2008(率文献质量评价)Prevalence of Urinary Tract Infection in Childhood.pdfVIP

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2008(率文献质量评价)Prevalence of Urinary Tract Infection in Childhood.pdf

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2008(率文献质量评价)Prevalence of Urinary Tract Infection in Childhood

ORIGINAL STUDIES Prevalence of Urinary Tract Infection in Childhood A Meta-Analysis Nader Shaikh, MD, MPH,* Natalia E. Morone, MD, MSc,? James E. Bost, PhD,? and Max H. Farrell, BS? Background: Knowledge of baseline risk of urinary tract infection can help clinicians make informed diagnostic and therapeutic deci- sions. We conducted a meta-analysis to determine the pooled prev- alence of urinary tract infection (UTI) in children by age, gender, race, and circumcision status. Methods: MEDLINE and EMBASE databases were searched for articles about pediatric urinary tract infection. Search terms included urinary tract infection, cystitis, pyelonephritis, prevalence and inci- dence. We included articles in our review if they contained data on the prevalence of UTI in children 0–19 years of age presenting with symptoms of UTI. Of the 51 articles with data on UTI prevalence, 18 met all inclusion criteria. Two evaluators independently re- viewed, rated, and abstracted data from each article. Results: Among infants presenting with fever, the overall preva- lence (and 95% confidence interval) of UTI was 7.0% (CI: 5.5–8.4). The pooled prevalence rates of febrile UTIs in females aged 0–3 months, 3–6 months, 6–12 months, and 12 months was 7.5%, 5.7%, 8.3%, and 2.1% respectively. Among febrile male infants less than 3 months of age, 2.4% (CI: 1.4–3.5) of circumcised males and 20.1% (CI: 16.8–23.4) of uncircumcised males had a UTI. For the 4 studies that reported UTI prevalence by race, UTI rates were higher among white infants 8.0% (CI: 5.1–11.0) than among black infants 4.7% (CI: 2.1–7.3). Among older children (19 years) with urinary symptoms, the pooled prevalence of UTI (both febrile and afebrile) was 7.8% (CI: 6.6–8.9). Conclusions: Prevalence rates of UTI varied by age, gender, race, and circumcision status. Uncircumcised male infants less than 3 months of age and females less than 12 months of age had the highest baseline prevalence of UTI. Prevalence estimates can help c