%0 Journal Article
%T Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study
%A Wing-Yee Kwok
%A Marjolein CE de Kwaadsteniet
%A Mirjam Harmsen
%A Lisette WA van Suijlekom-Smit
%A Fran£żois G Schellevis
%A Johannes C van der Wouden
%J BMC Pediatrics
%D 2006
%I BioMed Central
%R 10.1186/1471-2431-6-10
%X During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL) in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral.The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred.This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral.Urinary tract infections in childhood are common and may be difficult to diagnose in young children because of non-specific symptoms. Symptoms such as fever, vomiting, screaming, anorexia and irritability may indicate a urinary tract infection, but they are also common in other childhood diseases [1,2].The incidence of urinary tract infections during childhood is not only influenced by age, but also by gender. Before the age of 3 months, urinary tract infections are more common in boys; thereafter the incidence is considerably higher in girls [3,4]. In younger children, urinary tract infections are mainly caused by autoinfection with commensals from the intestinal tract [5], whereas urinary tract
%U http://www.biomedcentral.com/1471-2431/6/10