Age and gender based study of urine microscopy in children and adolescents: a retrospective study

Philip Umman, Tinu Philip, Hana George Babu, Pramod Thomas


Background: Urinary tract infection (UTI) is a common reason for accessing health care services in all age groups. Women are more susceptible to UTI across age groups. Among males, the prevalence decreases in adolescence. Socio-economic and behavioural factors may play a significant role in the higher prevalence of UTI among adolescent girls. A study on UTI among children and adolescents will give a better insight in to the gravity of the problem and suggest appropriate interventions. Aim of the current study was to investigate the prevalence of urinary tract infection in males and females in the age group 0 to 20 based on the urine routine examination.

Methods: This retrospective study included patients who had urine routine examination (URE) done based on clinical symptoms, during the period from January to December 2018 in a tertiary care teaching hospital. Data was obtained from the laboratory records and medical records department.

Results: 1574 (3.43%) out of 45896 patients had a URE. This included 716 males (46%) and 858 females (54%). Among those with positive URE results, females were more affected than their male counterparts and this was statistically significant (male 21.8%, female 78.2%, p< 0.0001). As age advances, the prevalence decreases in males.

Conclusions: Urinary tract infection is more prevalent in females across the pre- adolescent and adolescent age group. It decreases with age in males. Understanding the factors responsible for the persistent higher prevalence in females may decrease the prevalence of urinary infection in adolescent females.


Adolescent, Urinary tract infection, Prevalence

Full Text:



Al-Badr A, Al-Shaikh G. Recurrent Urinary Tract Infections Management in Women: A review. Sultan Qaboos Univ Med J. 2013;13(3):359-67.

Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002;113(1):5-13.

Wagenlehner F, Wullt B, Ballarini S, Zingg D, Naber KG. Social and economic burden of recurrent urinary tract infections and quality of life: a patient web-based study (GESPRIT). Expert Rev Pharmacoecon Outcomes Res. 2018;18(1):107-17.

Graber JA, Petersen AC. Cognitive changes at adolescence: Biological perspectives. Brain maturation and cognitive development: Comparative and cross-cultural perspectives. N Engl J Med. 1991:253-79.

Pregnancy and abortion in adolescence. Available at: Accessed on 20 October 2021.

Anderson MJ, Agarwal R. Urinalysis. In: Lerma EV and Nissenson AR. Nephrology Secrets. 3rd ed. Newzeland: Elsevier Mosby; 2012.

Montini G, Tullus K, Hewitt I. Indications. N Engl J Med 2011;365:239-250.

T.J.Walsh, S. Hsieh, R. Grady, B.A. Mueller. Antenatal hydronephrosis and the risk of pyelonephritis hospitalization during the first year of life. Urology. 2007;69:970-4.

Matsuoka H, Kajiwar I, Tahara H, Oshima K. Phimosis as a pathogenetic factor in urinary tract infection and vesicoureteral reflux. Nihon Hinyokika Gakkai Zasshi. 1994;85(6):953-7.

Singh-Grewal D, Macdessi J, Craig J. Circumcision for the prevention of urinary tract infections in boys: a systematic review of randomized trials and observational studies. Arch Dis Child. 2005;90:853-8.

Srivastava S. Analytical study of urinary tract infection in adolescent girls. Int J Reprod Contracept Obstet Gynecol. 2018;7:1385-8.

Janoowalla H, Keppler H, Asanti D, Xie X, Negassa A, Benfield N, et al. The impact of menstrual hygiene management on adolescent health: The effect of Go! pads on rate of urinary tract infection in adolescent females in Kibogora, Rwanda. Int J Gynaecol Obstet. 2019.

Mazzola BL, von Vigier RO, Marchand S, Tönz M, Bianchetti MG. Behavioral and functional abnormalities linked with recurrent urinary tract infections in girls. J Nephrol. 2003;16(1):133-8.

Weir M, Brien J. Adolescent urinary tract infections. Adolesc Med. 2000;11(2):293-313.

Hooton TM, Scholes D, Hughes JP, Winter C, Roberts PL, Stapleton AE, et al. A prospective study of risk factors for symptomatic urinary tract infection in young women. N Engl J Med. 1996;335(7):468-74.

Nygaard I, Linder M. Thirst at work--an occupational hazard? Int Urogynecol J Pelvic Floor Dysfunct Int. 1997;8(6):340-3.

Ahmed SM, Avasarala AK. Urinary tract infections (UTI) among adolescent girls in rural Karimnagar District, AP KAP STUDY. Indian J Pre Soc Med. 2008.

Kerala Schools. Available at: https://indianexpress. com/article/india/kerala/kerala-schools-ring-the-bell-to-remind-students-to-drink-water-6123536/. Accessed on23 November 2019.

Butler CC, O’Brien K, Pickles T, Hood K, Wootton M, Howe R, et al. Childhood urinary tract infection in primary care: a prospective observational study of prevalence, diagnosis, treatment, and recovery. Bri J General Pract. 2015;65(633):e217-23.

Marcon J, Stief CG, Magistro G. Urinary tract infections: What has been confirmed in therapy? Internist (Berl). 2017;58(12):1242-9.

Lerman-Garber I, Calva-Mercado JJ, Martinez-Sibaja C, del Castillo CF, Sanchez-Javier RM, Lara E, et al. Leukocyturia in women with diabetes and its clinical implications. Arch Med Res. 2000;31(2): 210-5.

Lugg-Widger FV, Angel L, Cannings-John R, Jones H. Long-term outcomes of urinary tract infection (UTI) in Childhood (LUCI): protocol for an electronic record-linked cohort study. BMJ Open. 2019;9:e024210.

Fahey T, Webb E, Montgomery AA, Heyderman RS. Clinical management of urinary tract infection in women: a prospective cohort study. Fam Pract. 2003;20(1):1-6.