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MIND THAT CHILD: UTI: A nasty childhood illness

PARENTS and caregivers should be aware that Urinary Tract Infections (UTIs), are common in children. The infections occur when bacteria (germs), get into the bladder or kidneys.

A baby with a UTI, for example, may have fever, may throw up or may be quite fussy. Older children may have fever and pain when urinating.

The ailing child may need to urinate many times and may have lower belly pain. Parents need to be aware that children with UTI must be taken to a doctor.

A UTI will not get better without medical intervention. I must mention at the outset that there are several types of UTIs and that all of them are easy to treat and usually clear up in a week or so. Taking antibiotics kills the germs and helps children to get well again. UTI can be a serious threat to a child’s life if untreated.

To be sure antibiotics work properly parents or caregivers must administer all the prescribed doses—even when their child starts feeling better. Most UTIs happen in the lower part of the urinary tract—the urethra and bladder. About 150 million people, including children, develop urinary tract infections every year.

The infections are more common in women than men. In women, they are the most widespread form of bacterial infection. The most common type of UTI is called cystitis. A child with cystitis may have pain and a burning or stinging sensation when urinating.

The child may also have an increased urge or more frequent need to urinate (though only a small amount of urine may be passed). These symptoms are common among ailing kids. Fever is also common among children with UTI. Ailing children often wake up at night many times with a need to go to the toilet.

Many may have bed wetting problems -- even though the child has been trained to use the pot. So, ailing children experience belly pain in the area of the bladder (generally below the belly button). They, invariably, pass foul-smelling urine that may look cloudy or contain blood strains.

These symptoms are also common among adults suffering from a UTI. An infection that travels up the ureters to the kidneys is called pyelonephritis and is usually more serious. It causes many of these same symptoms, but the child often looks sicker and is more likely to have a fever (sometimes with shaking chills).

The child may also have pain in the side or back, severe tiredness and vomiting. UTIs are much more common in girls because a girl’s urethra is shorter and closer to the anus.

Uncircumcised boys younger than one year also have a slightly higher risk for a UTI. Other risk factors for UTI include problems in the urinary tract (for example, a malformed kidney or a blockage somewhere along the tract of normal urine flow). Poor toilet and hygiene habits are common risk factors.

Family history of UTIs is another factor. Risk factors also include an abnormal backward flow (reflux), of urine from the bladder up the ureters and toward the kidneys. This is known as vesicoureteral reflux (VUR). Many children with a UTI are found to have it. UTIs are easy to treat, but it is important to catch them early. Undiagnosed or untreated UTIs can lead to kidney damage.

To diagnose a UTI health care providers ask questions about what is going on, do a physical examination and take a urine sample for testing. How a sample is taken depends on a child’s age. Older kids might simply need to pee into a sterile cup. For younger children in diapers, a catheter is usually preferred.

This is when a thin tube is inserted into the urethra up to the bladder to get a “good” urine sample. The sample may be used for a urinalysis (a test that checks the urine for germs or pus), or a urine culture (which attempts to grow and identify bacteria in a laboratory).

Knowing what bacteria are causing the infection can help the doctor choose the best treatment. UTIs are treated with antibiotics. After several days of antibiotics, the doctor may repeat the urine tests to confirm that the infection is gone. It’s important to make sure of this because an incompletely treated UTI can come back or spread. If a child has severe pain when urinating, the doctor may also prescribe medicine that numbs the lining of the urinary tract.

(This medication causes the urine to turn orange). Parents should give the antibiotics on schedule for as many days as a doctor directs. Parents should also keep track of their child’s trips to the toilet and ask the child about symptoms like pain or burning when urinating.

These symptoms should improve within two to three days after antibiotics are started. The ailing child should be encouraged to drink plenty of fluids but parents or caregivers should make sure beverages containing caffeine, such as soda and iced tea are avoided.

Kids with a more severe infection may need treatment in a hospital. So they can get antibiotics by injection or intravenously (delivered through a vein right into the bloodstream).

This might happen if the child has high fever or looks very ill, or a kidney infection is likely. This might also happen if the child is younger than six months old.

The sick child may also get antibiotics by injection if bacteria from the infected urinary tract have spread into the blood. Injection may also be administered if the child is dehydrated. A child who has low levels of body fluids (dehydrated), or is vomiting and cannot take any fluids or medicine by mouth should get antibiotics injections.

