Recurrent Urinary Tract Infection in Children Attending Mosul Governorate

Background: Recurrent urinary tract infection is an important health problem among children and may be associated with repeated morbidity, underlying urinary tract abnormalities, and risk of renal complications. It is commonly encountered in both primary health care and pediatric practice. Objectives: To assess recurrent urinary tract infection among children attending selected primary health care centers and pediatric consultation clinic in Nineveh Governorate and to identify associated demographic, clinical, and radiological factors. Methods: A cross-sectional study was conducted among children attending Baghdada Primary Health Care Centers and the Pediatric Consultation Clinic at Mosul General Hospital, Nineveh Governorate, Iraq, during the period from June 2025 to March 2026. The study included children from infancy up to 14 years of age with recurrent urinary tract infection. Data were collected using a specially designed questionnaire including demographic characteristics, clinical presentation, risk factors, laboratory findings, and imaging results. Statistical analysis was performed using appropriate tests, and a p-value of less than 0.05 was considered statistically significant. Results: The study included 54 children with recurrent urinary tract infection and 100 children with first attack urinary tract infection. Recurrent UTI was most common among children aged 1–4 years (33.4%) and was slightly more frequent among females (51.0%). Significant associations were found between recurrent UTI and low socioeconomic status (51.0%, p=0.002), type of feeding (p=0.001), and positive family history of renal problems (27.0%, p=0.002). Constipation was reported in 27.0% of recurrent cases. Fever was the most common symptom (43.0%), followed by diarrhea and vomiting (42.5%), lower abdominal pain (29.6%), and dysuria (28.3%). Ultrasound showed hydronephrosis in 41.0% of recurrent cases, while micturating cystourethrography showed vesicoureteric reflux in 20.9%. Conclusions: Recurrent urinary tract infection in children is associated with socioeconomic, familial, clinical, and radiological factors. Early diagnosis, proper urine testing, culture-guided treatment, management of constipation and voiding problems, parental education, and referral of complicated cases are recommended to reduce recurrence and prevent renal complications.