Directorate of Postgraduate Studies

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Browsing Directorate of Postgraduate Studies by Author "Chacha, Catherine"

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    Urinary Tract Infection among patients with Human Immunodeficiency Virus infection attending selected care and treatment clinics in Dar es Salaam.
    (Kairuki University, 2024) Chacha, Catherine
    Introduction: Urinary tract infections are common worldwide and represent a major concern in developing countries among immunocompromised populations. This study aimed to determine the prevalence of UTI by age, gender, marital status and the distribution of the CD4+ lymphocyte count, and viral load among people living with HIV. In addition, the study aimed to determine the common bacterial etiologies of UTI and their susceptibility patterns among people living with HIV attending Care and Treatment Clinics at Dar-es-salaam. Methods: A cross-sectional design was employed, involving interviews, medical record reviews, and laboratory analyses. Descriptive statistics, chi-square analysis, and logistic regression were used for data analysis. Results: The study found that urinary tract infection had a prevalence of 30.6%, was common in participants above 35 years and most specifically in those aged between 35- and 44 years, accounting for 37% of cases. The female gender and married participants were the most affected, with respective rates of 69.9 % and 78.5%. Participants with undetectable viral loads had a low chance of developing UTI (OR=0.1; 95% Cl=0.05-0.2). Conversely, participants with a CD4+ lymphocyte count >500 (OR=0.2, 95% Cl=0.11-0.3) had a decreased risk of presenting with UTI compared to those with a CD4+ lymphocyte count <500 (OR=3.4; 95% Cl=2.0-5.7). In addition, participants who take alcohol had significant (p=0.012) high risk (AOR=2; 95% Cl=1.1-3.5) to present with Urinary tract infection. E.coli, followed by Klebsiella pneumonia, was the most isolated, with respective rates of 51.6% and 29.2%. Ciprofloxacin and Nitrofurantoin were the most active drugs, with 63% and 53%, respectively, against isolated bacteria, both gram-positive and negative. The least effective antibiotic agent was ampicillin, which showed high resistance at 66.3% and sensitivity at 5.6% in all isolated bacteria. Conclusion: The prevalence of UTI by age and gender among People Living with HIV attending Care and Treatment Clinics in Dar-es-salaam was relatively average compared to that reported in the literature. Participants with low CD4+ lymphocyte count <500 and those with unsuppressed viral load had a high risk of presenting UTI. On the other hand, gramnegative bacteria (E.coli and Klebsiella pneumonia) were prevalent bacteria isolated. Nitrofurantoin, ciprofloxacin, and ceftriaxone were the most sensitive antibiotic agents, with ampicillin being the least sensitive to all isolated bacteria. Recommendations: Use nitrofurantoin, ciprofloxacin, and ceftriaxone as the empirical antibiotic agents in People Living with HIV with undetectable viral load. In addition, patients should be selected by culture and sensitivity before prescribing ampicillin and cotrimoxazole in managing UTIs.