Abstract

Background: Urinary tract infections are a major health problem in young population and the burden of urinary tract infections in adolescent girls have been understudied in Cameroon. The aim of this study was to determine the knowledge on risk factors and Preventions of urinary tract infections among High school girls in Lycee Molyko Buea.

Method: The cross-sectional method was used. Data was collected using structured questionnaires containing 4 questions related to participant’s demographic data, 5 questions related to knowledge on urinary tract infections, 7 questions related to knowledge on risk factors associated with urinary tract infections and 12 questions related to prevention practices of participants on urinary tract infections.

Results: Among the respondents, 100% females and 50% were from lower sixth while 50 % were from upper sixth with the majority (52%) being (15-17 years old), 71% were Christians and a majority (97.5%) were single. The results showed that most the participants (50.6%) had inadequate knowledge on urinary tract infections while 49.4% had adequate knowledge.

A majority 51.9% of participants had poor knowledge on risk factors associated with urinary tract infections whereas 48.1% had adequate knowledge and 50.9% reported poor prevention practices of urinary tract infections while 49.1% reported adequate prevention practices of urinary tract infections.

CHAPTER ONE

INTRODUCTION

1.1 Background

Urinary Tract Infection (UTI) refers to the inflammatory disorders of the urinary tract caused by the abnormal growth of pathogens (O Amali et al., 2009). Urinary tract infection (UTI) is a term used for a wide range of clinical disorders, from asymptomatic bacteriuria to kidneys infection and sepsis. In more than 80% of cases, UTI is caused by a bacterium that the most commonly responsible organism for this bacterium is E coli which is part of the normal flora of the intestine (Leung et al.,2019).

The high prevalence of infection, the likelihood of recurrence of the disease, the variety of clinical symptoms in different age groups followed by the difficulty of clinical and laboratory diagnosis, the resistance of the causative agent to antibiotics and the long-term serious complications in girls, have caused the infection of the urinary system to be of special importance  (Okarska et al., 2017) so that nowadays, urinary tract infections is one of the most common bacterial infections in girls and mostly in children and is considered as one of the most important health indicators of communities (Kaufman et al., 2019).

Micturition or also known as urination, involves expulsion of urine from the bladder, hence emptying the urinary bladder through the urethra to the exterior of the body. Urinary framework of healthy people is intended to keep urine from backing up to the ureters and kidneys from the urinary bladder and the stream of the urine from the bladder normally helps wash away any microorganisms.

However, factors such as poor personal hygiene or sexual intercourse would cause the organisms to travel up the urethra and may likewise contaminate the urinary bladder. Urinary tract infection (UTI) is also defined as microbial infiltration of the otherwise sterile urinary tract. Eventually, when infection in urinary system is not treated, infected individuals may only show rather vague symptoms and may cause numerous complications. The infection may encompass complications such as infection of the urethra (known as urethritis), bladder (known as cystitis), prostate (known as prostatitis) and kidney known as pyelonephritis.

Urinary tract infection is the most serious global health issues in the 21st century (Morris and Masterson, 2002). They are the frequent cause of morbidity in outpatients as well as most frequently involved in the cause of nosocomial infection in many hospitals (Sussman and Hausler, 1998). Urinary tract infections are an infection caused by the presence and growth of microorganisms anywhere in the urinary tract and is perhaps the single commonest bacterial infection of mankind (Morgan and McKenzie, 1993; EBie et Al.,2001).

Urinary tract infection is the second most common infectious presentation in community medical practice. Worldwide about 150 million people are diagnosed with UTI each year. It is much more common in women than in men, due to anatomical and physiological reasons; by virtue of its position, urinogenital tract is more vulnerable to bacterial infections caused by both internal and external flora (Maripandi et Al., 2010).

About 3% of all women in the United States visit a physician at least once each year for UTIs, and at least 50% of women report at least one Urinary tract infection in life time (Nicolle et al., 2006). Urinary tract infection can lead to renal scars and if undiagnosed, leads to permanent renal damage causing hypertension or end stage renal disease.

