| dc.description.abstract |
Background information: Urinary tract infection accounts for a major disease burden globally especially in
the developing countries. Community-acquired urinary tract infections (UTIs) occur mostly in women and are
commonly caused by Escherichia Coli.
Objective and study design: This was a cross-sectional study carried out in Kwale and Kinango Sub-county
hospitals, Kenya. This study aimed to determine the proportion and etiology of UTI and establish the factors
influencing healthcare seeking behaviour of UTI patients among female attending the outpatient department for
a period of twelve months(from September 2014 to September 2015).
Method: Mid-steam urine samples were collected from seven hundred and sixty six non-pregnant female
participants who consented in our study and fulfilled the study criteria. Physical, chemical, microscopic and
culture techniques were performed on urine samples obtained from the seven hundred and sixty six (766)
women.for drug sensitivity, Kirby-Bauer technique was employed where 14 antibiotics were ttested against
identified uropathogens.
Results: Out the 766 female involved in the study,220 were diagnosed with UTI where, 152(69.1%) were young
females in the ages between 15 to 29,while those in the age groups 30-39 were 42 (19.1%) the least diagnosed
with UTI being females in ages between 40 and 49 who accounted for 11.8%(26 females). Considering marital
status of those who were diagnosed with UTI,141(64.1%) were married, while those who reported to be single
during the period of the study accounted for 30%(66 women) while the third group which were few, were in the
group of divorced or widowed who were only 13,representing 5.9%. Out of the 766 subjects who took part in
this study,546 , (71.3%) sought healthcare services while 220(28.7%) did not seek healthcare service even after
developing signs of UTI.
Among those who hadn’t sought healthcare services, 110(50%) cited the cost of treatment as the barrier for not
seeking healthcare, while 106(48.18%) were ignorant of the disease. Women in the age bracket of 15-29 years
old were the most affected. Among the 220 diagnosed with UTI Significant bacteriuria (>105 colony forming
units/ml of urine was found in 220/766(28.7%) urine specimens. Of the six bacteria isolated, Escherichia coli
was the most predominant at 97(44.1%), Candida albicans, 29(13.2%), Pseudomonas aureginosa, 28(12.7%),
Staphylococcus aureus, 26(12.7%), Coagulase/Catalase negative Staphylococcus saprophyticus, 20(9.1%) and
Proteus mirabilis, 20(9.1%). This study concludes that, Women aged between 15-29 years old were the most
affected with 546(71.3%) having sought healthcare compared to only 220(28.7%) who didn’t. Escherichia coli
were the most predominant urinary tract pathogen isolated (44.1%), with high levels of resistance against most
antimicrobial agents to most uropathogens being evident. Low economic status among participants is the major
contributing factor that influenced poor healthcare seeking behavior with 28.7% delaying or failing to seek
healthcare in the previous episode where 110(50%) citing the cost of treatment as the major barrier for not
seeking healthcare. Making evidence based management of urinary tract infections for both asymptomatic and
symptomatic compulsory will be helpful in detecting the etiology of UTI, thus reducing period of infection and
cost of treatment.The cost of screening UTI should be revised and scaled down to increase detection of the
disease causative agent before prescribing of antibiotics to patients by clinicians. |
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