Background People living with long-term indwelling urinary catheterization at home are increasing globally. Few studies on prevalence have been done globally and none in Sub-Saharan Africa. This study investigated the prevalence and indications of long-term indwelling urinary catheterization (IUC) at home in Northwestern Tanzania and to determine the reasons for staying long with an indwelling urinary catheter after diagnosis of benign prostatic hypertrophy was confirmed. Methods This was a cross-sectional study conducted at urology clinic at Bugando Medical Centre, a referral hospital in the Northwestern Zone of Tanzania. The study population included 2112 patients attending the urology clinic from December 2016 to September 2017 with different conditions. From this population, 202 out-patients living with a long-term IUC either suprapubic or urethral were conveniently selected. A review of hospital records of these 202 out-patients was done using a pre-tested checklist. Patients were interviewed to collect additional information. Data were analyzed using STATA version 13(college station, Texas). Descriptive statistics were used for categorical variable, whereas median [inter quartile range (IQR)] was used for continuous variables. Results The prevalence of out-patients living at home with an IUC was 9.6% (202/2112), CI (8.4–10.8). Age ranged from 18 to 95 years with the median age of 69 [IQR 61–77] years. Males 195(96.5%) formed the majority of participants. A total of 111 (54.9%) had catheters for ≥ six weeks and 123 (60.9%) had their catheters changed at least once. Common indications were benign prostatic hypertrophy (BPH), 129 (63.9%) and urethral stricture 34 (16.8%). Reasons for the long stay with an IUC at home, especially for those without National Health Insurance Fund (NHIF) 49(94.2%) were endless appointments 23(52.3%), no money to pay for surgery 9(20.5%) and medical conditions 7 (16%). Only 3(0.1%) were under NHIF and were treated promptly. Conclusion Prevalence of long-term IUC in Northwestern Tanzania is high. Improved health care system is required to lower the high prevalence of long-term IUC at home through training of more urologists and these patients to be under the scheme of NHIF.

Nosocomial infections related to indwelling urinary catheters (IUC) are a worldwide problem. While this is true in areas of the globe where care facilities are optimal, it is even more the case that in countries where care conditions are compromised or when practice is lacking a substantial knowledge base. The primary aim of this study was to investigate nurses’ knowledge and clinical practise regarding care of patients with IUC in preventing nosocomial infections in four hospitals in Tanzania. Additionally, the study investigated patients’ views about received care relating to the presence of an IUC. Registered and enrolled nurses (n = 135) working in four hospitals in Dar‐es‐Salaam municipality completed a questionnaire about IUC procedures. Four nurse students performed bedside observations of nurses (n = 127) on the care for patients with IUC. Sixty patients were interviewed about their views of the care given in relation to IUC. The nurses’ overall knowledge was good, but there was a discrepancy between knowledge and clinical practice. Hand washing prior to care for patients with IUC was poor due to lack of water and soap. Half of the patients experienced problems; haematuria, offensive smell, pus around the catheter and swelling of the scrotum in male patients. Patients expressed frustration regarding the care of IUC. There was a shortage of trained hospital staff, shortage of beds to the extent that patients had to share beds and appropriate equipment was not available. Although the nurses’ knowledge in IUC care was relatively good, the nursing care for patients with IUC in the studied hospitals ought to be improved. This can be done by developing evidence‐based, culturally congruent guidelines for assurance of quality care. Many of the problems that were considered to increase the risk of nosocomial infections were identified as being related to the logistics of the wards and lack of staff. Therefore, on the strength of these findings, it is recommended that unnecessary use of IUC should be avoided particularly where weak infrastructure has been identified.

