Global prevalence of nocturnal enuresis and associated factors among children and adolescents: a systematic review and meta-analysis.

Abstract

Background: Nocturnal enuresis (NE), a prevalent childhood condition associated with significant emotional morbidity, including anxiety, guilt, and diminished self-esteem. Notably, NE exhibits substantial variability in prevalence across diverse geographical and sociocultural contexts ranging from 2 to 75%, highlighting the influence of environmental and societal factors. The associated social stigma exacerbates emotional distress, negatively impacting self-perception and overall quality of life. This systematic review and meta-analysis seek to synthesize global epidemiological data on NE, accounting for inter-country prevalence variations, and to elucidate its associated factors, thereby informing the development of culturally sensitive and effective intervention strategies.

Methods: All observational quantitative research articles conducted among children and adolescents in the world were included. We used PubMed Central, Cochrane Library, Scopus, and Google Scholar searching databases. The study quality was checked using the Newcastle - Ottawa Scale. Then I² statistics and Cochran's Q test were used to evaluate heterogeneity. Funnel, Egger's test, and non-parametric trim and fill effect tests were used to check publication bias by using a random effect model. Finally, subgroup analysis was done to evaluate statistical heterogeneity, and sensitivity analysis was also done to detect the presence or absence of any influential study.

Results: In the final analysis, one hundred twenty-eight studies involving 445,242 individuals in 39 countries. The overall pooled prevalence of Nocturnal enuresis among children and adolescents was 7.2% (95% CI: 6.2-8.1%). Positive family history AOR 1.49 (95% CI: 1.26-1.71), positive urinary tract infection AOR; 3.89, 95% CI (2.93-4.46), parental death AOR = 1.93 (95% CI: 1.73-2.12), first birth order AOR 0.5 (95% CI: 0.37-0.62), and male sex AOR 1.63; 95% CI (1.31-1.94 were the significant associated factors with Nocturnal enuresis among children and adolescent.

Conclusion: The study found that nocturnal enuresis affects approximately 7.2% of children and adolescents. Family history, urinary tract infection, parental death, birth order, and sex were statistically significant factors. It is recommended that healthcare providers should implement routine screening for nocturnal enuresis, particularly for children with known risk factors such as family history and urinary tract infections, and the development of targeted interventions and support mechanisms should be prioritized, considering the significant impacts of these factors among children and adolescents.