Kids with vesicoureteral reflux (VUR), will be watched closely by the doctor. VUR might be treated with medicines or, less commonly, surgery.

Most kids outgrow mild forms of VUR, but some can develop kidney damage or kidney failure later in life. In infants and toddlers, frequent diaper changes can help prevent the spread of bacteria that cause UTIs. When kids are potty trained, it’s important to teach them good hygiene. Girls should know to wipe from front to rear—not rear to front. This prevents germs from spreading from the rectum to the urethra. Schoolage girls should avoid strong soaps that might cause irritation.

They should wear cotton underwear instead of nylon because it is less likely to encourage bacterial growth. The kidneys do a lot, but their most important job is to take waste out of the blood and make urine.

The urinary tract takes this waste out of the body when a person urinates.

All children should be taught not to “hold urine.” They must urinate when they feel like it. As mentioned before, children should drink plenty of fluids and avoid caffeine, which can irritate the bladder.

Most UTIs are cured within a week with treatment. Parents should take that ailing child to a medical doctor immediately if their child has an unexplained fever with shaking chills, especially if there’s also back pain or any type of pain when urinating or if their child has bad-smelling, bloody or discolored urine. Other telling symptoms include low back pain or belly pain (especially below the belly button) or a fever of over 101°F (38.3°C) in children or 100.4°F (38°C) rectally in infants.

An infant may also have a fever, may feed poorly, vomit repeatedly, or be unusually irritable. It is imperative to repeat here the stark reality that Urinary Tract Infection (UTI), is a common and critical clinical problem in childhood. Urinary tract infection may lead to renal scarring, hypertension, and end-stage renal disease.

Although children with UTI tend to present with fever, it is often difficult on clinical grounds to distinguish UTIs from other febrile illnesses in Tanzania and other developing countries.

This makes UTI one of the most missed diagnosis in the paediatric wards. UTI whether symptomatic or asymptomatic have greater significance in childhood than in adults as most renal scars occur after such infections within the first five years of life. Children catch lots of bugs in their first few years of life. Colds and other respiratory infections are common. But, as mentioned before, children can get urinary tract infections, too. Up to eight per cent of girls and two per cent of boys will get UTI by age five.

Sometimes the symptoms of this infection can be hard to spot. It is important to get your child treated, because a UTI can turn into a more serious kidney infection. With the right treatment, your child should start to feel better in just a few days. UTI happens when bacteria from faeces gets into the urinary tract and multiply.

These nasty germs can cause infections anywhere in the urinary tract, which is made up of the: kidneys, which filter wastes and extra water out of the blood to make urine; ureters, which send urine from the kidneys into the bladder and bladder, which stores urine. UTI bacteria also attack the urethra, which empties urine from the bladder out of the body.

A bladder infection is called cystitis and a kidney infection is called pyelonephritis. It is also worth mentioning here that the “urinary tract” is the organs in a child’s (or adult’s), body that makes, stores and gets rid of urine, one of the waste products of the body. Urine is made in the kidneys and travels down to the bladder through the ureters. Ureters are the tubes that join the kidneys to the bladder. The kidneys make about 1½ to 2 quarts of urine a day in an adult, and less in children, depending on their age.

In children, the bladder can hold 1 to 1½ ounces of urine for each year of age. For example, a four-year-old child’s bladder can hold four to six ounces—a little less than a cup. The bladder stores the urine until it is emptied through the urethra, a tube that links the bladder to the skin, when a child (or adult), urinates. The urethra opens at the end of the male sexual organ in boys and in front of the female organ in girls.

The kidneys also balance the levels of many chemicals in the body (sodium, potassium, calcium, phosphorous and others) and check the blood’s acidity. Older children may complain of pain in the lower stomach area or back, as well as needing to urinate often.

The child may cry when he or she urinates, or complain that it hurts to urinate and pass only a few drops. The child may also have trouble controlling urine.

If a child has a high fever and appears sick without a clear reason (such as a runny nose or ear ache), the child should be taken to a doctor.

If the cause is a kidney infection and it is not treated at once, the bacteria may cause a life-threatening infection or kidney damage.

spmwita@yahoo.com

AFRICA witnessed a big shame few days ...

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Author: Sosthenes Mwita

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