PREDISPOSING FACTORS TO URINARY TRACT INFECTION IN PREGNANCY AMONG WOMEN AT KISUMU COUNTY REFERRAL HOSPITAL, KISUMU COUNTY-KENYA

Abstract

The urinary tract is a vital system designed to remove waste from the human body in the form of urine. Of late, cases of urinary tract infection among pregnant women have been on the increase. These infections can be categorized as infections of the upper urinary tract or infections of the lower urinary tract. According to the first systemic review and meta-analysis of the global prevalence of UTI in pregnancy in the year 2023 (where the number of participants was 30,641), prevalence of these infections was estimated to be at 23.9% including both symptomatic and asymptomatic cases. In Africa, these infections range from 11.6% to as high as 75%. Kenya’s prevalence rate of urinary tract infection in pregnancy stands at 10% to 19%, however, most of the studies arriving at this prevalence focus on selected bacterial pathogens, the maternal, pregnancy-specific and maternal behavioral factors associated with UTIs among Kenyan pregnant mothers remain uninvestigated, this is leaving a deficiency which, without being looked at to core, and appropriate action taken, we will only be going round repetitive cycles without being able to sort the issue at hand to the optimum, leaving the susceptible group in the society (i.e. the pregnant mothers alongside with the unborn) at the mercy of urinary tract infection’s undesirable outcomes. The main objective of this study was to assess the maternal, pregnancy specific and behavioral factors associated UTI among pregnant mothers in Kisumu County and Referral Hospital – Kisumu County. This study adopted a descriptive cross-sectional study with stratified random sampling of 50 participants who were interviewed using interviewer guided questionnaires. Ethical approval was sought from Uzima university research department with permission and informed consent being sought from the selected participants. The study findings were to assist the hospital and the community at large in coming up with necessary intervention measures on curbing UTIs among pregnant mothers. From the demographic findings, 20% (10 respondents) were aged between 18-25 years, 40% (20 respondents) were between 26-35 years and the remaining 40% (20 respondents) were above 35 years. 60% of these women had a history of urinary tract infection while the remaining 40% had no history. 40% were found to have cormobidities like diabetes and hypertension while the remaining 60% had no cormobidities. Only 50% were multiparous. 30% had a history of urinary catheterization while the remaining 70% had no such history. Only 50% reported inability to completely empty their bladder. The study also found that 40% of the respondents had gestational diabetes when the remaining 60% didn’t have the condition. Lowered immunity was found in 60% of the respondents while the remaining 40% were of good immunity. 70% reported of inadequate hygiene practice when only 30% of the respondents reported adequate hygienic practices. Only 50% reported high sexual activity while the remaining half reported low sexual activity. On fluid intake, 60% of the respondents reported inadequate intake while the remaining 40% maintained adequate intake. It was concluded that the key factors that predisposed pregnant women to urinary tract infections at Kisumu County Referral Hospital were history of previous UTIs, cormobidities such as diabetes and hypertension, pregnancy-specific conditions such as urinary stasis, gestational diabetes, inadequate hygiene practices and high levels of sexual activity. Routine screening and relevant management among all pregnant women was therefore recommended, particularly those with a history of UTIs and gestational complications like diabetes and hypertension to prevent complications associated with UTIs during pregnancy.