leukocyte esterase was found better in detecting UTI comparing nitrite test. Escherichia coli is the most common isolated organism. Bangladesh Journal of Medical Microbiology, July 2023;17(2):55-59