Epidemiological assessment of nocturnal enuresis and associated risk factors in elementary school children: a cross-sectional study in North Sumatra, Indonesia

Abstract Background Enuresis remains a common pediatric concern with multifactorial causes, yet prevalence data from Indonesia remain limited. This study aimed to determine the prevalence of enuresis and its associated factors among primary school children in North Sumatra, Indonesia. Methods A cross-sectional study was conducted with 2,154 elementary school students (mean age 9.67 ± 2.09 years; 55% female, 45% male). Data were collected using paper questionnaires distributed to seven schools in Medan and via online Google Forms shared through WhatsApp to reach broader populations across North Sumatra. Statistical analysis included chi-square tests and multivariate logistic regression to identify independent predictors. Results The overall prevalence of nocturnal enuresis was 20.8% (18.3% via physical questionnaire vs. 23.9% via Google Forms), with 75.16% having primary enuresis. Daytime urinary incontinence was reported in 38.9% of cases. Multivariate analysis revealed significant associations between enuresis and younger age (OR = 0.832, 95% CI: 0.789–0.877, p < 0.001), female gender (OR = 0.701, 95% CI: 0.560–0.876, p = 0.002), and constipation (OR = 2.598, 95% CI: 1.983–3.403, p < 0.001). Children with disabilities showed elevated risks: physical disabilities (OR = 9.044, p < 0.001), intellectual disabilities (OR = 4.893, p < 0.001), and sensory disabilities (OR = 2.732, p = 0.005). Conclusions This study reports a higher prevalence of enuresis in North Sumatra than in other regions. Younger age, physical disability, and constipation are significant independent predictors. These findings underscore the importance of early identification and targeted interventions, particularly for children with disabilities and a relevant family history.