Urine dipstick as a screening test for urinary tract infection

Antwi, S., Bates, Imelda ORCID: https://orcid.org/0000-0002-0862-8199, Baffoe-Bonnie, B. and Critchley, J. (2008) 'Urine dipstick as a screening test for urinary tract infection'. Annals of Tropical Paediatrics, Vol 28, Issue 2, pp. 117-122.

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Abstract

Background: Febrile illnesses are common among children in Ghana and are often diagnosed as malaria, thus overlooking urinary tract infection (UTI) as a possible cause of fever.
Aims: To determine the prevalence of UTI among febrile children,5 years and to estimate the sensitivity, specificity and positive and negative predictive values of urine dipstick as a screening test.
Methods: From March to July 2004, children aged 3-60 months attending an outpatient clinic at Komfo Anokye Teaching Hospital, Kumasi were systematically screened for UTI using Combi 10 dipstick (CyBow TM). All dipstick-positive and a sample of dipstick-negative urines underwent microscopy and culture (i.e. gold standard) from clean-catch or catheterised urine.
Results: Of 1393 children (median age 20 months), 112 (8%) had a positive dipstick and 29 of these (25.9%) had UTIs; 118/ 1278 (9.2%) children with a negative dipstick had urine cultured, one of whom (0.8%) had a UTI. The prevalence of UTIs was 2.1% (30/1393) and was higher among females (RR 3.99, 95% CI 1.76-9.04). 70% of UTIs were in children,2 years of age (p=50.08). The sensitivity, specificity and positive and negative predictive values of dipstick were 96.7%, 58.8%, 26.1% and 99.2%, respectively. Use of dipstick as a screening test for UTI was comparable to microscopic analysis for pyuria. 90% of all UTIs were clinically misdiagnosed (70% as malaria). Escherichia coli was the predominant isolate (60%). Co-trimoxazole and ampicillin, commonly used to treat uncomplicated UTIs at first level in Ghana, showed 0% and 8.3% in-vitro sensitivities, respectively. Ciprofloxacin and cefuroxime (widely used at regional/ tertiary level) showed good sensitivities, 99.0% and 86.2%, respectively.
Conclusions: Urine dipstick should be promoted as a screening test for UTI. First-line use of cotrimoxazole and ampicillin for UTI should be reviewed.

Item Type:	Article
Uncontrolled Keywords:	children girls
Subjects:	QY Clinical Pathology > Diagnostic Tests > QY 185 Urinalysis WS Pediatrics > Diseases of Children and Adolescents > By System > WS 320 Urogenital system
Faculty: Department:	Groups (2002 - 2012) > Disease Control Strategy Group
Digital Object Identifer (DOI):	https://doi.org/10.1179/146532808X302134
Related URLs:	Publisher
Depositing User:	Tina Bowers
Date Deposited:	11 Aug 2010 15:33
Last Modified:	22 Oct 2019 08:20
URI:	https://archive.lstmed.ac.uk/id/eprint/721

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