الفهرس 
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Abstract
Chronic kidney disease (CKD) is a major health problem worldwide with increasing incidence and prevalence. In the absence of a national registry, the exact prevalence of CKD in children in Egypt is not known. End stage renal disease is probably the ”tip of the iceberg,” where patients are diagnosed with renal disease when they have already reached the end-stage renal failure.
The aim of this work is assessment and study of urine abnormalities among asymptomatic primary school children at Menouf district – Menoufia governorate as this may be a risk factor for chronic kidney disease.
Subject and method
This was a cross sectional study which was done in primary schools in Menouf District, Menoufia Governorate. The study started from October 2019 to October 2020. This study included 840 students from one rural and one urban school; all the students of the rural school were selected (756). 84 students were selected randomly from the urban school to keep the ratio between rural and urban student 9:1 in relation to the total number of primary school students in rural and urban schools.
Ethical consideration
The study was approved by the Ethical Committee of the Faculty of Medicine, Menoufia University.
A written consent was signed by authorities of the ministry of education and schools‘ managers.
Informed consent was obtained from all participants‘ parents.
All participants were subjected to:
History taking: personal data (name, age, gender, telephone number), assessment of the socioeconomic level (SES) according to (100) scoring system, present, past and family medical history of symptoms suggesting renal or urological disorders.
General clinical examination and local examination for chest, heart and abdomen.
Urinary screening through dipstick urine analysis. Microscopic urine examination was performed for children with any abnormality in dipstick test. Children with Pyuria or dipstick Nitrite had undergone urine culture.
Urea and Creatinine were done for confirmed cases of hematuria or positive urine culture
This study showed that
The prevalence of urinary abnormalities by dipstick test among primary school children was 18.1%. This percentage was higher in females.
Within all studied group; 13.1% had leucocytes in urine dipstick, 5% had RBCs, 4% were positive in nitrite test and 1.7% had protein.
Within positive dipstick cases, 25% showed at least one abnormality in microscopic urine analysis, representing 4.5% of the total study group, as 20.39% of cases who undergone microscopic urine analysis showed
Summary
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microscopic Pyuria, 3.95% showed microscopic hematuria, while there was no detected cases of proteinuria.
Urine culture was done in 31 student representing 3.69% of the total study group. Out of them, 30 showed positive urine culture representing 96.77% of all cases that undergone urine culture.
The most frequently detected organism detected in urine culture was E. Fecalis, followed by E. coli and S. Epidermidis.
from this study we concluded that:
1- Urine analysis using Dipstick test is a low cost, simple and non-invasive screening test.
2- Defective cleaning after toilet may be the cause of more than 50% of cases of UTI.
3- There was no big difference between rural and urban students in Menouf district; this may be due to improved health care and health education in rural areas.
We recommend that
1- Mass screening of school children by dipstick test followed by microscopic urine analysis for positive cases.
2- Cases with positive findings in microscopic urine analysis should be referred to secondary referral hospitals to be fully investigated.
3- Further studies are needed for detecting sensitivity and specificity of dipstick screening test.
4- Health training and education regarding the proper way of toilet cleaning especially in females.