Disposable Diaper Overuse and Nocturnal Enuresis in School-aged Children: A Hospital-based Case–Control Study in Eastern Sudan

Abstract

Background: Disposable diaper (DD) overuse is defined as the use of diapers after age two, which can affect toilet training (TT) and may result in nocturnal enuresis. Methods: This hospital-based case–control study was conducted at Kassala Teaching Hospital in Eastern Sudan. The main adjusted odds ratio (OR) for DD overuse with a 95% confidence interval (CI) was calculated. The sample consisted of 150 children with nocturnal enuresis (case group) and 150 healthy children (control group), all recruited from the same population during the same period. Results: The study identified several predictors of nocturnal enuresis, including difficulty waking from sleep (OR = 2.4; CI = 1.4–4.1; P = 0.001), family history of enuresis (OR = 2.6; CI = 1.5–4.4; P = 0.000), lack of TT (OR = 2.0; CI = 1.2–3.5; P = 0.006), delayed age of TT initiation (OR = 1.2; CI = 1.04–1.3; P = 0.002), and DD overuse (OR = 12.9; CI = 7.4–22.5; P = 0.000). Conclusion: This study found that excessive use of DDs and other factors—such as difficulty waking from sleep, family history of nocturnal enuresis, lack of TT, and delayed age of TT—are linked to nocturnal enuresis among Sudanese children.