Urinary tract infections and associated factors in HIV infected pregnant women at a tertiary hospital in Lusaka, Zambia

Mukosha, Moses; Nambela, Lukundo; Mwila, Chiluba; Chigunta, Micheal; Kalungia, Aubrey Chichonyi; Lubeya, Mwansa Ketty; Vwalika, Bellington

doi:10.11604/pamj.2020.37.328.20245

Cited by 12 publications

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“…Studies done in Kenya and Zambia with similar ethnodemographic and cultural practices reported similar prevalence rates of UTIs among pregnant women. 14,22 Consistent with the extant literature, the index study did not find any relationship between serum Zn and UTIs among pregnant women. 7,25 A meta-analysis on micronutrient status and their outcomes in women of reproductive age and pregnant women from Ethiopia, Kenya, Nigeria and South Africa reported no relationship between serum Zn status and UTIs.…”

Section: Discussionsupporting

confidence: 84%

“…Based on the prevalence of UTIs in the study setting of 16.5% we needed to enroll 212 participants in order to establish the true prevalence with 80% power and alpha level of 0.05. 14 Adjusting for non-response rate of 10% the final sample size was 234 participants. Similar to other studies the sample size was sufficient to detect a difference of 10.14 ug/dl between those with and without UTIs, at an alpha level of 0.05, assuming a mean Zn level of 108.81 ug/dl among women with UTIs and equal standard deviation of 2.91 ug/dl in either group.…”

Section: Sample Sizementioning

confidence: 99%

“…[11][12][13] In Zambia, the prevalence of UTIs among pregnant women in the study setting in 2019 was 16.5%. 14 Pregnant women are more susceptible to developing UTIs, mainly due to physiological changes during pregnancy, especially to the bladder and ureter. These changes are mainly caused by gravid pressure by the uterus on the urinary tract and progesterone's overproduction, which causes ureteral muscle relaxation and consequently, accumulation of urine in the bladder.…”

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confidence: 99%

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Maternal serum zinc levels and urinary tract infections among pregnant women at a tertiary hospital in Lusaka, Zambia: a cross-sectional study

Musaba

Mukosha

Mukololo

et al. 2021

Int J Basic Clin Pharmacol

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Background: Micronutrient deficiency is one of the leading public health problems, particularly in lower-middle-income countries. The link between serum zinc (Zn) levels and urinary tract infections (UTIs) among pregnant women is still poorly understood. We investigated the association between maternal serum Zn levels and UTIs among pregnant women at women and newborn hospital in Lusaka, Zambia.Methods: We conducted an analytical cross-sectional study among 228 pregnant women aged 18 to 45 years between 1 September and 30 November 2019. Serum Zn levels were measured using atomic absorption spectrophotometry (AAS), whereas UTIs were determined based on the local hospital guidelines. We used the logistic regression model to determine the association between Zn levels and UTIs. The analysis was done at a significance level of 5% and 95% confidence interval.Results: Of the total participants, 118/228 (51.75%) tested positive for UTIs from urine culture. The mean serum Zn levels in the group diagnosed with UTIs were 53.95 ug/dl (SD=35.10), while in those who had no UTIs, it was 50.05 ug/dl (SD=35.10). In a multivariable logistic regression analysis, we found no evidence of an association between serum Zn levels and UTIs (p=0.435).Conclusions: From the study findings, there was no association between serum Zn levels and UTIs. This result suggests that Zn may not have any role in urinary tract infection. Nevertheless, more extensive studies are needed to confirm our findings.

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Section: Discussionsupporting

confidence: 84%

Section: Sample Sizementioning

confidence: 99%

mentioning

confidence: 99%

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Maternal serum zinc levels and urinary tract infections among pregnant women at a tertiary hospital in Lusaka, Zambia: a cross-sectional study

Musaba

Mukosha

Mukololo

et al. 2021

Int J Basic Clin Pharmacol

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“…On average, 9000 pregnant women are seen annually, and about 4000 births per year are recorded at WNH-UTH. In addition, the hospital receives referrals from over 20 clinics and five general hospitals from surrounding areas of Lusaka and other parts of the country [16]. The LMUTH is a tertiary-level hospital and teaching hospital receiving referrals from facilities located on the Northern and Eastern sides of the district.…”

