INCIDENCE OF UROLOGICAL ANOMALIES IN CHILDREN WITH URINARY-TRACT INFECTIONS IN INDIA

A total of 2,970 infants and children with symptoms suggestive of urin ary tract infection (UTI) were investigated. Diagnosis was based on cl inical, microbiological, radiological, and sometimes endoscopic invest igations, Quantitative culture of an uncontaminated sample of urine is the most sensitive screening test. An additional 548 children had pos itive physical findings such as enlarged kidneys and/or bladder and we re excluded from this study, There were 2,970 children with urinary sy mptoms but no definite positive physical findings, and this group is d iscussed in detail; 73% (2,168) were boys and 27% (802) were girls. Th e commonest presenting symptoms were frequency of micturition, enuresi s, and straining on voiding. One hundred sixty-six had significant bac teriuria and were fully investigated, Only 148 children completed the investigations and treatment 130 had an underlying structural abnormal ity causing stasis of urine, It is well known that removal of the caus e of the stasis will. help to prevent further infections in most patie nts, and also reduces the effects of back-pressure on the upper tracts , This study illustrates: (1) the importance of proper urine culture t echnique (2) the high incidence (88%) of structural abnormalities caus ing UTI in children; and (3) the importance of investigating all child ren with proven UTI to determine the cause of stasis, In India, the pa tterns of UTIs and their causes are markedly different from chose publ ished in the English literature.