TITLE:
Contribution of the Urine Dipstick to Urinary Tract Infection Diagnosis among Children in Two Hospitals in Cotonou-Benin
AUTHORS:
Godonou Gratien Sagbo, Fredias Sogbo, Honorat Francis Lalya, Joseph Agossou, Yevedo Tohodjèdé, Florence Alihonou, Gilles Bognon, Diane Ahinonhossou, Afolabi Dissou, Blaise Ayivi
KEYWORDS:
Urinary Tract Infection, Urinary Dipstick Test, Urine Culture
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.7 No.4,
November
21,
2017
ABSTRACT: Introduction: Urinary tract infections are a daily concern in pediatric nephrology with long-term risks for high blood
pressure and renal failure. The purpose of this study was to determine
the contribution of a urine dipstick (UD) to the diagnosis of urinary
infections among children at the CNHU-HKM and the Lagoon Mother and Child
University Teaching Hospital (CHU-MEL) of Cotonou. Patients and Methods: This study is a cohort, descriptive and analytical study focused on children
with suspected urinary infections in the pediatric units of the CNHU-HKM and
CHU-MEL of Cotonou from March 25 to August 25, 2015. Results: Two
hundred and four children out of a total of 5125 admitted children (4%)
presented with at least one clinical sign of a urinary tract infection. Children under 36 months of age were predominant (41%). The main clinical signs of urinary infections were fever (60.8%) and urinary disorders (38.2%). The urinary dipstick test was positive in 145
children (71.2%). A urinary tract
infection was confirmed by urine culture in 38 children (18.6%). In cases with
leucocyturia- and nitrituria-positive urine dipstick tests, the sensitivity
was estimated to be 13.2%, and the specificity was 95.2%, with a negative predictive value (NPV) of 82.8%. Only when
the leucocyturia test was positive,
the sensitivity was 76.3%, and the specificity was 31.9%. When the leucocyturia
test was negative, the specificity was estimated to be 94%, and the sensitivity was 83% in the nitrituria-positive cases
and 15.8% in the nitrituria-negative cases.
The main isolated pathogens were Escherichia coli (n = 21)
and Klebsiella pneumoniae (n = 14). Conclusion: In our environment, a negative leucocyturia test may help exclude urinary
tract infections in most cases.