TRENDS IN THE HEALTH BURDEN DUE TO URINARY-TRACT INFECTION IN CHILDREN IN AUSTRALIA

Objective: To estimate the health burden of urinary tract infection in children less than 15 years of age in Australia and to ascertain whet her any significant change has occurred during the past decade. Method ology: The number of children less than 15 years of age who were admit ted in New South Wales for urinary tract infection between 1981 and 19 94 was ascertained from the Department of Health, and age and sex spec ific incidence rates were calculated using Australian Bureau of Statis tics population data. Costs for inpatient care were calculated using t he cost weights from Australia National Disease Related Groups Version 3 for urinary tract infection (DRG 577). The frequency of the four mo st commonly requested renal tract imaging procedures in children follo wing urinary tract infection and which qualified for Medicare reimburs ement were obtained from the Health Insurance Commission for 1984-1994 : micturating cystourethrography, intravenous urography, renal ultraso nography, and nuclear medicine renal studies. Results: There were 1203 children who were admitted with urinary tract infection in New South Wales in 1994, at an estimated cost of $A1.6 million. Since 1981, the age standardized annual incidence of urinary tract infection requiring hospitalization has increased from 0.5 to 0.9 per 1000 children, larg ely because of an increase in the number of young children admitted (f rom 0.6 to 2.0 per 1000 children less than 5 years of age). In 1994, 4 6 230 non-inpatient renal imaging procedures were undertaken in childr en under 15 years of age at a cost of $A5.3 million. Conclusions: Urin ary tract infection is an important and increasing health problem for Australian children, particularly for preschool children. Whether this represents a true increase in the incidence of urinary tract infectio n or improved diagnosis and more intensive management is not possible to establish with this study design. Prospective population based stud ies are required to assess more completely the frequency with which ur inary tract infection occurs in children and any changes that may be o ccurring.