4. dang van chuc
14
Some determinants Some determinants of of urinary tract infection in children urinary tract infection in children from 2 months to 6 years old from 2 months to 6 years old In In hai phong vietnam In 2008 hai phong vietnam In 2008 Dang Van Chuc Nguyen Ngoc Sang Dang Viet Linh
Transcript of 4. dang van chuc
Some determinants Some determinants
ofof urinary tract infection in children urinary tract infection in children
from 2 months to 6 years old from 2 months to 6 years old
In In hai phong vietnam In 2008hai phong vietnam In 2008
Dang Van Chuc Nguyen Ngoc Sang
Dang Viet Linh
1. introduction
• Urinary Tract Infection (UTI):
- Renal Scarring=> anemia, hypertention (7-17%),
preclampsia, clampsia, renal failure and ended stage renal diseases.
- Hospital based studies.
- Limited community based studies
Objective:
To determine some risk factors of UTI in children from 2 month to 6 years old at some areas of Hai Phong.
2.1. Population and research time.
- All children from 2 months to 6 years old at some areas of HP.
- Research time: 7/2006-10/2008.
-UTI criteria: Leucocyturia ≥ 30/mm3 and bacteriuria ≥ 105/ml urine.
2.2. Method
- Research area: 3 counties/districts representative of rural, urban and
coastal of HP.
- Study design: Descriptive and Cross-sectional study.
- Sample size: using the following formula:
2. Population and method
n: Sample Size Z21-α/2 = (1,96)2 (Confidence degree 95%)p = 0,04 (UTI incidence in children of HP in a commune from Nguyen Ngoc Sang et al in 2005)d: Expected accuracy = 20% of p Applying to this formula , it needs about 4610 children for the study.-Sampling procedure: Multistage sampling. 3 county/districts: Kien An (urban), Kien Thuy (coastal) and Thuy Nguyen (rural). 9 cummunes: Nam son, Trang Minh and Van §au (Kien An), §ai Ha, Tan Trao and Ngu §oan(Kien Thuy), Phuc Le, Lap Le and Pha Le (Thuy Nguyen).
2
22/1
1
d
ppZn
- Data collection:
+ Determing UTI:
Clean morning midstream urine samples were used to screen
for urinary tract infection.
UTI was defined when having both
bacteriuria ≥105/ml and Leucocyturia ≥ 30/mm3.
+ Children’ parent interview:
On socio-economic conditions, children’s diseases and
history of children’diseases.
+ Physical examination:
Pediatricians directly examined children to find out children’s
diseases then weigh and measure to estimate their nutritional
status.
Data analysis: Using Epi-Info and SPSS version 13.0 to enter
and analyse data, calculate UTI incidence and determine
risk factors.
Dependent variables: 128 UTI cases, independent variables:
socio-economic and children’s diseases.
Risk factor: OR>1, 95% IC includes OR.
Multivariable analysis by using Logistics Regression.
3.1. Common information on children:-There were 4631 children screened among them
boys were 2268 (49%); girls 2363 (51%);
rural children 1603 (34,6%); coastal children 1568
(33,9%); urban children 1460 (31,5%).
-128 children had both leucocyturia and bacteriuria or
UTI incidence was 2.8%.
3. results
3.2. Some determinants of UTI:Table 1. The relationship of socio-economic condition and UTI.
Risk factors
Exposure nRate
%
ORBi
variables
95%CI
ORMulti
variables
95%CI
Maternal education
< secondary* 105 3.11.7 1.1-2.7
≥ secondary 23 1.8
Paternaleducation
< secondary * 109 3.32.2 1.3-3.7
≥ secondary 19 1.5
EconomyPoverty* 29 5.8
2.5 1.6-3.8 2.9 1.3-6.5Non poverty 99 2.4
WaterUnsafe water 31 2.6
0.9 0.6-1.3Safe water 97 2.8
Ware of UTI
Unware of UTI 115 2.81.2 0.7-2.2
Ware 13 2.3
Paternal care of child
Indirect paternal care of child*
84 3.61.9 1.3-2.8
Direct care 44 1.9
3.2. Some determinants of UTI:Table 2. The relationship of socio-economic condition and UTI (continued).
Risk factors
Exposure nRate
%
ORBi
variables
95%CI
ORMulti
variables
95%CI
Maternal care of child
Indirect maternal care of child*
71 3.91.9
1.4-2.8
Direct care 57 2.0
HouseStable 73 2.5
0.70.5-1.1Unatable 55 3.3
Lavatory
Unhygienic lavatory
58 2.30.65
0.4-0.9Hygienic
lavatory70 3.4
House’s square
< 20 m2 98 2.50.5
0.3-0.8≥ 20 m2 30 4.3
3.2. Some determinants of UTI:Table 3. The relationship of hygienic factors and UTI.
Risk factors
Exposure nRate
%
ORBi
variables
95%CI
ORMulti
variables
95%CI
Hygiene after urination
Clean* 102 3.31.9
1.3-3.0Clean and
washing26 1.8
DiaperYes* 23 5.8
2.41.5-3.8
No 105 2.5
Hygiene after stool
Clean * 99 3.21.7
1.1-2.6Clean and
washing29 1.9
3.2. Some determinants of UTI:Table 4. The relationship of hygienic factors and UTI (continued).
Risk factors
Exposure nRate
%
ORBi
variables
95%CI
ORMulti
variables
95%CI
Way of washing after stool
Posterio-anterior*
123
2.9
2.61.1-6.3
1.91.2-3.9Anterio-
posterior, in place
5 1.2
Kinder-garten
Yes 94 2.60.9
0.5-1.1No 34 3.3
Preschool
Yes 16 2.50.8
0.5-1.4No
112
2.8
3.2. Some determinants of UTI:Table 5. The relationship of children’s diseases and UTI.
Risk factorsExposur
en
Rate %
ORBi
variables
95%CI
ORMulti
variables
95%CI
StuntingYes * 49 3.5
1.41.0-2.1No 79 2.4
Low weightYes * 41 4.0
1.61.1-2.4
1.71.1-3.3No 87 2.4
WastingYes * 26 4.7
1.971.3-3.3No 102 2.5
PhimosisYes * 30 6.6
6.63.7-11.9
6.73.7-12.2No 19 1.0
ConstipationYes * 44 4.6
2.01.4-2.9No 84 2.3
EnuresisYes * 81 3.3
1.51.1-2.3No 45 2.1
- Family poverty
- Low weight malnutrition
- Phimosis in boys
- Parental Incorrect washing method for their child
4. conclusion
