الفهرس 
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Abstract
Actually, most kidney diseases are asymptomatic until the disease has progressed; so, mass screening helps to determine the prevalence of kidney disease in asymptomatic children and may lead to effective interventions and reduce the number of end-stage renal disease cases by early proper management and prevention of irreversible complication. Mass urine screening is thought to be of benefit in many countries.
The present study was designed for screening the urine of school-aged children in Al-Riyad District, Kafr El-Sheikh governorate by dipstick to detect silent urine abnormalities, spotting light on the role of dipstick as a non-invasive and feasible screening tool of early detection and prevention of progressive renal diseases among primary school children.
This study was aimed to detect the prevalence of urinary disorders in children screened for abnormal urine analysis in population of apparently healthy children of both sex and aged 6-11year, born and continue to reside in Al-Riyad District.
Screening was done upon 500 school aged children of both sexes and from two primary schools. Those children were apparently healthy and aged 6-11year.
The children included in the study had complete history taking and complete physical examination. The following investigations were done: Dipstick urine analysis for all the 500 child, Microscopic urine analysis for 88 children who found positive by dipstick and Urine culture to 28 children with positive pyuria.
This study shows that the total number of the studied group was 500 students from which the females were 257 students (51.4%) while the males were 243 students (48. 6%) of the studied group.
It also shows that the rural students were 400 students (80%) while the urban students were 100 students (20%) of the studied group.
Initial screening was by dipstick urine analysis to detect the presence of urinary abnormalities as hematuria, pyuria, nitrituria and proteinuria in urine.
Results of dipstick in current study differ from results of microscopic urine analysis so urine analysis is recommended for abnormal dipstick finding. This reinforces the necessity of screening school children by dipstick test followed by urine analysis in the developing countries with poor socioeconomic status and poor education where routine visits to pediatricians are infrequent. Many studies reported that urinalysis screening is still mandatory in many countries of Asia as in Japan, Taiwan and Korea, whether the last AAP guideline would be modified in the near future such as screening will be limited to a selected number of children.
In current study, the prevalence of urinary abnormalities among primary school children by dipstick test was 17.6% with slightly higher prevalence in female than male with no significance. As there was no statistically significant difference in the prevalence of urine abnormalities as regarding residence, sex or age, while there is statistically significant difference as regarding different socioeconomic status, as students of low socioeconomic status were the most common students affected.
Dipstick results showed leucocytes in 7.8%, hematuria in 9.2%, nitrite in 2% and protein in 0.6% of the studied group. The most common abnormality in dipstick results was hematuria.
Regarding results of microscopic urinary examination of children, 17.6%(88 students) who had abnormal findings by dipstick test showed the following : 31.82 % of them (28 students) had pyuria which represents 5.6% from the total studied group, 14.77% of them (13 students) had microscopic hematuria which represents 2.6% from the total studied group, 26.14% of them (23 students) had crystalluria which represents 4.6% from the total studied group, while no protein appeared in microscopic results. The most common abnormality in microscopic urine examination was pyuria.
In present study, Urine culture was performed for 28 students (5.6%) that had urinary tract infection and was positive in 23 of them. E-Coli was the most common organism in 13 students (46.4%) of the total culture results ,7 students (25%) were positive for klebsiella, 3 students (10.7%) were positive for staph. Epidermidis while 5 students (17.8%) showed no growth.
Finally, in conclusion, dipstick is considered a good screening tool, a non-invasive and feasible test for early detection of silent renal diseases.
from our study, we concluded that results of dipstick in current study differ from results of microscopic urine analysis which means that dipstick alone is not a satisfied test, and urine analysis is a highly recommended for abnormal dipstick findings to decrease the cost burden.
National screening programs should be recommended for school children for early detection of renal diseases as a part of the school health program in primary schools. Training programs about the urinary disorder screening for health care givers about health education should be carried out for parents and children of low socioeconomic status, giving more attention for those children.