Prevalence, Risk Factors and Impact Associated with Nocturnal Enuresis Among Children in Some Rural Areas of Assiut Governorate: A Cross Sectional Study

Background: Nocturnal enuresis is an important developmental problem for school age children and it can cause emotional and social problems for the child as well as family. Aim of the Study: The purpose of this study was to determine the prevalence of nocturnal enuresis in children aged 613 years of age in the study area, to investigate the risk factors associated with nocturnal enuresis and to identify the different treatment methods for those children. The current study aimed to investigate the impact of enuresis on the parents' and the child's life. Subjects and Methods: This was a cross-sectional survey. The survey was conducted during a three months period (1 st of August 200930 th of October 2009) by interviewing randomly selected parents of children aged from sixth to thirteen years at their homes in three villages of Abnoub district of Assiut Governorate. A total of 1050 questionnaires were filled. To describe enuresis the ICD-10 definition of at least one wet night per month for three consecutive months was used. Chi-square test and a logistic regression model were used to identify significant predictive factors for enuresis. Results: A total of 1050 children aged between 6 and 13 years were investigated. 154 (14.7%) children with nocturnal enuresis were identified. Several parental factors that are related to enuresis were low educational level of the parents and mothers' working status were insignificantly higher among parents' of enuretic children. Also gender of child as being male and high birth order were insignificantly higher among enuretic children. On the other hand younger age, positive family history of enuresis, increased family size, divorced parents were significantly higher in children with enuresis when compared to non-enuretics. Recurrent UTI, chronic constipation and deeper sleep children were also significantly higher in enuretics when compared to non-enuretics. After multivariate analysis Enuresis was significantly associated with age (OR=5.489), positive family history of enuresis (OR=3.291), family size (OR=1.784) and history of recurrent urinary tract infection (OR=2.065). Correspondence to: Dr. Etemad A.A. El-Shereef, The Department of Public Health, Faculty of Medicine, Assiut University. Nocturnal enuresis was primary in 76.0% and secondary in 24.0% of the cases. In most children (40.2%), episodes of enuresis occurred less than 2 nights per week in Less than half of children (40.2%). Of the enuretic children, 53.9% (83 children) had visited a physician. The majority of the respondents who visited the physician, 53 (63.9%) stated that the recommended plan was not helpful. As regards parents' attitude, Seventy parents (45.5%) were reacted with understanding and support. On the other hand, 87 (56.5%) felt that their child was embarrassed, shy and hesitant to spend the night away from home. Conclusion: Our findings suggest that nocturnal enuresis is a common problem among school children, especially younger age, increased family size, positive family history and recurrent attacks of UTIs. Enuresis is a pediatric public health problem and efforts at all levels should be made such as preventive, etiological and curative.