Objective: To determine the composition of caculi and the predisposing factors for stone nucleation and growth in children from two regions of Cameroon.Methods: This was a cross–sectional study involving 21 children, 17 from the northern and 4 from the southern region, over a 6–year period. Data on age, diet, residence, clinical presentation, location of stone, and results of stone analysis were collated following a preestablished proforma. A computerized analysis of the data was carried out. The constituents of stone sections and nidus were assembled so as to determine the principal causes of stone nucleation and growth.Results: Pediatric urolithiasis was more common in the northern Sahelian belt of Cameroon. Males and rural dwellers were more commonly affected. Endemic (bladder) stone disease was found in the majority of the patients. All stones were mixed. The most frequent constituents of the stones were ammonium urate, struvites, and whewellite in descending order of percentage mean volume per stone. The nidus was available for study in only 10 stones, and its composition revealed heterogeneity of causes of nucleation. The commonest cause for stone formation and growth were infection and hyperuricosuria (malnutrition).Conclusions: Pediatric bladder stone disease is not uncommon in northern Cameroon. Many factors combined to predispose to stone nucleation and growth, but the level of socioeconomic development was preponderant. Stone composition indicated that urolithiasis in children was a heterogeneous disorder, but hyperuricosuria, insufficient diuresis, and infection associated with malnutrition seemed to be the most common causes.

Keywords:
Pediatric urolithiasis, Endemic stone disease, Sahel, Sub–Saharan Africa
1.
Shah AM, Kahnunkar S, Punekar SV, Billimoria FR, Bapat SD, Deshmukh SS: Spectrum of pediatric urolithiasis in western India. Indian J Pediatr 1991;58:543–549.
2.
Asper R: Epidemiology and socioeconomic aspects of urolithiasis. Urol Res 1984;12:1–5.
3.
Dajani AM, Abu–Khadra AL, Baghdani FM: Urolithiasis in Jordanian children: A report of 52 cases. Br J Urol 188;61:482–486.
4.
Srivastava RN, Hussainy MA, Goel RG, Rose GA: Bladder stone disease in children in Afghanistan. Br J Urol 1986;58:347–377.
5.
Jones TW, Henderson TR: Urinary calculi in children in Western Australia: 1972–1986. Aust Paediatr J 1989;25:93–95.
6.
Diamond DA, Richwood AM, Lee PH, Johnston JH: Infection stones in children: A twentyseven–year review. Urology 1994;43:525–527.
7.
Gearhart JP, Herzberg GZ, Jeffs RD: Childhood urolithiasis: Experiences and advances. Pediatrics 1991;87:445–450.
8.
Polinsky MS, Kaiser BA, Baluarte HJ: Urolithiasis in childhood. Pediatr Clin North Am 1987;34:683–710.
9.
Bettex M, Oetliker O, Zimmerman A, Kehrer B: Urinary calculi in association with glomerular immaturity. Eur Urol 1987;13:182–185.
10.
Palmer LS, Franco I, Kogan SJ, Reda E, Gill B, Levitt SB: Urolithiasis in children following augmentation cystoplasty. J Urol 1993;150:2 Pt 2):726–729.
11.
Nurse DE, McInerney PD, Thomas PJ, Mundy AR: Stones in enterocystoplasties. Br J Urol 1996;77:684–687.
12.
World Bank, April 4, 1995: Cameroon: Diversity, Growth and Poverty Reduction. Report No. 13167–CM, pp viii, ix, 31, 50–53.
13.
Daudon M, Bader CA, Jungers P: Urinary calculi: Review of classification methods and correlations with etiology. Scanning Microsc 1993;7:1081–1104.
14.
Mbonu O, Attah C, Ikeakor I: Urolithiasis in an African population. Int Urol Nephrol 1984;16: 291–296.
15.
Ndirangu K, Ngwanyam NY: The epidemiological and clinical picture of urolithiasis at the Kenyatta National Hospital. East Afr Med J 1990;67:685–688.
16.
Mkony CA, Chuwa LM, Kahamba JF, Mteta KA, Mbembati NA: Urinary stone disease in Dar es Salaam. East Afr Med J 1991;68:461– 467.
17.
Hassan I, Mabogunje OA: Urinary stones in children in Zaria. Ann Trop Paediatr 1993;13: 269–271.
18.
Wisniewski ZS, Brockis JG, Ryan GD: Urinary bladder stones in aboriginal children. Aust NZ J Surg 1981;51:292–295.
19.
Drach GW: Urinary lithiasis; in Walsh PC, Gittes RF, Perlmutter AD, Stamey TA (eds): Campbell’s Urology, ed 5. Philadelphia, Saunders, 1986, vol 1, p 1099.
20.
Loufti AH, van Reen R, Hamid A: Studies on bladder stones in Egyptian children. J Egypt Med Assoc 1974;57:96.
21.
Nahlowsky J, Fahal M, Gharbi S: Fréquence extraordinaire de la lithiases chez les enfants en Tunisie et leur cause probable. J Urol Néphrol 1969;75:539.
22.
Kambal A, Wahbab SMA, Khattar AH: The pattern of urolithiasis in the Sudan. Br J Urol 1978;50:376–377.
23.
Orvar J: Vesical calculus in Ethiopian children. Ethiop Med J 1995;33:31–35.
24.
Pin NT, Ling NY, Siang LH: Dehydration from outdoor work and urinary stones in a tropical environment. Occup Med 1992;42:30–32.
25.
Van Reen R: Idiopathic urinary bladder stones of childhood. Aust NZ J Surg 1980;50:18–22.
26.
Coe FL, Keck J, Norton ER: The natural history of calcium urolithiasis. JAMA 1977;238: 1518–1522.
27.
Hodgkinson A: Composition of urinary calculi from some developing countries. Urol Int 1979;34:26–35.
28.
Kamoun P, Daudon M, Kabaar N, Dhaoui R, Ben Ammar S, Zghal A, Zerilli L, Chaouachi B, Belkahia C, Lakhoua R: Facteurs étiologiques de la lithiase urinaire de l’enfant en Tunisie. Prog Urol 1995;5:942–945.
29.
Diamond DA: Clinical patterns of pediatric urolithiasis. Br J Urol 1991;68:195–198.
30.
Drach GW: Metabolic evaluation of pediatric patients with stone disease. Urol Clin North Am 1995;22:95–100.
2000
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