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Pediatric urolithiasis in sub-saharan Africa: a comparative study in two regions of Cameroon
F F Angwafo1, M Daudon, A Wonkam
1Urology Unit, Yaoundé General Hospital, Yaoundé, Cameroon.
Insights
Pediatric urolithiasis in Cameroon is linked to infection and malnutrition, with stones primarily composed of ammonium urate, struvites, and whewellite. Socioeconomic factors significantly influence stone formation in children.
Area of Science:
- Pediatric Nephrology
- Urology
- Nutritional Science
Background:
- Urolithiasis in children presents unique challenges, particularly in resource-limited settings.
- Understanding the specific etiological factors in different geographic regions is crucial for targeted prevention and treatment.
- Previous studies on pediatric urolithiasis in Cameroon are limited, necessitating further investigation into stone composition and predisposing factors.
Purpose of the Study:
- To investigate the chemical composition of urinary calculi in Cameroonian children.
- To identify predisposing factors contributing to the nucleation and growth of kidney stones in pediatric patients.
- To explore the relationship between socioeconomic development and the prevalence of urolithiasis in different regions of Cameroon.
Main Methods:
- A cross-sectional study was conducted over six years involving 21 pediatric patients with urolithiasis.
- Data collected included patient demographics, dietary habits, residence, clinical presentation, and stone analysis results.
- Computerized analysis was employed to determine stone constituents and identify causes of nucleation and growth.
Main Results:
- Pediatric urolithiasis was more prevalent in the northern Sahelian belt, affecting males and rural dwellers disproportionately.
- Endemic bladder stone disease was common, with all analyzed stones being mixed.
- The most frequent stone constituents were ammonium urate, struvites, and whewellite. Infection and hyperuricosuria (linked to malnutrition) were identified as primary causes of stone formation.
Conclusions:
- Pediatric bladder stone disease is a significant health issue in northern Cameroon, influenced by socioeconomic development.
- Urolithiasis in this pediatric cohort is heterogeneous, with hyperuricosuria, inadequate fluid intake, and malnutrition-associated infections being key contributing factors.
- Comprehensive management strategies addressing nutrition, hydration, and infection are essential for controlling pediatric urolithiasis in the region.
Objective:
To determine the composition of caculi and the predisposing factors for stone nucleation and growth in children from two regions of Cameroon.
Methods:
This was a cross-sectional study involving 21 children, 17 from the northern and 4 from the southern region, over a 6-year period. Data on age, diet, residence, clinical presentation, location of stone, and results of stone analysis were collated following a preestablished proforma. A computerized analysis of the data was carried out. The constituents of stone sections and nidus were assembled so as to determine the principal causes of stone nucleation and growth.
Results:
Pediatric urolithiasis was more common in the northern Sahelian belt of Cameroon. Males and rural dwellers were more commonly affected. Endemic (bladder) stone disease was found in the majority of the patients. All stones were mixed. The most frequent constituents of the stones were ammonium urate, struvites, and whewellite in descending order of percentage mean volume per stone. The nidus was available for study in only 10 stones, and its composition revealed heterogeneity of causes of nucleation. The commonest cause for stone formation and growth were infection and hyperuricosuria (malnutrition).
Conclusions:
Pediatric bladder stone disease is not uncommon in northern Cameroon. Many factors combined to predispose to stone nucleation and growth, but the level of socioeconomic development was preponderant. Stone composition indicated that urolithiasis in children was a heterogeneous disorder, but hyperuricosuria, insufficient diuresis, and infection associated with malnutrition seemed to be the most common causes.