Urinary tract infection in children under five with fever of no obvious cause at Kenyatta National Hospital

Abstract

A descriptive cross-sectional survey was carried out in the out-patient paediatric filter clinic of Kenyatta National Hospital, Nairobi, to determine the prevalence of urinary tract infection among 185 children under 5 years of age who presented with fever of no obvious cause. The male to female ratio was 1.3:1 and the mean age was 23 months. Significant bacteriuria (SBU) was found in 41 out of the 185 patients giving a prevalence of 22.2%. The prevalence was higher in males than in females, but the difference was not statistically significant(P=0.2582). Clinical symptoms"and signs were found to be poor indicators of the presence of urinary tract infection. Leucocyturia occured in 40 out of the 41 children with SBU, giving a sensitivity of 97.6%, while presence of nitrites was found to be very specific (94.4%). Bacteriological studies indicated that E.coli was the commonest organism isolated (43.9%) followed by Staph aureus (19.5%), Staph Saprophyticus (17.1%), Klebsiella (9.8%) and proteus (7.3%). Nitrofurantoin, augmentine, nalidixic acid and the cep ha1ospori'ns (2nd and 3rd genera t .Lioorniss)were the drugs mos t sensitive to the organisms isolated while ampici 11in and cotrimoxazole showed high resistant patterns. The high prevalence rate found in this study emphasizes the need for regular urine checking in children with fever whose cause cannot easily be clinically determined.