Epidemiology of urinary tract infection among febrile children under five years in Morogoro Municipality, Tanzania
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Date
2016
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Sokoine University of Agriculture
Abstract
Urinary tract infection (UTI) is among the commonest causes of febrile illness in children of less than five years of age in Sub-Saharan Countries and is in most cases associated with poor hygiene. This cross sectional study was conducted between August 2014 and October, 2015. It aimed at determining the epidemiology of urinary tract infection in children less than five years of age who attended healthcare facilities in Morogoro Municipality and also to establish bacteria susceptibility to antibiotics commonly used in treatment. A questionnaire was administered to 275 mothers/children caregivers to establish their awareness and risk factors for UTI. Subsequently, urine samples from 275 children were collected for urinalysis, bacterial culture and antibiotic sensitivity test. All respondents had heard about UTI, and they knew mode of transmission, clinical signs, treatment and control of the disease. Predictors of UTI in children that were found to be statistically significant (P<0.05) were inappetence, frequent urination, nitrite in urine, bed wetting and washing of baby with no specific patterns after urination/ defecation. Urinalysis results detected some children with yellow urine (74.6%), turbid urine (40.4%) and some abnormalities like urobilirubin, glucose, proteins, nitrates, bilirubin, ketones, traces of red blood cells and leucocytes. The specific gravity and pH of urine above normal was 4.4% and 5.5% respectively. Up to 43.6% of the urine samples had bacterial growth. Children aged between 0 and 36 months had more bacteria growth (35.6%) and female children were more affected (23.6%). The commonest bacteria isolated were E. coli (18.2%), Klebsiella (10.2%) and Staphylococcus (8%). All bacteria isolated (n=120) had high resistance to clindamycin (97.5%), Cotrimoxazole (85.8%), Ampicillin (73.3%), Ciprofloxacin (70.8%), Erythromycin (72.5%) and Ampiclox (68.3%). This study shows that the awareness on UTI is high among the mothers/children care givers nevertheless, the magnitude of the disease is high and most bacteria isolated had multi-antibiotic resistance. Therefore deliberate measures aimed at minimizing the problem need to be taken.
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Keywords
Morogoro Municipality, Tanzania, Urinary track infection, Under five Children, Urinary track epidemiology, Antibiotic bacteria susceptibility