DOI: https://doi.org/10.53350/pjmhs22164857 ORIGINAL ARTICLE P J M H S Vol. 16, No. 04, APR 2022 857 Infection of the Urinary Tract and its Prevalence Among Children Presenting with Malnutrition SIJAD-UR-REHMAN 1 , BILAL NOOR 2 , MUHAMMAD ISHAQ 3 , KALEEM ULLAH 4 , GULE LALA 5 , ROMANA BIBI 6 1 Associate prof department of peads Gajju khan Medical college swabi. Pakistan 2 Medical officer Liaqat Memorial Hospital kohat. Pakistan 3 Senior Register HMC hospital Peshawar .Pakistan 4 Medical officer saidu teaching hospital swat Pakistan 5 Lecture Anatomy K.G.M.C Peshawar. Pakistan 6 Resident Gynecologist Peshawar . Pakistan Corresponding author: Sijad Ur Rehman, Email: drsijad@yahoo.com ABSTRACT Background: UTIs are a common cause of acute illness in newborns and young children, affecting 8% of girls and 2% of boys by age seven, with a recurrence rate of 10% to 30%. A UTI is a serious condition that can develop into sepsis and other life-threatening consequences in children Objective: To assess the frequency of urinary tract infections in malnourished children. Material and Methods: The study included 241 patients from the Pediatric Department of Children Gajju khan medical collage Swabi. Pakistan. July 7, 2019 – January 7, 2020, All children had urine samples taken by urine bags and catheterization and forwarded to the hospital laboratory to test for UTIs. The same consultant microbiologist with at least five years of expertise supervised all laboratory studies. Results: As per frequencies and percentages for UTIs, 19 (7.88%) patients had UTIs. Conclusion: Given the high frequency of UTIs in children with severe malnutrition, additional research utilizing standardized microbiological approaches is essential. To support the treatment recommendations for UTIs in these children, using urine dipsticks and microscopy in conjunction with urine culture is critical. Keywords: Protein Energy Malnutrition, Bacterial Infection, Urinary Tract Infections. INTRODUCTION The incidence of urinary tract infections (UTIs) in newborns and young children is high, with recurrence rates between 10% and 30%. 1 The Canadian Pediatric Society has revised its guidelines for diagnosing UTIs and should be reviewed for sample collection, testing, and treatment strategies 2 . Urinary tract infection (UTI) in young infants generally has vague symptoms, making the collection of a urine sample difficult 3 . A lower than recommended sampling rate means that up to half of primary care children with UTIs may not be detected at initial contact 4 . The research indicated that up to 80% of UTIs go undiagnosed in basic care. Primary care practitioners have been recommended to get a urine sample for culture from sick children 5 . Early childhood nutrition is critical for a child's immune system and physical and mental development 6 . Especially in South-East Asia and Sub-Saharan Africa 7 , malnutrition persists in youngsters. Poverty and illiteracy are key contributors to malnutrition in children under five years old 8 . Various anthropometric measures have been used to assess child nutrition. Stunting (age-related height), wasting (weight-related height), and underweight (weight- for-age). However, measuring the MUAC is a simple, rapid, and exact way to diagnose malnutrition in children under five years old. 9 . Malnourished children are more prone to UTIs than their well-nourished peers, and the risk rises with malnutrition. SAM is related to immunological weakness, making afflicted infants more susceptible to serious infections 10,11 . Most studies in impoverished nations found a significant incidence of UTI among hospitalized children with SAM. Recognizing this risk may help doctors make better diagnostic and treatment choices in these children 12,13 . UTI is recorded in 16.5 percent of malnourished children, 6 percent of 13, and 16 percent of 12. This research aims to investigate the frequency of UTIs in malnourished children 14 . Considering the previous research, it is proposed that the worldwide burden of UTI is increasing and varies greatly amongst populations 15 . Malnourished children have low immunity and are susceptible to clinical and subclinical UTIs. A UTI is a serious condition that may develop into sepsis and other life-threatening consequences in children. Since no studies on this issue have been undertaken in the previous five years, this research will provide us with current information on the frequency of urinary tract infections in malnourished children under five. The study's findings will also be shared with other health professionals and researchers 16 . Sampling Technique: consecutive non-probability sampling Sample Selection Inclusion Criteria:  all children presenting with malnutrition with a duration >6 months and have not used any antibiotics for the last 2 weeks.  Age: 1 year to 18 years.  Sex: both male and female. Exclusion Criteria:  children with already diagnosed UTI.  Children with a history of antibiotic intake in the last 48 hours.  Children with congenital urinary tract abnormalities as diagnosed by medical records and ultrasound examination. If included, the conditions mentioned above act as confounding factors and will introduce bias in the study results.