Epideomiological Characteristics of Urinary Tract Infection in School Children

Written by docteam Friday, 08 October 2010 07:46

School children had been thought to have a low frequency of symptomatic urinary infections. It is now clear that this is by no means a quiescent period. The prevalence of bacteriuria among girls is high compared to that among boys, a ratio 30 : 1. These data confirm the marked susceptibility of the female to urinary infection. They also support the hypothesis that most infection in this age group is by the ascending route, that is, arising in the urethra and bladder and extending to other sites. The nature of the organism is, for the most part, the aerobic gram-negative bacilli found in the stool, adding further support to the notion that they arise from the bowels.

The actual risk of a girl acquiring bacteriuria during the school year is much greater than the prevalence of 1.2% since this rate only represents those found to be colonized at one point in time. It is estimated that 5 to 6% of girls will have had at least one episode of bacteriuria between the times of entering the first grade and graduating from high school. This must be considered as the minimum frequency since it is based on school surveys conducted only once yearly and does not account for girls who developed symptomatic episodes between surveys and received effective treatment.

Many groups have confirmed the prevalence rate of 1 to 2% of bacteriuria in school girls and the low prevalence in boys . Slightly lower rates of recurrent infection, than shown in the figure, were reported by Cohe but a different method of follow up was used. Preschool and school girls discovered to have infection for the firs time, when carefully evaluated, also are found to have associated renal scars and vesicoureteral reflux. A small proportion will require corrective urologic surgery. Lindber et al reported that 30% had a history referable to the urinary tract. The C reactive protein was elevated in 9.5%, and lowered concentrating capacity was found in 3.4%