Prevalence and Determinants of Asymptomatic Bacteriuria in Children with Sickle Cell Anaemia in Jos, North-Central Nigeria

Asymptomatic bacteriuria in children with sickle cell disease

Abstract

Background: In Sickle cell anaemia (SCA), renal dysfunction including symptomatic and asymptomatic bacteriuria (ASB) usually starts in childhood. Children with ASB need to be identified early to forestall disease progression and attendant consequences. Jos that has peculiar conditions that could predispose to accentuated morbidities in children with SCA lack current data on ASB.

Objectives: The study therefore assessed the prevalence of ASB in children with SCA, its determinants and offending pathogens and compared it to findings in apparently healthy haemoglobin AA (HbAA) counterparts.

Methods: This was a comparative cross-sectional study involving 136 SCA and 136 HbAA children aged 2-17 years. Urinalysis, urine microscopy, culture and sensitivity were performed on samples from all the participants. The diagnosis of ASB was based on urine culture. Data on socio-demographics was obtained using a proforma. The association between the socio-demographic characteristics and asymptomatic bacteriuria was determined using chi squares test. A p-value <0.05 was considered statistically significant. 

Results: Prevalence of ASB in SCA children was 8.1% compared to 1.5% in HbAA children. Prominent isolated organisms were Escherichia coli (45.5%) and Staphylococcus aureus (27.3%) in SCA children; and Proteus spp (50%) and Providencia spp (50%) in HbAA counterparts. The female gender was significantly associated with the occurrence of ASB (p = 0.003).

Conclusion: The prevalence of ASB in children with SCA in Jos is high. Escherichia coli is the dominant organism responsible for ASB in children with SCA in Jos. Girls with SCA are more predisposed to asymptomatic bacteriuria than boys.

Keywords: Sickle cell disease, asymptomatic bacteriuria, urinary tract infection, Nigeria