Background
Methods
Study site
Study population
Study procedures
Data analysis
Results
Participants’ enrollment and characteristics
Factor | Median/IQR, n (%) N = 513 | With RD N = 83 | Without RD N = 430 | Univariate OR [95% CI] | p-value | Multivariate OR [95% CI] | p-value |
---|---|---|---|---|---|---|---|
Female gender | 216 (42.1) | 41 (49.4) | 175 (40.7) | 1.42 [0.89–2.28] | 0.14 | ||
Age in months | 42 [28–72] | 34 [27–60] | 46.5 [29–72] | 0.99 [0.99–1.00] | 0.10 | ||
Study site | |||||||
Bugando Medical Centre | 369 (71.9) | 65 (78.3) | 304 (70.7) | RG0.67 | RG | ||
Sekou Toure Hospital | 144 (28.1) | 18 (21.7) | 126 (29.3) | [0.38–1.17] | 0.16 | ||
Water source | |||||||
Tap water | 350 (68.2) | 58 (69.9) | 292 (67.9) | 0.91 [0.55–1.52] | 0.72 | ||
Lake or pond water | 163 (31.8) | 25 (30.1) | 138 (32.1) | ||||
Toilet | |||||||
Modern flush toilet | 250 (48.7) | 35 (42.2) | 215 (50.0) | 1.37 [0.85–2.21] | 0.19 | ||
Pit latrine | 263 (51.3) | 48 (57.8) | 215 (50.0) | ||||
Medical history | |||||||
Herbal medications use | 187 (36.5) | 45 (54.2) | 142 (33.0) | 2.40 [1.50–3.87] | < 0.001 | 2.11 [1.23–3.61] | 0.007 |
Gentamycin use | 47 (9.2) | 7 (8.4) | 40 (9.3) | 0.90 [0.34–2.08] | 0.80 | ||
Ceftriaxone use | 51 (9.9) | 8 (9.6) | 43 (10.0) | 0.96 [0.43–2.12] | 0.92 | ||
NSAID use | 81 (15.8) | 10 (12.1) | 71 (16.5) | 0.69 [0.34–1.41] | 0.31 | ||
Throat/skin infection | 36 (7.0) | 11 (13.3) | 25 (5.8) | 2.48 [1.17–5.25] | 0.018 | 2.74 [1.14–6.56] | 0.024 |
History of SCD | 71 (13.8) | 21 (25.3) | 50 (11.6) | 2.5 [1.44–4.58] | 0.001 | 2.59 [1.31–5.10] | 0.006 |
Family history of SCD | 40 (7.8) | 6 (7.2) | 34 (7.9) | 0.91 [0.37–2.24] | 0.83 | ||
Prior surgeries | 28 (5.5) | 1 (1.2) | 27 (6.3) | 0.18 [0.02–1.36] | 0.10 | ||
Presenting symptoms | |||||||
Hematuria | 28 (5.5) | 4 (4.8) | 24 (5.6) | 0.86 [0.29–2.54] | 0.78 | ||
Fever | 373 (72.7) | 59 (71.1) | 314 (73.0) | 0.91 [0.54–1.53] | 0.72 | ||
Dysuria | 63 (12.3) | 12 (14.5) | 51 (11.9) | 1.26 [0.64–2.48] | 0.51 | ||
Rash | 28 (5.5) | 6 (7.2) | 22 (5.1) | 1.45 [0.57–3.68] | 0.44 | ||
Diarrhea | 112 (21.8) | 23 (27.7) | 89 (20.7) | 1.47 [0.86–2.51] | 0.16 | ||
Bloody diarrhea | 24 (4.7) | 7 (8.4) | 17 (4.0) | 2.24 [0.90–5.58] | 0.08 | ||
Vomiting | 176 (34.3) | 27 (32.5) | 149 (34.7) | 0.91 [0.55–1.50] | 0.71 | ||
Recurrent UTI | 45 (8.8) | 5 (6.0) | 40 (9.3) | 0.63 [0.24–1.63] | 0.34 | ||
Urine output | |||||||
Normal | 458 (89.3) | 66 (79.5) | 392 (91.2) | RG | RG | ||
Increased | 15 (2.9) | 2 (2.4) | 13 (3.0) | 0.91 [0.20–4.14] | 0.91 | ||