Complications of indwelling urinary catheterization (IUC) are associated with significant morbidity and mortality, thus affecting patient’s well-being. Understanding the magnitude and factors associated with complications is crucial in designing appropriate preventive strategies. A cross-sectional study was conducted at Bugando Medical Centre, involving patients with long-term and short-term IUC from December 2016 to September 2017. The data were analyzed by STATA 13.0. Catheter-associated urinary tract infection (CA-UTI) was the leading (56.8%; 250/440) complication among patients with IUC. Gram-negative bacteria were predominantly isolated (98.1%, 252/257), whereas E. coli (30.7%, 79/257) and Klebsiella spp. (29.6%, 76/257) were the leading pathogens. CA-UTI was significantly higher among out-patients than in-patients (82.2% v 35.3%, p < 0.001). Older age (OR: 1.3, (95%CI: 1.1–1.5), p < 0.001), level of education (OR: 1.8, (95%CI: 1.1–3.1), p = 0.029) and catheter duration of ≥6 weeks (OR: 2.43, (95%CI: 1.1–5.5), p = 0.031) independently predicted CA-UTI among outpatients, while female gender (OR: 2.1, (95%CI: 1.2–3.7), p = 0.014), catheter bags not freely hanging (OR: 0.4, (95%CI: 0.2–0.7), p = 0.002) and residing outside Mwanza region (OR: 0.4, (95%CI: 0.2–0.6), p < 0.001) predicted CA-UTI among in-patients. CA-UTI is the common complication among patients with IUC, significantly higher in out-patients than in-patients. We recommend involving patients and carers in infection prevention and control measures in out-patients living with IUC.

Experiences from patients living with a long-term indwelling urinary catheter (IUC) at home among men attending urology clinics have not been reported. Evidence-based information on such experiences is important for improving nursing care in low- and middle-income countries such as Tanzania. Using a descriptive phenomenological qualitative research design, we observed two main themes: “Adjustments to positive living with a catheter at home”, denoting that social interaction and psychological and spiritual support are important to positively live with the catheter, and “The home environment influences negative or positive living”, considering intimacy and altered body image to significantly influence the ability to practice sex, leading to wives’ self-sacrifice. Respondents experienced difficulties in living with a long-term IUC at home due to a lack of information from healthcare professionals on how to manage their catheters and urine bags. In adjusting to positive or negative living with a catheter at home, respondents had to figure out strategies to minimize psychological and emotional trauma and hasten the adjustment process. A clear guideline or checklist is needed to ensure that all important information is provided by health professionals at the time of discharge and during subsequent visits to patients on how to care for the catheter insertion sites and help them adjust to living with a long-term IUC.

Background This study aimed to determine quality of life (QoL) among patients living with long-term indwelling urinary catheter (IUC) at home in the Northwestern Tanzania. To the best of our knowledge for the first time in Africa, we report on quality of life for patients living with a long-term IUC at home. Methods This was a descriptive cross‑sectional study conducted between December 2016 and September 2017. A total of 202 out-patients aged 18 years and above living with a long-term IUC were conveniently recruited. The QoL was determined using WHOQOL‑BREF tool. Quantitative data were entered into Microsoft Excel for cleaning and coding, then into STATA software version 13.0 for analysis. Descriptive statistics were used to compute means and standard deviations for numerical variables as well as frequencies for nominal and ordinal variables. Significance of association between various variables and QoL were tested using t test with equal variances. Inferential statistics applied included an independent sample’s t‑test for comparing numerical socio-demographic variables. A P-value < 0.05 was considered statistically significant. The mean score indicating good QoL according to our study is a mean score of 50 and above. The higher the score the higher the QoL. Results Median age of participants was 69 (IQR 61–77) years. Majority of participants were males (195, 96.5%), married (187, 92.6%), and having primary education (116, 57.3%). Generally, the QoL was poor in all the domains: mean score for physical health being 36.67 ± 0.89, psychological 29.54 ± 0.87, social relationship 49.59 ± 1.61, and environment 26.05 ± 0.63. Married participants were slightly better under social domain 51.1 ± 1.6 than singles 31.1 ± 5.4; P-value 0.001. Those with primary education & above were slightly better in environmental domain 26.1 ± 0.7 than those with no formal education 23.5 ± 1.5; P-value 0.039. Conclusion QoL of participants with a long-term IUC in Northwestern Tanzania is generally poor in all domains. Those with primary education & above and the married were slightly better in environmental and social domains respectively. We recommend on the needs of improved social economic status and the importance of close follow up at home for the married participants living with long-term IUC.