Prevalence of Urinary Tract Infection among Pregnant Women in Ogun State, Nigeria

Abstract

Background: Urinary Tract Infection (UTI) is a common health problem among women and pregnancy is a predisposing factor. Aims: To determine the prevalence of Urinary Tract Infection among pregnant women in Ogun State, Nigeria. Study Design: This is a prospective, analytical and Institutional based study. Place and Duration of Study: Ante-natal Clinic, General Hospital, Ijebu-Ode, Ogun State, Nigeria, between March and May, 2017. Methodology: Clean catch mid-stream urine samples were collected from 100 consenting pregnant woman with no prior antibiotic or herbal therapy in the preceding two weeks. Prior to specimen collection, their demographic and clinical Information were collected by oral interview and administration of a structured questionnaire. Urine macroscopy, microscopy and culture were carried out using standard methods. Isolates were characterized by their colonial morphology, Gram staining, motility and biochemical tests. Antibiotic susceptibility test was performed by the disc diffusion method. Results: Out of the 100 urine samples examined, 31 were positive for significant bacteriuria (≥105 cfu/ml), and therefore a prevalence of 31% among the study participants and the highest occurrence was among participants who were 21-25 years old (29.0%), married (74.2%), Christians (77.4%), Yoruba by tribe (90.3%), and traders (38.7%). Still, the prevalence of UTI was significantly higher (P<0.05) among participants with secondary education (45.2%) and among those with pregnancy in the second trimester (48.4%). Eighteen (58.1%) out of the 60 participants with no knowledge of UTI were positive for UTI (P<0.05). Also, 14 (45.2%) out of the 37 participants who indicated past history of UTI, were positive for UTI with P value <0.05. Most of them indicated symptoms consistent with UTI: frequency of urination (64.5%), dysuria (16.1%), haematuria (16.1%), urgency (51.6%) and nocturia (54.8%). Frequency of urination was found to be more strongly associated with the occurrence of UTI among participants than other symptoms (P<0.05). A total of 9 different organisms were recovered from the participants. These include Gram positive and negative bacteria, parasites and fungi at varying frequency: K. pneumoniae (26.5%), E. coli (26.5%), Proteus mirabilis (11.8%), Klebsiella oyntocum (2.9%), Citrobacter freundii (2.9%), Staphylococcus aureus (17.7%), Coagulase negative Staphylococcus (2.9%), Candida albicans (5.9%) and Trichomonas vaginalis (2.9%). Seven Gram positive isolates were recovered from the urine samples and were found to be most sensitive to Ofloxacin (100%), but least sensitive to Augmentin (0%). On the other hand, the 24 Gram negative isolates recovered from the urine samples were found to be most sensitive to Ofloxacin (95.8%), but least sensitive to Gentamicin (8.3%).  Conclusion: UTI exists among pregnant women in Ogun State with a prevalent rate of 31%. Routine screening of pregnant women for UTI is therefore very crucial in order to prevent adverse effects on both maternal and foetal health.