Contraception as a risk factor for urinary tract infection in Port Harcourt, Nigeria: A case control study

Abstract

BackgroundThe concerted effort of government and donor agencies to limit fertility by the use of contraceptives has been reported in some studies to predispose to urinary tract infection (UTI). Similar studies have not been conducted in the General Outpatient Department (GOPD) of the University of Port Harcourt Teaching Hospital (UPTH).ObjectivesThis study was aimed at assessing the role of contraceptives in the development of UTI amongst adult females attending the GOPD of UPTH.MethodA case control study in which contraceptive users who attended the GOPD of the UPTH in four months, and an equal number of age-matched controls, were screened for UTI. The information obtained from them was entered into a specially designed pre-tested questionnaire for analysis. The results were analysed using SPSS version 14.ResultsA total of 150 contraceptive users and controls were evaluated. Their age range was 18–50 years, with a mean of 27.8 ± 5.3 years. Most of the participants belonged to the lower socioeconomic classes. The combined prevalence of UTI amongst the contraceptive users and the controls was 23.7%, with the contraceptive users at 35.3% and the controls at 12.0%. The association of UTI with contraceptive use was statistically significant, with McNemar's χ2 = 16.28, p = 0.000, odds ratio (OR) = 2.9, 95% confidence interval (CI) = 1.7 – 5.3, attributable risk (AR) = 23.3, population attributable risk (PAR) = 11.7. The users of barrier contraceptives were more predisposed to UTI (OR = 17.30, 95% CI = 7.49 -39.96).ConclusionContraceptive use is a significant risk factor for acquiring urinary tract infection, with the barrier methods being more predisposing. Health education for the hygienic and safe use of family planning methods will prevent long-term complications.

Investigation of vaginal microbiota in sexually active women using hormonal contraceptives in Pakistan

“…In present study, we report that the overall percentage of vaginal microbiota amongst the contraceptive users of age group 20–30 and 31 to 40 years was high (45%) and this finding is consistent with other researchers [ 6 , 11 - 13 ]. The reason why the study was confined to the microbial species reported here is that these microorganisms represent opportunistic group (except Lactobacillus fermentum ) and etiology of most urinary tract infections have been attributed to these microbiota.…”

Characterization of the Risk Factors Associated With Urinary Tract Infection (Uti) in Lebanon, and Evaluation of the Antibacterial Activity of Hawthorn Extract Against Uti-Causative Bacteria

“…This finding is opposing with other studies proving a correlation between UTI and contraceptives. The difference in these findings can be explained by differences in patient selection, study design, number of samples (4) .…”

Lifestyle Issues and Prevention of Recurrent UTIs

“…Although, genital hygiene practices such as frequency of coitus, urinating after coitus, washing genitals precoitus, male partner washing genitals precoitus, washing genitals postcoitus, taking baths, frequent replacing of underwear, and washing genitals from front to back were associated with a reduced frequency of UTIs [21]. Low socioeconomic status, depression, anxiety, inadequate water intake, low educational status, anemia, catheterization, poor personal hygiene, poor access to condoms and other contraceptive devices, spermicide-coated condoms, poor access to qualified healthcare systems, high rate of family disruption, mental disorders are also risk factors [14,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]. Catheter-associated-UTIs are common in more than 80% of all ICU patients with indwelling catheter (more than 1 million such cases found in US) [46,47] and should be avoided unless there is medically necessity [48].…”