Urinary Tract Infections among HIV-Positive Pregnant Women in Mwanza City, Tanzania, Are High and Predicted by Low CD4+ Count
Introduction. Urinary tract infection (UTI) among pregnant women can lead to adverse maternal and foetal outcomes. UTI has been widely studied in the general obstetric population in Tanzania; the present study evaluated the magnitude, antimicrobial resistance, and predictors of UTI among HIV-positiv...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | International Journal of Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2017/4042686 |
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| author | Tito Chaula Jeremiah Seni Nhandi Ng’walida Alphaxaid Kajura Mariam M. Mirambo Rebekah DeVinney Stephen E. Mshana |
| author_facet | Tito Chaula Jeremiah Seni Nhandi Ng’walida Alphaxaid Kajura Mariam M. Mirambo Rebekah DeVinney Stephen E. Mshana |
| author_sort | Tito Chaula |
| collection | DOAJ |
| description | Introduction. Urinary tract infection (UTI) among pregnant women can lead to adverse maternal and foetal outcomes. UTI has been widely studied in the general obstetric population in Tanzania; the present study evaluated the magnitude, antimicrobial resistance, and predictors of UTI among HIV-positive pregnant women. Methods. Between March and May 2016 midstream urine samples from 234 women attending prevention of mother to child transmission of HIV (PMTCT) clinics were analyzed using standard methods. Data was analyzed by STATA version 11.0. Results. The prevalence of UTI was 21.4%, 50/234 [95% CI: 16.1–26.6]. The asymptomatically significant bacteriuria was higher than symptomatically significant bacteriuria (16.6% versus 4.7%, p<0.001). On multivariable logistic regression analysis, single marital status (OR: 2.6, 95% CI: 1.1–6.1, and p=0.026), low CD4+ counts of <200/μL (OR: 2.9, 95% CI: 1.1–7.7, and p=0.031), and having UTI symptoms (OR: 2.5, 95% CI: 1.1–6.0, and p=0.03) were independent predictors of UTI. Escherichia coli predominated (57.7%) and exhibited a low prevalence of resistance to nitrofurantoin (16.7%), gentamicin (10.0%), and ceftriaxone (13.3%). Four (13.3%) of these were extended-spectrum beta-lactamase producers. Conclusions. A considerable proportion of HIV-positive pregnant women in Mwanza have significant bacteriuria which calls for the need to introduce routine UTI screening at PMTCT clinics to guide specific treatment and prevent associated complications. |
| format | Article |
| id | doaj-art-a85e6b2e0f324b4b994a7ec2c179740c |
| institution | Kabale University |
| issn | 1687-918X 1687-9198 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Microbiology |
| spelling | doaj-art-a85e6b2e0f324b4b994a7ec2c179740c2025-08-20T03:38:54ZengWileyInternational Journal of Microbiology1687-918X1687-91982017-01-01201710.1155/2017/40426864042686Urinary Tract Infections among HIV-Positive Pregnant Women in Mwanza City, Tanzania, Are High and Predicted by Low CD4+ CountTito Chaula0Jeremiah Seni1Nhandi Ng’walida2Alphaxaid Kajura3Mariam M. Mirambo4Rebekah DeVinney5Stephen E. Mshana6Department of Obstetrics and Gynecology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Bugando, Mwanza, TanzaniaDepartment of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Bugando, Mwanza, TanzaniaDepartment of Obstetrics and Gynecology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Bugando, Mwanza, TanzaniaDepartment of Obstetrics and Gynecology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Bugando, Mwanza, TanzaniaDepartment of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Bugando, Mwanza, TanzaniaDepartment of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, CanadaDepartment of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Bugando, Mwanza, TanzaniaIntroduction. Urinary tract infection (UTI) among pregnant women can lead to adverse maternal and foetal outcomes. UTI has been widely studied in the general obstetric population in Tanzania; the present study evaluated the magnitude, antimicrobial resistance, and predictors of UTI among HIV-positive pregnant women. Methods. Between March and May 2016 midstream urine samples from 234 women attending prevention of mother to child transmission of HIV (PMTCT) clinics were analyzed using standard methods. Data was analyzed by STATA version 11.0. Results. The prevalence of UTI was 21.4%, 50/234 [95% CI: 16.1–26.6]. The asymptomatically significant bacteriuria was higher than symptomatically significant bacteriuria (16.6% versus 4.7%, p<0.001). On multivariable logistic regression analysis, single marital status (OR: 2.6, 95% CI: 1.1–6.1, and p=0.026), low CD4+ counts of <200/μL (OR: 2.9, 95% CI: 1.1–7.7, and p=0.031), and having UTI symptoms (OR: 2.5, 95% CI: 1.1–6.0, and p=0.03) were independent predictors of UTI. Escherichia coli predominated (57.7%) and exhibited a low prevalence of resistance to nitrofurantoin (16.7%), gentamicin (10.0%), and ceftriaxone (13.3%). Four (13.3%) of these were extended-spectrum beta-lactamase producers. Conclusions. A considerable proportion of HIV-positive pregnant women in Mwanza have significant bacteriuria which calls for the need to introduce routine UTI screening at PMTCT clinics to guide specific treatment and prevent associated complications.http://dx.doi.org/10.1155/2017/4042686 |
| spellingShingle | Tito Chaula Jeremiah Seni Nhandi Ng’walida Alphaxaid Kajura Mariam M. Mirambo Rebekah DeVinney Stephen E. Mshana Urinary Tract Infections among HIV-Positive Pregnant Women in Mwanza City, Tanzania, Are High and Predicted by Low CD4+ Count International Journal of Microbiology |
| title | Urinary Tract Infections among HIV-Positive Pregnant Women in Mwanza City, Tanzania, Are High and Predicted by Low CD4+ Count |
| title_full | Urinary Tract Infections among HIV-Positive Pregnant Women in Mwanza City, Tanzania, Are High and Predicted by Low CD4+ Count |
| title_fullStr | Urinary Tract Infections among HIV-Positive Pregnant Women in Mwanza City, Tanzania, Are High and Predicted by Low CD4+ Count |
| title_full_unstemmed | Urinary Tract Infections among HIV-Positive Pregnant Women in Mwanza City, Tanzania, Are High and Predicted by Low CD4+ Count |
| title_short | Urinary Tract Infections among HIV-Positive Pregnant Women in Mwanza City, Tanzania, Are High and Predicted by Low CD4+ Count |
| title_sort | urinary tract infections among hiv positive pregnant women in mwanza city tanzania are high and predicted by low cd4 count |
| url | http://dx.doi.org/10.1155/2017/4042686 |
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