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The prevalence and management strategies of gestational urinary tract infections (UTI) in Kisumu County, Kenya

Background Urinary tract infections (UTI) contribute to substantive proportions of adverse pregnancy outcomes. Current national statistics in Kenya show high maternal mortality (488/100,000) and neonatal mortality (24/1,000) rates. Kenya continues to report increasing prevalence and incidence rates of UTI associated with maternal and neonatal deaths. Kisumu County in western Kenya has a high maternal mortality rate of 495/100,000 with uncaptured maternal morbidity relative to the national average. However, information on the epidemiology of gestational UTI in the County, is limited. Semi-urban Chulaimbo and Nyahera Sub-County hospitals were used as model facilities to establish the burden of UTI during pregnancy and the specific clinical diagnosis and therapeutic management strategies. Methods Socio-demographic, laboratory and clinical history data was extracted from 416 pregnant womens maternal child health data sets from health records between February 2019 to February 2020 using pre-designed data collection forms. Descriptive analysis was used to summarize the study populations demographic characteristics. Chi-square test was used to establish proportionality. Qualitative data were thematically summarized. For all analyses, P <=0.05 was considered statistically significant. Results The study population had a mean of two (2) ({+/-}1.14) ante-natal (ANC) visits; a mean mothers age of 23.92 ({+/-} 6) years old; a mean parity of 2 ({+/-}2) and a mean haemoglobin level of 10.73({+/-}1.8). About 56% (233/416) of the mothers attended the first ANC visit at varied gestational age. Only 1.4% (6/416) had a clinical history capturing UTI infection out of the total prevalence of 57.9% (241/416) diagnosed UTI positive by routine ANC profile deep stick urinalysis test. These clinical history data sets 1.4% (6/416) revealed a broad-spectrum therapeutic management of gestational bacterial infections using first line antibiotics. Conclusions Most UTI positive cases go without specific clinical diagnosis and management, posing a high risk of antibiotic drug resistance and development of specific bacterial allied gestational complications.