Prevalence And Clinical Relevance Of Urine Dipstick Ketonuria Via Point-Of-Care- Testing At Salgaa Health Services, Nakuru County

Background

The presence of ketones in urine, ketonuria, serves as a clinical marker for various metabolic shifts in the body, including low-carbohydrate diets, fasting and diabetes. Increased production of ketones occurs when the body utilizes fat instead of glucose for energy, often in cases of dietary regimens, illness and insulin deficiency. Salgaa Town, in Nakuru County, is of significant interest as its socio-economic dynamics may predispose its population to higher cases of ketonuria. Point-of-care testing (POTC) using urine dipsticks offers an affordable and quick method of identifying ketonuria in clinical settings. The study evaluates the prevalence and clinical relevance of ketonuria among patients attending Salgaa Health Services.

Objective

The aim of the study is to assess the increased prevalence of ketonuria through the use of urine dipstick testing among patients attending Salgaa Health Clinic services. The study further explored associations between ketonuria and demographic factors (age, gender) while categorizing the clinical relevance of ketonuria into suspected diabetic ketoacidosis (DKA), starvation/ prolonged fasting, vomiting /diarrhea and other causes.

Methodology

A cross-sectional study was performed using retrospective patient records from June to August 2024 at Salgaa Health Services Clinic, Nakuru County. The sample comprised of 50 patients whose records met the inclusion criteria. Urine ketone levels were assessed using URS-10T Reagent Strips for Urinalysis, a semi-quantitative point-of-care method. The strips provided ketone values via colorimetric changes, corresponding approximately to mmol/L as follows: Trace (+/- = 0.5 mmol/L), Mild (+ = 1.5 mmol/L), Moderate (++ = 4.0 mmol/L), High (+++ = 8.0 mmol/L), and Very High (++++ = 16.0 mmol/L).
Demographic data (age, gender), clinical presentations, and ketone levels were extracted and classified. Results were grouped into categories of clinical relevance: (a) suspected DKA, (b) starvation or prolonged fasting, and (c) vomiting/diarrhea. Descriptive statistics were used to analyze the data, and findings were illustrated using tables and charts.

Conclusion

This study identifies a 46% prevalence of ketonuria among patients attending Salgaa Health Services, with a concentration among young adult females and severe ketonuria in 30% of cases. Routine point-of-care URS-10T urine dipstick screening, offering mmol/L readings, proves valuable in early detection and classification of metabolic disturbances in low-resource settings. Public health interventions focusing on nutritional education, targeted screening and diabetes awareness are recommended to reduce the metabolic health burden in this community.

Keywords: Ketonuria, URS-10T urine dipstick, point-of-care testing, diabetic ketoacidosis, starvation, vomiting, prevalence, Nakuru County.