In Malaysia, the study of UTI prevalence among adolescents have never been done before and previous studies that have been done on same population and other countries and regions were also limited. However, the findings of studies in other countries such as India and United States of America showed high prevalence of UTI.

For instance, study done by Fouad and Boraie found percentage of asymptomatic urinary abnormalities among adolescents in East of Egypt,

JFTK Akoachere (2012) in their study Etiology profile and antimicrobial susceptibility of community acquired urinary tract infections in two Cameroonian towns stated that, Urinary tract infection (UTI) represents one of the most common diseases encountered in community medical practice.

In resource poor settings, treatment is usually empiric due to the high cost and long duration required for reporting diagnosis by culture and antibiotic susceptibility testing. With the growing problem of drug resistance knowledge of antibiotic susceptibility pattern is pertinent for successful eradication of invading pathogens. Their study, the first of its kind in Cameroon, analyzed the distribution and antibiotic susceptibility of bacteria causing community-acquired urinary tract infection (CAUTI) in two towns (Bamenda and Buea) with a large number of young and middle-aged persons, to provide data that could guide empiric treatment.

The study found that 235 urine specimens were cultured and analyzed the antibiotic susceptibility of isolates by the disc diffusion technique. Uropathogens were recovered from 137 (58.3%), with prevalence rates in Buea and Bamenda being 65.9% and 54% respectively. Predominant pathogens were Escherichia coli (31.4%), Klebsiella oxytoca (25.5%) and Staphylococcus spp (24.1%). Geographic variation in uropathogens distribution and antibiotic susceptibility was observed, and a significant difference in pathogen distribution with respect to gender. The 20–39 years age group had the highest prevalence of infection.

All pathogens isolated were detected in this group. Isolates exhibited low susceptibility to antibiotics tested. Bamenda isolates generally exhibited lower susceptibility compared to those from Buea. They therefore stated that Regional variation in etiology of CAUTI and antibiotic susceptibility that were observed in their study emphasized the need to establish local and national antimicrobial resistance monitoring systems in Cameroon to provide information for the development of CAUTI treatment guidelines.

Since the previous studies, no study has been conducted on knowledge on risk factors and preventions of urinary tract infections among high school girls in Cameroon. The present study aims at investigating the knowledge of high school girls of Lycée Molyko Buea on risk factors and preventions of urinary tract infections

1.2 Statement of the Problem

Urinary tract infections refer to the inflammatory disorders of the urinary tract caused by the abnormal growth of pathogens (O. Amali et al., 2009).  A study on “knowledge and practice regarding prevention of urinary tract infections among adolescent girls at selected high schools” by EM. Partel (2020) was carried out and revealed that a significant poor knowledge and practice was found regarding prevention of urinary tract infections among adolescent girls. In Cameroon, studies on knowledge of risk factors and preventions of urinary tract infections among adolescent have not been carried out.

While on internship in different hospitals, the researcher noticed that most cases that presented with Urinary tract infections were adolescent girls which probably could be as result of factors such as poor hygiene, dysfunctional voiding pattern, Inadequate intake of water, infrequent passage of urine, unhygienic school toilets, improper teachings regarding menstrual hygiene and many others.

It’s therefore because of this reasons that the investigator felt the need to conduct a study to investigate if the students have knowledge on risk factors and preventive measures of urinary tract infections and if they do have knowledge on UTI, the researcher seeks to investigate their level of awareness on risk factors and preventions of urinary tract infections.

1.3 Rational

This study is conducted with the aim of assessing the knowledge of high school girls on risk factors and preventions of urinary tract infections.

1.4 Research Questions

1.4.1 Specific Research Question

1. What are the levels of high school girl’s knowledge regarding urinary tract infections and their causes?
2. Do high school girls have knowledge of the risk factors associated with urinary tract infections?
3. What are the preventive self-care practices against urinary tract infections in high school girls of Lycée Molyko Buea?

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