Yemeni children suffer from renal system stones

A study of Yemeni children has found a disturbing rate of Urolithiasis – renal stones – in the young people of this country. The landmark study, conducted by doctors from the Sana’a University of Medical and Health Sciences, surveyed more than 100 children. Manal al-Ansi, one of the researchers, said “This study is the first one to report on Urolithiasis in the pediatric age group in this country.”  

Pediatric Urolithiasis is an endemic disease in certain parts of the world. Most developed countries have beaten off the disease, however, the Arabian Gulf region, including Yemen, has the highest incidence. 

In a study of Yemeni children who had suffered from Urolithiasis between December 1, 2006 and May 31, 2007, researchers found that the risk of having a stone to be 26 percent of 415 patients with Urolithiasis and 13 percent amongst the 807 patients who were admitted to the Urology Center at Al-Thawrah hospital, during the study. 

This center was opened in November 2004 and it is considered the only specialized center for kidney disease, transplantations and urology surgery in Yemen.  Urolithiasis is defined as the presence of calculi or a hard mass of mineral salts in any part of the urinary tract, where they cause irritation and secondary infection. It is found primarily in adults, but it does occur in the pediatric age group. 

Children younger than 5 years old were found to have a higher rate (40 percent) of infection than those aged between 11 and 18 years.

It is known that males suffer more renal stones than females, a feature reported in many studies around the world. Boys in the study returned a 62 percent incidence rate, compared with 38 percent of girls. 

Diagnosing kidney stone disease is known to be difficult in children because those with renal stones do not necessarily present with the classic symptoms of pain and haematuria. Patients were often complaining from symptoms such as abdominal pain, urine retention and blood in the urine, the study said. 

The findings, published and presented at the 19th Scientific Graduate Research Conference on March 3, showed that a familial history of urinary stones was reported in around 53 percent of children suffering from urolithiasis.   

The study found that most patients with the condition were living in mountainous areas. The highest rate was in Sana’a (25 percent) and the surrounding governorates of Amran, Dhamar, and Ibb.

76 percent of the patients depend on deep water for drinking since most of them live in mountainous areas, the study found. It also discovered that stones were more prevalent in the kidneys than other renal organs such as the bladder and urethra; about 14 percent of patients had more than one stone in more than one site. 

Hydronephrosis is a related condition in which one or both kidneys become stretched, or swollen, due to a build-up of pressure when urine becomes blocked. About 73 percent of patients were diagnosed with hydronephrosis, including 22 percent of whom suffer from severe symptoms, the study found.   
The stone size was larger than 10 millimeters in more than half of the cases, which differs from studies done in other countries where the majority of stones were smaller than 10mm. This difference may be accounted for because the diagnosis in Yemen is made late and  only when large size stones produce mechanical and/or infectious complications; a fact corroborated by the high rate of hydronephrosis in Yemeni patients, the study said.  

The study, supervised by Professor Ali al-Maqramani and Professor Khaled al-Qohlani, also shows that lower awareness of the initial symptoms of urolithiasis, delayed diagnosis and late surgical intervention add to the costs and pain of the patient. 

73 percent of patients had to be treated by open surgery and another 15 percent by endoscope only. “A careful follow-up is needed for patients after their stone removal, especially children with a familial history,” said al-Ansi. “More attention is also required for those patients with a high likelihood of stone re-growth and recurrence.” 

The research has demonstrated that all children with stones or a family history should be screened for infectious, anatomic and metabolic factors. When these factors are detected, the patient may be treated appropriately.

The study recommended raising parents’ awareness about possible infections; having more urology centers in as many governorates as possible; supplying such centers with new modalities to help early diagnosis and management of urolithiasis; and conducting more future studies to discover the causes of urolithiasis in Yemen in a broader sample space.

The study was conducted by Ahmed al-Jarbani, Adel Salah, Ali al-Ashwal, Thiyezen al-Qal’i, Hamdi Hefthallah, Nesma N’oman, Lila Abu-Taleb, Najla Taresh and Mostafa al-Junaid. 

Related Content

•  Conference on allergy and immune system held at Sana'a University
•  Males more likely to suffer from liver cirrhosis in Yemen
•  2,232 AIDS infections found in Yemen
•  Prophet Mohammed guides scientists to medicine
•  Yemen launches vaccination campaign against Maternal and Neonatal Tetanus
•  Astronomical prices are pushing people to the brink
•  Yemeni babies still suffering from malnutrition
•  Yemeni children suffer from renal system stones
•  Rheumatic heart disease remains serious health threat to Yemenis
•  Renal failure in Yemen: a serious problem seeks attention