Benefit of urinalysis.
OBJECTIVE
In the pilot Iran school screening programme, the minimal cost of screening dipstick urinalysis in 1601 asymptomatic school children was determined.


METHODS
The cost of screening dipstick urinalysis was calculated by reviewing the literature for the prevalence of asymptomatic proteinuria, hematuria, bacteriuria, and glucosuria determined by an initial dipstick urinalysis. The minimal cost utilizing data of 3 general physicians was calculated. Costs were determined by using current charge for supplies ordered to perform tests, charges for tests performed by a commercial laboratory, and the cost of a final evaluation by a pediatric nephrologist.


RESULTS
4.7% (76/1601) of patients were calculated to have an initial abnormal urinalysis. Upon retesting 1.37% (22/1601) of patients were calculated to have a persistent abnormality. The calculated cost was $167 to initially screen all 1601 patients with a dipstick urinalysis or $0.092 per patient. The calculated cost to evaluates the 22 patients with any persistent abnormality on repeat dipstick urinalysis was $0.02 or $0.001 per patient. This is the calculated cost for a single screening of 1601 asymptomatic pediatric patients.


CONCLUSIONS
Multiple screening dipstick urinalysis in asymptomatic pediatric is costly and should be discontinued. We propose that a single screening dipstick urinalysis be obtained at school entry age, between 6 and 7 years, in all asymptomatic children.
Shajari
Ahmad
A
Department of Pediatric Nephrology, Shahid Sadoughi Hospital, School of Medicine, Yazd, Iran. a_shajari@yahoo.com
Shajari
Hamideh
H
Zade
Mohammad Hossein Fallah
MH
Kamali
Karmella
K
Kadivar
Mohammad Rahim
MR
Nourani
Forough
F
D002265:Carboxylic Ester Hydrolases / Q000652:urine; D002648:Child; D003362:Cost-Benefit Analysis; D004180:Direct Service Costs; D005260:Female; D006029:Glycosuria / Q000175:diagnosis; D006417:Hematuria / Q000175:diagnosis; D006801:Humans; D007492:Iran; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000706:statistics & numerical data; D010372:Pediatrics / Q000191:economics*; D010865:Pilot Projects; D011507:Proteinuria / Q000175:diagnosis; D011934:Reagent Strips / Q000191:economics; D016482:Urinalysis / Q000191:economics* / Q000706:statistics & numerical data
D011934:Reagent Strips; C021443:leukocyte esterase; D002265:Carboxylic Ester Hydrolases