Decreased | 40 (7.8) | 15 (18.1) | 25 (5.8) | 3.56 [1.79–7.11] | < 0.001 | 1.11 [0.60–2.06] | 0.73 |
Presenting signs | |||||||
Pallor | 212 (41.3) | 32 (38.6) | 180 (41.9) | 0.87 [0.54–1.41] | 0.58 | 0.001 0.62 | |
Dehydration | 65 (12.7) | 21 (25.3) | 44 (10.2) | 2.97 [1.66–5.33] | < 0.001 | 3.12 [1.56–6.26] | |
Edema | 59 (11.5) | 15 (18.1) | 44 (10.2) | 1.94 [1.02–3.67] | 0.04 | 1.21 [0.56–2.62] | |
Vital signs | |||||||
Pediatric GCS | 15 [15–15] | 15 [15–15] | 15 [15–15] | 0.83 [0.69–0.10] | 0.05 | ||
Saturation | 97 (95–98) | 97 [94–98] | 97 [95–98] | 0.97 [0.93–1.01] | 0.09 | ||
Temperature | 37 [36.6–38] | 36.5 [36.2–36.8] | 37 [36.6–38] | 0.92 [0.72–1.16] | 0.47 | ||
Respiratory rate | 30 [23–40] | 30 [24–40] | 30 [22–38] | 1.01 [0.10–1.03] | 0.08 | ||
Pulse rate | 112 [98–128] | 110 [98–128] | 112 [98–130] | 0.10 [0.99–1.01] | 0.38 | ||
Blood pressure | |||||||
SBP | 90 [85–100] | 90 [85–102] | 90 [85–100] | 1.01 [0.99–1.03] | 0.27 | ||
DBP | 60 [58–67] | 60 [60–70] | 60 [58–66] | 1.01 [0.99–1.04] | 0.29 | ||
HIV positivity | 30 (5.8) | 5 (6.0) | 25 (5.8) | 1.04 [0.38–2.79] | 0.94 | ||
Positive BS for MPS | 59 (11.5) | 16 (19.3) | 43 (10.0) | 2.15 [1.14–4.03] | 0.017 | 2.67 [1.26–5.66] | 0.01 |
Urine protein | |||||||
Negative | 417 (81.3) | 46 (55.4) | 371 (86.3) | RG | RG | ||
Positive | 96 (18.7) | 37 (44.6) | 59 (13.7) | 5.06 [3.03–8.45] | < 0.001 | 5.28 [2.97–9.39] | < 0.001 |
Urine RBC | |||||||
Negative | 493 (96.1) | 77 (92.8) | 416 (96.7) | RG | RG | ||
Positive | 20 (3.9) | 6 (7.2) | 14 (3.3) | 2.32 [0.86–6.21] | 0.10 | ||
Urine CCA | |||||||
Negative | 344 (67.1) | 47 (56.6) | 297 (69.1) | RG | RG | ||
Positive | 169 (32.9) | 36 (43.4) | 133 (30.9) | 1.71 [1.05–2.76] | 0.028 | 1.19 [0.36–3.95] | 0.77 |
Urine CCA | |||||||
Negative | 344 (67.1) | 47 (56.6) | 297 (69.1) | RG | RG | ||
Line faintly visible | 83 (16.2) | 19 (22.9) | 64 (14.9) | 1.88 [1.03–3.41] | 0.039 | 1.31 [0.36–4.80] | 0.68 |
Line lighter than control | 64 (12.5) | 13 (15.7) | 51 (11.9) | 1.61 [0.81–3.41] | 0.17 | ||
Intensity equal to control | 22 (4.2) | 4 (4.8) | 18 (4.2) | 1.40 [0.46–4.33] | 0.56 | ||
Nutritional status | |||||||
Normal | 268 (52.2) | 47 (56.6) | 221 (51.4) | RG | RG | ||
Mild malnutrition | 95 (18.5) | 12 (14.5) | 83 (19.3) | 0.68 [0.34–1.34] | 0.23 | ||
Moderate malnutrition | 76 (14.8) | 12 (14.5) | 64 (14.9) | 0.88 [0.44–1.76] | 0.72 | ||
Severe malnutrition | 74 (14.5) | 12 (14.5) | 62 (14.4) | 0.91 [0.45–1.82] | 0.79 |