Prevalence and predictors of childhood enuresis in southwest Nigeria: Findings from a cross-sectional population study.
BACKGROUND
Childhood enuresis is common, but the prevalence and factors associated with childhood enuresis in Africa have been poorly described. Furthermore, most studies from the continent have not provided data distinguishing monosymptomatic from non-monosymptomatic enuresis. This distinction is important as it guides enuresis therapy.


OBJECTIVE
The primary objective of this study was to determine the prevalence of enuresis in children aged 5-17 years in a community in Nigeria. The secondary objectives were to determine the relative proportions of monosymptomatic and non-monosymptomatic enuresis and identify independent sociodemographic and clinical predictors of enuresis.


METHODS
Parents or guardians in the community were interviewed using a pretested questionnaire. Standardized definitions were used, as recommended by the International Children's Continence Society.


RESULTS
A total of 928 children were included in the study. The prevalence of enuresis or daytime incontinence and enuresis was 28.3% (enuresis 24.4%, and daytime incontinence and enuresis 4%); it decreased with age. Primary and monosymptomatic enuresis were the most common types of enuresis. In multiple logistic regressions, children aged 5-9 years were 10.41 (5.14-21.05) times more likely to have enuresis or daytime incontinence and enuresis compared with those aged 14-17 years. Other predictors of enuresis or daytime incontinence and enuresis were: male gender (OR 1.56 (1.13-2.14)); constipation (OR 2.56 (1.33-4.93)); and a sibling (OR 2.20 (1.58-3.06)) or parent (OR 3.14 (2.13-4.63)) with enuresis. Enuresis or daytime incontinence and enuresis was 1.92 (1.06-3.48) times more likely in fourth-born, or higher, children compared with first-born children. Only parents of nine (3.4%) children with enuresis had consulted a medical doctor about it.


CONCLUSIONS
The high prevalence of childhood enuresis in the present study was consistent with most studies from developing countries and contrasted sharply with the lower rates reported among children in developed countries. Common reasons for this disparity were the influence of socioeconomic status on enuresis rates and the low utilization of effective enuresis therapies in developing countries. Consistent with published literature, monosymptomatic enuresis was the commonest form of enuresis in the present study. Furthermore, younger age, male gender and a family history of enuresis were strongly associated with enuresis. A major limitation of the study was the lack of use of a voiding diary.


CONCLUSIONS
Childhood enuresis was common in the community but parents rarely sought medical attention. Predictors of enuresis were younger age, male gender, constipation, higher birth order, and a family history of enuresis.
Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria; Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria. Electronic address: esezobor@gmail.com.
C I
CI
Esezobor
Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria; Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria.
M R
MR
Balogun
Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria; Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria.
T A
TA
Ladapo
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004775:Enuresis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D014549:Urinary Incontinence / Q000453:epidemiology*
Birth order; Constipation; Enuresis; Incontinence; Monosymptomatic enuresis