Prevalence of urinary tract infection among women at Bugando Medical Center, Mwanza, Tanzania

Department of Obstetric and Gynaecology, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania.
Tanzania journal of health research 07/2009; 11(3):154-9. DOI: 10.4314/thrb.v11i3.47704
Source: PubMed


Urinary tract infections (UTI) are the most common bacterial infections during pregnancy and these infections. Untreated UTI can be associated with serious obstetric complications. This cross-sectional study was carried out to determine the prevalence of UTI among symptomatic and asymptomatic pregnant women attending Bugando Medical centre (BMC) in Mwanza, Tanzania. A total of 247 pregnant women were enrolled, of these 78 (31.5%) were symptomatic and 169 (68.4%) asymptomatic. UTI was diagnosed using mid stream urine (MSU) culture on standard culture media and urinalysis was done using rapid dip stick. The prevalence of bacteriuria among symptomatic and asymptomatic pregnant women were 17.9% and 13.0% respectively, with no significant difference between the two groups (p = 0.307). Using univariate analysis there was no association of parity (p = 0.825), gestational age (p = 0.173), education (p = 0.615), age (p = 0.211) and marital status (p = 0.949) with bacteriuria. The sensitivity and specificity of urine dipstick was 38.9% and 86.7% respectively. Escherichia coli (47.2%) and Enterococcus spp (22.2%) were the most commonly recovered pathogens. The rate of resistance of Escherichia coli to ampicillin, tetracycline, sulfamethaxazole/trimethoprim, gentamicin, ciprofloxacin, nitrofurantoin, ceftriaxone, and imipenem were 53%, 58.8%, 64.7%, 5.9%, 11.8%, 5.9%, 29.4% and 0%, respectively. In conclusion, asymptomatic bacteriuria among pregnant women is prevalent in our setting and majority of Escherichia coli are resistant to ampicillin, tetracycline, SXT and ceftriaxone. Due to low sensitivity of rapid dip stick, routine urine culture and susceptibility testing is recommended to all pregnant women at booking.

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    • "reported a prevalence of 21.7% but relatively lower that the study of Onuh et al. (2006) in Benin with a 32.7% prevalence rate and Okonko et al. (2009) with a prevalence rate of 45.7% in Ibadan. However, it is higher than the study in Abakaliki by Onyemelukwe et al. (2003) who reported a prevalence of 12.7% and 14.6% prevalence in Tanzania by Masinde et al., 2009. In other parts of the world, 8.5% by Sevki et al. (2011), 10.4% by Agersew et al. (2012) and 10.4% by Nawaz et al. (2012). "

    Full-text · Article · Feb 2015 · African journal of microbiology research
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    • "In our study the sensitivity and specificity of urine dipstick (nitrate and leukocyte esterase in combination) was 22.9% and 99.1% respectively which is comparable with the study done by Masinde et al.[10] in Tanzania, who reported the sensitivity and specificity of the dipstick test result 38.9% and 86.7% respectively. In the current study the sensitivity of leukocyte esterase and nitrite was 51.4% and 42.9%, while its specificity was 88.9% and 98% which has similar pattern with the study reported by Kacmaz et al.[6] where the sensitivity of urine leukocyte esterase and nitrite was found to be 70% and 60%, and specificity was 92.5% and 99.2% respectively. "
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    ABSTRACT: Background Untreated bacteriuria during pregnancy has been shown to be associated with low birth-weight and premature delivery. Therefore, routine screening for bacteriuria is advocated. The decision about how to screen pregnant women for bacteriuria has always been a balance between the cost of screening versus the sensitivity and specificity. This study was designed to evaluate the diagnostic accuracy of the rapid dipstick test to predict urinary tract infection in pregnancy against the gold standard urine culture. Method A total of 367 mid stream urine samples were collected, inoculated on MacConkey, Manitol salt agar (MSA) and blood agar and incubated aerobically at 37°C for overnight. Specimens were classified as “positive” for urinary tract infection (UTI) if the growth of the pathogen(s) was at a count ≥ 105 colony-forming units per milliliter (cfu/mL) of urine and classified as “negative” with growth of <105 cfu/mL. Urine samples were tested for the presence of nitrite and leukocyte esterase using dipstick rapid test in accordance to the manufacturer’s instructions. Results From the total study participants, 37 pregnant women were symptomatic and the remaining 330 pregnant women were asymptomatic. The sensitivity and specificity of dipstick tests of leukocyte esterase was 50% and 89.1% for pregnant women with asymptomatic UTI(ABU) and 71.4% and 86.7% for symptomatic UTI respectively and for nitrite 35.7% and 98.0% for ABU and 57.1% and 96.7% symptomatic UTI. Conclusion This study revealed that the use of dipstick leukocyte esterase and nitrite for screening UTI particularly asymptomatic bacteriuria was associated with many false positive and negative results when it was compared against the gold standard culture method. The low sensitivity and positive predictive value of urine dipstick test proved that culture should be used for the diagnosis of UTI.
    Full-text · Article · Jul 2014 · BMC Research Notes
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    • "In the United States, UTI account for 8.3 million out-patient visits and 1 million hospitalizations annually. Masinde et al., [13] published a cross-sectional study from Tanzania in 2009 to determine the prevalence of UTI in both symptomatic and asymptomatic pregnant women. Of the 247 women in the 70 sample, 31.5% were symptomatic and of those women, 18% had bacteriuria. "

    Full-text · Article · Feb 2014
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