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BACKGROUND AND OBJECTIVES
Urinary Stone Disease (USD) affects mankind worldwide. USD which has been rare in African population seems to increase. Change of life style and food habits in African population, effects of climate change and availability of diagnostic facilities in most countries may contribute to revealing of USD magnitude. Unfortunately little is known on USD in Africa despite observed rise in incidence. Lack of researched data and defined burden of the disease has prevented proper planning, technology acquisition and resource allocation to manage USD in developing countries .The aim of the study was to find out pattern of presentation of patients with USD and chemical composition of urinary stones, also to serve as baseline data to further researches.
METHODOLOGY
We conducted one year descriptive analytical crossectional hospital based study at Kilimanjaro Christian Medical Centre, a university teaching hospital starting June 2013-May 2014. We looked at social demographic characteristics, clinical symptoms at presentation, common diagnostic modalities, chemical composition of urinary stones and bacterial presence in urine cultures.
RESULTS
Forty nine patients were diagnosed with USD during the study period. Median age at presentation was 53 years, majority were males (82%) with male to female ratio 4:1. Male sex, reduced daily water intake <1lt/day, peasantry (63%), salt addition in foods at table(84%) were important risk factors, while obesity and family history did not show to be important risk factors.
Haematuria, flank pain, dysuria, and lower urinary tract symptoms were the commonest presenting symptoms. Alkaline urine (84%), WBC in urine (92%), RBC in urine (61%) were the commonest findings.
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Abdominopelvic ultrasound (100%), plain abdominopelvic X-ray (98%) were the commonest diagnostic modalities with urinary bladder (47%) being the commonest location. Calcium-containing urinary stones (98%) were the majority. Bacterial growth (E.Coli) was isolated in 2% of urine cultures with prior antibiotic consumption in 92% of patients.
CONCLUSION
Compared to western countries, in our setup USD affects persons of low socioeconomic status. Reduced water intake, peasantry, addition of salt to food at table have been observed to contribute to USD incidence. Whether this contribution is real still needs to be determined. Presence of calcium ions in majority of extracted urinary stones needs metabolic evaluation in all USD patients for preventive purposes hence another long term prospective study. |
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