Context and objective. Urinary screening is a useful and inexpensive tool for the early detection of urinary abnormalities in asymptomatic children. This might contribute to the prevention of chronic kidney disease later in life. This study aimed to determine the prevalence of urinary abnormalities among school children in the town of Kisantu. Methods. In a cross-sectional study, apparently healthy children aged 6 to 16 years were randomly recruited from 7 schools. Using dipstick test, recorded parameters of interest were proteinuria, hematuria, urinary tract infection (defined as nitrite positive and/or leukocyte positive). Logistic regression was used to assess the determinants of urinary abnormalities in this population. Results. Out of 253 children, the prevalence of urinary abnormalities was 51.8% (131/253). Twenty-four (9.5%) presented with hematuria and only 1 (0.4 %) presented with proteinuria on dipstick. Urinary tract infection was found in 123 children (48.6 %). In multivariate regression analysis, female sex emerged as the major determinant of urinary tract infection (OR 2.79, CI 95 % 1.67 – 4.65). Conclusion. This campaign showed the significant presence of urinary abnormalities and more particularly urinary tract infection in apparently healthy children in a rural school setting. Hence the importance of urine screening for prevention and early management of kidney diseases. Received: February 2nd, 2024 Accepted: June 11th, 2024 https://dx.doi.org/10.4314/aamed.v17i4.3

Malaria remains a leading cause of morbidity and mortality among children in sub-Saharan Africa. Acute kidney injury (AKI) is increasingly recognized as a frequent and severe complication of pediatric severe malaria, yet it remains largely underdiagnosed. This under-recognition is driven by important limitations in current diagnostic approaches. The World Health Organization (WHO) criteria rely on fixed serum creatinine (SCr) thresholds that are poorly adapted to children, whereas Kidney Disease Improving Global Outcomes (KDIGO) criteria require baseline SCr (bSCr) values that are rarely available in low-resource settings. The estimation of bSCr using back-calculation methods is further complicated by population-specific factors, particularly malnutrition, which reduces creatinine generation and may mask kidney injury. In addition, urine output (UO) monitoring is often underutilized despite its diagnostic value, and access to laboratory testing remains limited. Emerging biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, and kidney injury molecule-1 (KIM-1) show promise for early detection and risk stratification but remain insufficiently validated in African pediatric populations. In this narrative review, we highlight key challenges in diagnosing malaria-associated AKI (MAKI) in children and discuss potential strategies to improve early detection in resource-limited settings, with the aim of reducing morbidity and mortality.