Risk factors for urinary tract infection in children: A population-based study of 2856 children
Article first published online: 3 FEB 2009
© 2009 The Authors. Journal compilation © 2009 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 45, Issue 3, pages 87–97, March 2009
How to Cite
Sureshkumar, P., Jones, M., Cumming, R. G. and Craig, J. C. (2009), Risk factors for urinary tract infection in children: A population-based study of 2856 children. Journal of Paediatrics and Child Health, 45: 87–97. doi: 10.1111/j.1440-1754.2008.01435.x
- Issue published online: 13 MAR 2009
- Article first published online: 3 FEB 2009
- Accepted for publication 22 July 2008.
- risk factors;
- urinary tract infection
Aim: To identify risk factors for urinary tract infection (UTI) in children to inform the development of preventative strategies.
Method: A validated questionnaire covering demographic factors, perinatal, developmental, bowel and urinary history was sent to a cross-sectional sample of parents of elementary school children randomly selected from the first 4 years of school. UTI was ascertained by parental report, verified by cross-referencing with microbiological reports for all positive cases and 50 randomly selected negative cases.
Results: Parents of 2856 children (mean age 7.3 years, range 4.8–12.8 years) responded. A total of 3.6% of children had a bacteriologically verified UTI, compared with 12.6% by parental report alone. Multivariate polychotomous logistic regression showed that a history of structural kidney abnormalities (odds ratio (OR) 15.7, 95% confidence interval 8.1–30.4), daytime incontinence (OR 2.6, 1.6–4.5), female gender (OR 2.4, 1.5–3.8), and encopresis (OR 1.9, 1.1–3.4) were independently associated with UTI. Daytime incontinence increased risk more in boys (8.3% vs. 1.2%) than girls (8.1% vs. 4.6%), and kidney problems increased risk in older compared with younger children (29% vs. 2% in ≥8 year olds, 0% vs. 4% in 4–6 year olds).
Conclusions: Parents over-report UTI by about threefold. Effective treatment of daytime urinary incontinence and encopresis may prevent UTI in children, especially boys.