Diagnostic Accuracy of Urine Analysis in Diagnosis of Urinary Tract Infection in Malnourished Children Taking Urine Culture as Gold Standard
Abstract
Background: Urinary tract infection (UTI) is a frequent cause of morbidity in children, particularly in malnourished populations where immune compromise increases susceptibility and complications. Early diagnosis is essential to prevent renal damage; however, urine culture—the gold standard—is time-consuming and resource intensive. Urine analysis offers a rapid and economical alternative, but its diagnostic reliability in malnourished children in Peshawar remains insufficiently explored. Objective: To determine the diagnostic accuracy of urine analysis for detecting UTIs in malnourished children, using urine culture as the reference standard. Methods: The current cross-sectional validation study was carried out at the Department of Pediatrics, Lady reading Hospital, Peshawar, during the period between July 2024 and January 2025. The malnourished children who were aged 1-5 years and had suspected UTI were enrolled consecutively (290 in total). A urine sample was collected either in a clean-catch or suprapubic aspiration and placed under urine analysis and culture. Definitions of Pyuria were 10 or more WBC/mm 3 or 5 or more WBC/HPF. Sensitivity, specificity, predictive values, and accuracy were determined in terms of diagnostic indices. Results: UTI was established in 61 (21.0%) children by urine culture. Urine examination was affirmative in 86 (29.7) cases. The sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy of…
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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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