THE FREQUENCY of ASYMPTOMATIC BACTERIURIA AMONG HEALTHY and MALNOURISHED CHILDREN under 5 YEARS AGE at SALAH ALDEEN GENERAL HOSPITA

Abstract

Background: Malnutrition is considered the most important public health problem inchildren in the developing countries and risk factor for the burden of diseases which associated with impairment of immunity that aggravate infections including asymptomatic bacteriuria and urinary tract infection. There was a significant association between asymptomatic bacteriuria and the malnourished children that may have predisposed them to urinary tract infection, so urine from all such children should be routinely screened for the presence of asymptomatic bacteriuria and appropriate antibiotic should be given if the culture is positive.Aim: The aim of this study is to decrease morbidity among malnourished children by early detection of asymptomatic bacteriuria.Pateints and methods : A cross sectional descriptive study was done on patients aged 2 months to 5 years with malnutrition attending the rehabilitation ward and the outpatient clinic at Salah_Aldeen General Hospital during the period from 1st of February to the last of the June 2019. The study involved 110 child who were divided into 2 groups (cases and control group). Each case included in the study was assessed initially by a prepared questionnaire that included name, age, sex ...etc. and presence of signs of malnutrition as where as assessed for some anthropometric measures used in the assessment of nutritional states which include weight, height and weight for height. Both study and control cases were sent for urinalysis, urine culture and abdominal ultrasound.Results : Significant asymptomatic bacteriuria was found in 65.5% of malnourished cases and34.5% in control children. This study also showed that asymptomatic bacteriuria in malnourished children increase in rural area was 73.9%, also increased with low educational level of the mother. The most common age of bacteriuria was under 3 years and more common in female, also asymptomatic bacteriuria was more common in bottle fed than breast fed. The risk of bacteriuria not increased by severity of malnutrition. This study showed that Escherichiacoli was the most common micro-organism in both cases and control group.Conclusion : It is concluded that asymptomatic bacteriuria is a significant problem among malnourished patients which need early diagnosis to prevent further complications. The malnourished patient should be routinely screened for the presence of asymptomatic bacteriuria to decrease morbidity in these patients, also assessment, management and evaluation of urinry tract infection is recommended, because symptoms of urinary tract infection in children often vague and not specific.