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JOURNAL OF SCIENCE, Hue University, N
0
61, 2010 SOME DETERMINANTS OF URINARY TRACT INFECTION IN CHILDREN
FROM 2 MONTHS TO 6 YEARS OLD IN HAI PHONG VIETNAM IN 2008
Dang Van Chuc, Nguyen Ngoc Sang, Dang Viet Linh
SUMMARY
This research was conducted to establish some determinants of urinary tract infections
(UTI) in children from 2 months to 6 years old in some areas of Haiphong in 2008. Method:
Cross-sectional study. Results and Conclusions: “Poverty”, “Underweight weight
malnutrition”, “Phimosis” and incorrect washing method after children have passed stools
were statistically significant with the presence of UTI using a logistic regression analysis. There
was a relationship between UTI development, poverty and poor knowledge of child hygiene.
Keyword: Urinary Tract Infection, Determinant.

1. Introduction
Urinary Tract Infections (UTI) are of interest to scientists because they can lead
to renal scarring, which causes dangerous complications when children grow up such
as: anemia, hypertension (7-17%), preeclampsia, eclampsia, renal failure and end stage
nephropathologies. Most research has been conducted in hospitals to determine the
incidence of UTI, type of bacteria and treatment effectiveness. In Vietnam, no studies
have been conducted in the community to evaluate the Prevalence rate, In particular, to
determine some risk factors of UTI. Therefore, this study was conducted with the
following objectives:
Determine some risk factors of UTI in children from 2 months to 6 years old in
some areas of Haiphong, Vietnam.




n: Sample size
Z
2
1-α/2
= (1, 96)
2
(confidence 95%)
p = 0, 04 (UTI rate in children of Haiphong after Nguyen Ngoc Sang et al in one
commune in 2005)
d= (p*

) or 20% of p
So approximately 4610 children were needed for the study.
Sampling process: Multistage sampling was used.
The 3 districts chosen were Kien An (urban), Kien Thuy (coastal) and Thuy
Nguyen (rural). The 9 communes/ quarters selected were Nam son, Trang Minh and Van
Dau (Kien An), Dai Ha, Tan Trao and Ngu Doan (Kien Thuy), Phuc Le, Lap Le and Pha
Le (Thuy Nguyen).
Data collection:
+ Identification of UTI:
We carried out screening of midstream urine of children in the morning to detect
UTIs. In the previous night and in the morning the child’s genitals were cleaned using
safe water and soap. The first urine was eliminated and 5 ml of midstream urine was
collected in a neutral tube. If the urine sample has leucocyturia ≥ 30/mm
3
, it was
cultured to identify bacteriuria. A UTI was identified if urine sample had both

Exposure n Rate %

OR Bi
variables

95%CI

OR
Multi
variables

95%CI

Maternal
education
<
secondary*
105 3.1
1.7 1.1-2.7
≥ secondary 23 1.8
Paternal
education
< secondary
*
109 3.3
2.2 1.3-3.7
≥ secondary 19 1.5
Economy
Poverty* 29 5.8
2.5 1.6-3.8 2.9 1.3-6.5

Table 2. The relationship of socio-economic conditions and UTIs (continued).
Risk
factors
Exposure n Rate %

OR Bi
variables

95%CI

OR
Multi
variables

95%CI

Maternal
care of
child
Indirect
maternal care
of child*
71 3.9
1.9 1.4-2.8
Direct care 57 2.0
House
Stable 73 2.5
0.7 0.5-1.1
Unstable 55 3.3
Lavatory

Multi
variables

95%CI
Hygiene
after
urination
Clean* 102 3.3
1.9
1.3-
3.0

Clean and
26 1.8 35
washing
Diaper
Yes* 23 5.8
2.4
1.5-
3.8

No 105 2.5
Hygiene
after stool
Clean * 99 3.2
1.7
1.1-


2.9
2.6 1.1-6.3 1.9 1.2-3.9
Back-
ward, in
place
5 1.2
Kinder-
garten
Yes 94 2.6
0.9 0.5-1.1
No 34 3.3
Preschool
Yes 16 2.5
0.8 0.5-1.4
No 112

2.8
Remark: Factors such as “incorrect washing method after urination and passing
stools” were statistically significant in bivariate and multivariable analysis. Others were
not significant.
Table 5. The relationship of child’s diseases and UTIS.
Risk
factors
Exposure

n Rate %

OR Bi
variables

No 19 1.0
Consti
pation
Yes * 44 4.6
2.0 1.4-2.9
No 84 2.3
Enuresis
Yes * 81 3.3
1.5 1.1-2.3
No 45 2.1
Remark: Factors marked with an asterisk were significant in bivariate analysis,
including “Malnutrition of all kinds”, “phimosis”, “constipation” and “enuresis”. In
multivariable analysis, only “phimosis and “low weight malnutrition” were significantly
associated with UTIS.
4. Discussion
4.1. Socio-economic conditions and maternal education level:
Table 1, 2 showed that “poverty”, paternal education level under secondary
school”, and “indirect paternal care of child” were significantly associated with UTI.
The results revealed the relationship between poverty, ignorance and disease. People
with low education levels generally do not earn a high income later in life. Once being
poor, parents have to work hard and so they do not have enough time to take care of
their child, they are not able to get access to medical services and their child’s disease
makes them become poorer. In multivariable analysis, only “poverty” remained
significantly associated with UTI (OR = 2, 9).
4.2. Paternal practice for UTI prevention:
Table 3, 4 showed that “incorrect method of cleaning after urination”, “diapers”,
“clean after stool”, and “incorrect washing methods after stools” were risk factors of
UTIs. According to Gal and Steven Use of an incorrect hygiene method after urination
and stools helps bacteria colonize on the perineal surface and then penetrate into urinary
tract and cause UTI. In multivariable analysis, “incorrect washing method after stool

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