Section: Study Design and Settingmentioning

confidence: 99%

Maternal COVID-19 infection and associated factors: A cross-sectional study

et al. 2023

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Background Since the declaration of COVID-19 as a global pandemic, several studies have been conducted to examine associated factors. However, few studies have focused on pregnant women infected with COVID-19 in sub-Saharan Africa. Therefore, this study investigated the prevalence and factors associated with COVID-19 infection among pregnant women at the Levy Mwanawasa University Teaching Hospital and Women and Newborn Hospital of the University Teaching Hospitals in Lusaka, Zambia. Methods A cross-sectional study was conducted between March and July 2021. Women were recruited as they presented for antenatal care. Data was collected using a structured questionnaire to capture variables of interest (socio-demographic, clinical and obstetric). COVID-19 diagnosis was made using a nasopharyngeal swab by PCR test. Multivariable logistic regression was used to control for confounding and calculate the odds ratios for each explanatory variable and respective 95% confidence intervals. Results The study enrolled 352 participants with a mean (standard deviation [SD]) age of 30.1 years (5.6). One hundred thirty of 352 (36.9%; 95% CI: 31.9 to 42.2) participants had a confirmed positive SARS-CoV-2 test result. At univariable analysis, factors associated with COVID-19 were increased gestational age, education status and maternal HIV serostatus. Women with a secondary level of education were less likely to have COVID-19 infection than those with a primary level of education (AOR = 0.23, 95% CI: 0.09–0.63). On the other hand, a one-week increase in gestational age was associated with higher odds of COVID-19 infection (AOR = 1.03, 95% CI: 1.01–1.06). Conclusion The results showed that the prevalence of COVID-19 infection among pregnant women was 36.9% and was associated with increased gestational age and a lower level of education. To mitigate adverse maternal outcomes, there is a need to screen for COVID-19 strictly and broadly monitor prenatal women presenting for healthcare.

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“…The World Health Organization recommends antibiotics for the prevention and treatment of infections in people living with HIV/AIDS [12]. Most infections, such as urinary tract infections (UTI) caused by enteric pathogen Escherichia coli and pneumocystis pneumonia caused by Pneumocystis jirovecii, can progress from asymptomatic to severe disease and death due to the increased susceptibility to disease in people living with HIV/AIDS [13]. This study location is reported to have a high HIV prevalence of 16.3% [14] (NACC, 2018) and the population is at risk of being exposed to antibiotic resistant Escherichia coli.…”

Section: Introductionmentioning

confidence: 99%

Contamination of groundwater with sulfamethoxazole and antibiotic resistant Escherichia coli in informal settlements in Kisumu, Kenya

et al. 2023

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High frequency of antibiotic detection in groundwater in informal settlements is attributed to increased usage and improper disposal, thus difficult to identify sources of antibiotic resistance in the environment, worsened by inadequate sanitation facilities and increased population density, particularly in developing-countries. Reliance on groundwater exposes them to pollutants and risk of antibiotic resistance, in addition to experiencing inequities in accessing vital services. Sulfamethoxazole and trimethoprim, used for prophylaxis by HIV/AIDS patients were tested in 49 groundwater sources in Kisumu, Kenya. Only Sulfamethoxazole (SMX) was found, with a detection frequency of 14.3% and concentrations ranging from below limit of quantification (LOQ) to 258.2 ng/L. Trimethoprim (TMP), marketed in combination with sulfamethoxazole, was not detected, owing to its high distribution coefficient (kPa7.12) and, generally, being a bigger molecule with modest water mobility and solubility. Furthermore, TMP ratio in cotrimoxazole is low (5:1), it is expected that mass loading will be lower, as well as influence of the study area’s hydrogeology, where soil is clayey with high porosity and permeability. Escherichia coli was recovered in 98% (n = 48) of water samples, with counts ranging from 16 to 8,850 MPN/100ml. Additionally, resistance to sulfamethoxazole was identified in 6% (n = 3) samples with Inhibition Zone Diameters of 0.8mm(resistant), 10.5mm (resistant), and 11.5mm (intermediate), but not among samples where SMX was detected. Antibiotic concentrations in water that can cause resistance are unknown because antibiotic-resistant E. coli was not found in water samples where sulfamethoxazole was identified, raising concerns about f environmental resistance spread. Concentration of SMX was lower in a previous research, which only collected water from one groundwater source, than the current study, which included additional samples (49). Presence of SMX and Escherichia coli resistance is of concern and necessitates greater attention and regular monitoring for potential contaminants and resistance trigger to avert potential risks to human health.

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Urinary tract infections and associated factors in HIV infected pregnant women at a tertiary hospital in Lusaka, Zambia

Cited by 12 publications

References 0 publications

Maternal serum zinc levels and urinary tract infections among pregnant women at a tertiary hospital in Lusaka, Zambia: a cross-sectional study

Maternal serum zinc levels and urinary tract infections among pregnant women at a tertiary hospital in Lusaka, Zambia: a cross-sectional study

Maternal COVID-19 infection and associated factors: A cross-sectional study

Contamination of groundwater with sulfamethoxazole and antibiotic resistant Escherichia coli in informal settlements in Kisumu, Kenya

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