ASYMPTOMATIC PROTEINURIA AND HAEMATURIA IN SCHOOL CHILDREN IN SOKOTO METROPOLIS

Abstract

Renal diseases may be present without any obvious symptom. However, proteinuria as well
as haematuria may be the only early detectable urinary abnormalities of a renal disease. There is
paucity of data on urinalysis screening for proteinuria and haematuria in children in Nigeria,
particularly in Sokoto, North-Western Nigeria.
The objectives of this study were to determine the prevalence of proteinuria and of
haematuria among asymptomatic primary school children, the age specific prevalence of
proteinuria and of haematuria, the gender specific prevalence of proteinuria and of haematuria,
and the sensitivity and specificity of the 10SG Multistix urinalysis strip in detecting haematuria as
compared with microscopy.
The study was a prospective cross sectional one that involved six hundred (308 males and
292 females) apparently healthy primary school children aged 5 to 14 years who met the
inclusion criteria. They were recruited from 31 randomly selected public and private primary
schools in Sokoto metropolis between May and September 2013. Early morning urine samples
were obtained from the children and subjected to urinalysis using 10 SG Multistix to detect
proteinuria and haematuria. Urine microscopy was performed to confirm the presence of
haematuria. Pupils with positive results on initial screening had a second screen 1-2 weeks later,
to determine the persistence of urine abnormalities.

Sixty eight (11.3%) subjects had asymptomatic proteinuria on first screening while 30 (5.0%)
had persistent asymptomatic proteinuria. The prevalence of asymptomatic proteinuria was
highest among children in the age group 11-12 years (15.3%). Persistent proteinuria was also
more common in the same age group (9.4%). Though not significant, males had higher prevalence
of asymptomatic proteinuria and persistent asymptomatic proteinuria than in females.
Nine (1.5%) subjects had asymptomatic haematuria while three (0.5%) subjects had
persistent asymptomatic haematuria. The prevalence of asymptomatic haematuria was highest
among children in the age group 11-12 years (4.3%). Persistent haematuria was also commoner in
the same age group (1.7%). Males (1.9%) had higher prevalence of asymptomatic haematuria
than females (1.0%). The three pupils with persistent asymptomatic haematuria were all males.
Combined proteinuria and haematuria was detected in 6 (1%) subjects but persisted in 3 (0.5%)
of them. Similar pattern of age and gender specific prevalence were also noticed in them. The
sensitivity, specificity, positive and negative predictive values of dipstick urinalysis in detecting
haematuria were 100%, 99.7%, 81.8% and 100% respectively.
Asymptomatic proteinuria and haematuria are common urinary abnormalities among
primary school children in the study area and Multistix (10SG) urinalysis strip is a reliable
screening tool for the detection of haematuria. Routine urine screening for abnormalities such as
proteinuria and haematuria using simple screening tools like Multistix strip should therefore, be
considered as part of medical screening among school children and those with persistent
abnormalities should be subjected to further evaluation and long term follow up.

ASYMPTOMATIC PROTEINURIA AND HAEMATURIA IN SCHOOL CHILDREN IN SOKOTO METROPOLIS