Uptake of further investigations following universal urinary screening among elementary and junior high school students in Shiga Prefecture, Japan: A retrospective cohort study
Uptake of further investigations following universal urinary screening among elementary and junior high school students in Shiga Prefecture, Japan: A retrospective cohort study
复制标题
DOI：
10.1111/nep.13710
复制
发表时间：
2020-03-20
期刊：
影响因子：
2.5
通讯作者：
Honda, Masataka
中科院分区：
文献类型：
--
作者：
Sakai, Tomoyuki;Nomura, Yasuyuki;Honda, Masataka
目的本研究旨在调查日本学校尿液质量筛查（SUS）项目从筛查阶段到进一步调查阶段的当前进展状况。方法这项关于2012年至2017年滋贺SUS项目的回顾性队列研究分析了学校生活指导表的数据，这是SUS项目的主要文件，关于尿液分析，结果2012年至2017年期间，在83749名小学生中，在SUS项目中，42870名初中生（12-14岁）中有215名首次发现尿液异常。在尿液异常的人中，平均4.2%的小学生和1.8%的初中生分别首次被诊断为疑似肾小球肾炎。总体而言，分别有5.9%（95%置信区间[CI] 4.1，7.7）和23.6%（95% CI 21.3，25.9）的蛋白尿阳性小学生和初中生未接受进一步调查。一个学生进行进一步调查的概率是不受当地提供的医疗benefits.Conclusion在目前的SUS项目，筛选经常不会导致进一步的调查，特别是初中学生。为维持单一系统计划的完整性及防止青少年肾脏疾病的恶化，当局应致力减少因尿液分析发现异常而不接受进一步检查的学生比例，包括阐明进一步检查的障碍。
Aim This study aimed to investigate the current progression status from screening phase to further investigation phase in the Japanese school urine mass screening (SUS) project.Methods This retrospective cohort study on the SUS project across the Shiga Prefecture during 2012 to 2017 analysed data from school life instruction sheets, which are principal documents in the SUS project, regarding urinalysis, attendance at follow-up and diagnoses.Results Between the years 2012 to 2017, a median of 107 out of 83 749 elementary school students (aged 6-11 years) and 215 out of 42 870 junior high students (aged 12-14 years) had urine abnormalities identified for the first time in the SUS project. Among those with urine abnormalities, a mean of 4.2% of elementary school and 1.8% of junior high school students, respectively, were diagnosed with suspected glomerulonephritis for the first time. Overall, 5.9% (95% confidence interval [CI] 4.1, 7.7) and 23.6% (95% CI 21.3, 25.9) of proteinuria-positive elementary and junior high school students, respectively, did not undergo further investigations. The probability of a student undergoing further investigations was not affected by the local availability of medical care benefits.Conclusion In the current SUS project, screening frequently does not lead to further investigation, especially among junior high school students. To maintain the integrity of the SUS project and to prevent the progression of renal disease in young students, efforts including elucidation of barriers to further investigations should be made to reduce the proportions of students not undergoing further investigations for abnormal urinalysis findings.