The prevalence of urinary tract infection (UTI) in children underfive years old presenting with an acute illness in UK generalpractice
Year: 2013
Type: dissertation
Study design: Observational Study
Abstract: Urinary tract infections (UTI) in young children have been associated with serious long-term \ncomplications such as renal scarring, hypertension and renal failure. The presenting \nsymptoms of UTI in children are non-specific. If UTI is not suspected, a urine sample is not \nobtained, and without this, UTI cannot be diagnosed. There is evidence that the diagnosis is \noften missed. \n \nMost published studies have not systematically sampled urine, and those that have are largely \nbased in US emergency departments and only include highly selected groups of children. The \ntrue prevalence of UTI in acutely ill children presenting in UK general practice is therefore \nunknown. \n \nMy thesis consists of a literature review discussing the association of childhood UTI with \nlong-term complications, the challenges of diagnosis and the evidence that UTIs are being \nmissed; a systematic review of papers reporting UTI prevalence in children which highlights \nthe need for a study in UK general practice; a pilot study to determine the feasibility of \nrecruiting children and obtaining urine samples in UK general practice; and a prospective \ncohort study to determine the point prevalence of UTI in 597 presenting children, determine \nthe predictive value of presenting symptoms, signs and risk factors, and describe the clinical \noutcomes for children with UTI. \n \nI found that the prevalence of UTI was 5.9% (95% confidence interval: 4.3-8.0%). This may \nbe sufficiently high to justify increased urine sampling in general practice. \n \n A multi-variable logistic regression model identified younger age range, pain on passing \nurine (dysuria) and urinary frequency as being associated with UTI. I propose a urine \nsampling strategy for GPs assessing acutely ill children and compare this to suspicion-led \nsampling and current guidelines. In my discussion I discuss the limitations, generalisability \nand implications of these findings.
Author: Kathryn O’Brien
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1570435492