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Prevalence of urinary tract infection in childhood: a meta-analysis
Nader Shaikh1, Natalia E Morone, James E Bost
1Division of General Academic Pediatrics, University of Pittsburgh, Pittsburgh, PA 15213-2583, USA. nader.shaikh@chp.edu
Insights
Urinary tract infection (UTI) prevalence in children varies significantly by age, gender, race, and circumcision status. Uncircumcised males under 3 months and females under 12 months show the highest UTI risk, informing clinical decisions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Urinary tract infections (UTIs) are common in children.
- Understanding baseline UTI prevalence is crucial for accurate diagnosis and treatment.
- Variations in UTI risk exist across different demographic groups.
Purpose of the Study:
- To determine the pooled prevalence of urinary tract infection (UTI) in children.
- To analyze UTI prevalence based on age, gender, race, and circumcision status.
- To provide data for informed clinical decision-making in pediatric UTI cases.
Main Methods:
- A meta-analysis was conducted using MEDLINE and EMBASE databases.
- Included studies focused on pediatric UTI prevalence in children aged 0-19 presenting with symptoms.
- Data from 18 eligible articles were independently reviewed and abstracted.
Main Results:
- The overall prevalence of UTI in infants with fever was 7.0%.
- Among febrile male infants under 3 months, uncircumcised males had a significantly higher UTI prevalence (20.1%) than circumcised males (2.4%).
- Females under 12 months showed higher UTI prevalence rates (ranging from 2.1% to 8.3% across age bands) compared to older children (7.8%).
- UTI rates were higher in white infants (8.0%) compared to black infants (4.7%).
Conclusions:
- Pediatric UTI prevalence is influenced by age, gender, race, and circumcision.
- Uncircumcised males under 3 months and females under 12 months represent high-risk groups for UTI.
- These prevalence estimates aid clinicians in diagnostic testing decisions for children with suspected UTIs.
Background:
Knowledge of baseline risk of urinary tract infection can help clinicians make informed diagnostic and therapeutic decisions. We conducted a meta-analysis to determine the pooled prevalence of urinary tract infection (UTI) in children by age, gender, race, and circumcision status.
Methods:
MEDLINE and EMBASE databases were searched for articles about pediatric urinary tract infection. Search terms included urinary tract infection, cystitis, pyelonephritis, prevalence and incidence. We included articles in our review if they contained data on the prevalence of UTI in children 0-19 years of age presenting with symptoms of UTI. Of the 51 articles with data on UTI prevalence, 18 met all inclusion criteria. Two evaluators independently reviewed, rated, and abstracted data from each article.
Results:
Among infants presenting with fever, the overall prevalence (and 95% confidence interval) of UTI was 7.0% (CI: 5.5-8.4). The pooled prevalence rates of febrile UTIs in females aged 0-3 months, 3-6 months, 6-12 months, and >12 months was 7.5%, 5.7%, 8.3%, and 2.1% respectively. Among febrile male infants less than 3 months of age, 2.4% (CI: 1.4-3.5) of circumcised males and 20.1% (CI: 16.8-23.4) of uncircumcised males had a UTI. For the 4 studies that reported UTI prevalence by race, UTI rates were higher among white infants 8.0% (CI: 5.1-11.0) than among black infants 4.7% (CI: 2.1-7.3). Among older children (<19 years) with urinary symptoms, the pooled prevalence of UTI (both febrile and afebrile) was 7.8% (CI: 6.6-8.9).
Conclusions:
Prevalence rates of UTI varied by age, gender, race, and circumcision status. Uncircumcised male infants less than 3 months of age and females less than 12 months of age had the highest baseline prevalence of UTI. Prevalence estimates can help clinicians make informed decisions regarding diagnostic testing in children presenting with signs and symptoms of urinary tract infection.
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