Prevalence of Asymptomatic Microscopic Hematuria in 7-12 Years School Age Children of Medhanealem Primary School in Addis Ababa
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Date
2014-10
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Abstract
Background
Hematuria is one of the most important signs of renal or bladder disease in children and it
can represent a process that is simple and benign or complex and life threatening.
Asymptomatic microscopic hematuria is common in unselected populations of children, with
a prevalence that ranges from 0.4% to 4.1% depending on the criteria used to define
hematuria.
Urine analysis, a simple and inexpensive test, is the cornerstone in the evaluation of the
kidney function. Proteinuria or hematuria may be the only early signs of renal disease
including membranous nephropathy, membranoproliferative glomerulonephritis, post
infectious glomerulonephritis, IgA nephropathy and others. The basic dipstick method is the
most rapid screening procedure that could be helpful in the early detection of renal or urinary
tract diseases among apparently healthy or asymptomatic subjects in the hope of preventing
and retarding progression to chronic renal failure. Many countries have used this screening
program to prevent and follow children with asymptomatic children. However the prevalence
of asymptomatic hematuria is unknown in Ethiopia and there is no recommendation on
routine screening urinalysis in Ethiopian school children.
Objective
To determine the prevalence of asymptomatic hematuria in school age children in
Addis Ababa
Methods
A cross sectional survey using urinalysis was done over a period of 8 weeks in 382 apparently
healthy school age children (7-12 years) at MAPS in Addis Ababa. The children who tested
positive in the first screening were re-tested after 2 weeks.
Results
In the first screening 32 children (8.4 %) tested positive for hematuria. Of these children, 16
(4.2 %) cases tested positive in a second screening. The prevalence was both age and sex
dependent. Co-existing proteinuria and leucocytes were common findings (19.6 % and 8.4 %
respectively) where as pyuria, glycosuria and nitrite were seen in < 1% of children.
Glomerulonephritis was the most commonly detected disorder (43.75%). 75 students (19.6%)
were positive for protein,7 students(1.8%) were positive for both blood and protein, 1
student(0.3%) was positive for glucose,1 student (0.3%) was positive for nitrite ,32 students
(8.4%) were positive for leukocyte- esterase.
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Subsequently, 10 children from the secondary screening group were lost to follow up and
only 6 students were referred to TAH pediatric renal clinic.
Conclusions
This study helped to assess the prevalence of urinary abnormalities in school-aged children
for the first time in Ethiopia. Urine abnormalities are common finding among apparently
healthy school aged children with hematuria and proteinuria being the most prevailing
abnormalities. Our study demonstrated that hematuria is higher in Ethiopian children than
other African children and worldwide. Coexisting urinary abnormalities especially
Leukocyturia and proteinuria (most are trace) are common while nitrituria and glucosuria are
uncommon.
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Keywords
Asymptomatic microscopic hematuria;Proteinuria