Urinary tract infections is a common disease in the outpatient setting in Kenya, but in some cases, requires the patient to be admitted. It is more common in women than men due to anatomy. This infection is common in pregnant women. A study done at KNH found that the prevalence of Urinary Tract Infection in pregnant women presenting with lower abdominal pains was about 26.7%. There are variations in other locations due to the differences in environment, social habits of the community, standards of personal hygiene and level of education.
Urinary Tract Infections (UTI’s) is an infection of the Urinary tract- urethra, bladder and the kidneys. It can be classified into: –
- Asymptomatic bacteriuria -where the infection does not present any symptoms. In this type there are actively multiplying bacteria in the distal urethra. This type can be picked in routine check-ups. If left untreated it develops into the other types below in 40%.
- Urethritis- urethral infection.
- Acute Cystitis- Infection resulting into Inflammation of the bladder.
- Acute Pyelonephritis- Infection of the kidneys.
What Causes Urinary Tract Infections?
Urinary Tract Infections UTI’s is mainly caused by bacteria such as Escherichia coli (about 70% of the infections), fungi, protozoa and parasites. Rarely does viruses cause Urinary Tract infection.
Majority of the Infections are from the Bacteria mentioned above (E.Coli) that is found in fecal matter. Hence majority of the infections come from ourselves and our dirty toilets!
Some UTIs are from Sexually Transmitted Infection such as Chlamydia and Gonorrhoea. However, this is less common compared to the faecal matter bacteria.
Presentation of Urinary Tract Infections.
For Acute Cystitis- Symptoms include increased urinary Frequency, Increased Urgency to Urinate, Pain or difficulty in urination (Dysuria), blood in urine (Haematuria) and Lower abdominal (suprapubic) pain.
For Acute pyelonephritis- This is a serious infection that needs hospitalisation for Intravenous Antibiotics. Besides the above symptoms, the patient presents with nausea and vomiting, flank pains, high fever and chills, dizziness and generalised malaise (feeling of being sick).
When you go to the Hospital, Your doctor will take your medical history and examine you. They would request for Urinalysis whereby your urine is analysed for Indicators of Urinary Infection.
Depending on how you presented and the physical examinations findings of your doctor, other Investigations such as Urine culture and sensitivity, blood culture, Renal Ultrasound and renal function tests may be required.
Treatment of Urinary Tract Infection (UTI)
For asymptomatic, usually 3 days of antibiotics is enough, for cystitis it would require a longer period of antibiotics, around 5-7 days. Your doctor would prescribe Antibiotics such as Amoxicillin, Nitrofurantoin and Cefuroxime.
For pyelonephritis, as noted earlier this requires admission to a hospital for Intravenous Antibiotics such as Ceftriaxone among others, rehydration and antipyretics (for fever).
Patients are advised to abstain from sexual contact with the partner until they finish their treatment and if a sexually Transmitted Infection (STI) is confirmed, then the partner is also treated.
How can you Prevent Urinary Tract Infections?
Urinary tract Infection can be prevented by drinking plenty of clear Fluids up to 2 litters in a day.
Frequent emptying of the bladder as soon as the urge to Urinate comes. Empty the bladder completely.
Passing urine before and after sexual intercourse. Also wash the genital area before having sex.
Good perineal hygiene, including women wiping from front to back after a bowel movement and after Urination.
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