Prevalence and factors associated with nocturnal enuresis and social anxiety among Palestinian primary school children: a cross-sectional study.

Abstract

Background: Nocturnal enuresis (NE) is a prevalent pediatric condition with significant physical, psychological, and social impacts. This study aimed to determine the prevalence of NE among primary school children in Palestine and investigate its demographic and biopsychosocial associates.

Methods: A cross-sectional study was conducted from October 2023 to January 2024 in primary schools across the West Bank, Palestine. A sample of 1003 children from grades one to six were recruited using convenient sampling. Data were collected through an online questionnaire administered to parents, covering sociodemographic variables, NE, social anxiety and separational anxiety. Statistical analyses including Chi-square tests and binary logistic regression were performed.

Results: The study reports a 27.9% prevalence of NE among 1,003 primary school children in the West Bank. The sample included 42.6% males and 57.4% females, with most attending public schools (65.3%) and 70.9% achieving excellent academic performance. Most fathers (79.3%) and mothers (94.9%) had higher education, and 37% of families reported a monthly income between 1,000 and 1,600 USD. NE was more prevalent in males (32.8%), children with lower academic performance (40.5%), and those from lower-income families. Significant factors associated with NE include being male (aOR: 1.6; 95% CI: 1.1-2.2), family history of NE (aOR: 6.1; 95% CI: 4.3-8.5), high fluid intake before bedtime (aOR: 1.6; 95% CI: 1.2-2.2), lower academic performance (aOR: 1.5; 95% CI: 1.1-2.1), daytime incontinence (aOR: 3.5; 95% CI: 1.4-8.5), and severe to extreme social anxiety (aOR: 7.4; 95% CI: 1.2-49.0).

Conclusions: Considering the high prevalence of NE in the current study and its strong link with social anxiety, it underscores the need for integrated psychological support alongside medical management. Therefore, cooperation between health policymakers, healthcare providers, school staff, and families is essential to develop targeted interventions addressing both the physical and psychological impacts of NE, ultimately improving the quality of life for affected children and their families.