ABSTRACT

BACKGROUND: Urinary tract infections (UTIs) is infection of any part of the urinary system be it the kidneys, ureter, bladder or the urethra (Komala et al, 2013). It is a severe public health problem affecting about 150 million people each year worldwide (Stamm et al, 2001). Most UTIs are commonly caused by the bacteria Escherichia coli while others are caused by viruses and fungi that ascends from the perineal area up the urethra where they stick to the walls of the urinary tract, multiply and cause annoying symptoms like; dysuria, oliguria and painful coitus amongst others (Willey et al, 2011). Studies have shown that, women are more at risk of developing this infection as compare to men with its complications being: still birth, pyelonephritis, and bladder damage amongst others. Objective: This study however was carried out to assess the knowledge of young adults age 18-35 years on the prevalence of UTIs in the Ndongo Community. Method: The researcher used a well structure questionnaire to collect data amongst young adults in the Ndongo Community using a non-probability method involving a randomize method of study. Results:  Out of the 100 participants who took part in this study, majority of them 50 (50%) didn’t know that UTIs is caused by a bacteria while a few proportion 30 (30%) were clueless that women are more prone to getting UTIs. Majority of the participants 69 (69%) didn’t also know that urinating when need be was one of the best ways to prevent UTIs though most of them knew 52 (52%) taking antibiotics was the best way to treat UTIs. Conclusion: From data collected and analyzed it can be concluded that, majority of young adults had very little knowledge on UTIs, its causes/risk factors, preventions and management. Thus, continuous education of young adults about UTIs will go a long way to improve on their health and wellbeing.

CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background of the Study

Urinary tract infections (UTIs) is infection of any part of the urinary system be it the kidney, bladder, ureters or urethra (Komala et al 2013) and is one of the most common bacteria ( Escherichia coli) infection affecting about 150 million people each year worldwide ( Stamm et al, 2001)  Most UTIs are cause by fecal pathogens that ascends and sticks to the wall of the urethra then multiply and move up the urethra to the bladder where they may cause annoying symptoms during urination (Willey et al, 2011).   However, the Native Americans were the first to provide medicinal treatment to UTIs and gastrointestinal disorders in the form of Cranberries whose plant leaves were used in the 19^th century. Scientist in 1920s reported that the consumption of cranberries contributed to the acidification of urine as evident by excretion of hip uric acid and until 1970s, acidification of urine by cranberries was considered to prevent UTIs. In the mid-and- late 1980s, there was the discovery of the importance of bacteria adherence in the pathogenesis of UTIs and it was discovered that cranberries prevented the adherence of bacteria organism especially the Escherichia coli (E. coli) to the uroepithelia cell walls. Studies in the 1920s suggested the consumption of cranberries juice cocktail as a means to reduce UTIs and inhibit bacteria adherence to mucosa surfaces. (Jason et al, 2017).

 But with the advances in the management and diagnosis of UTIs during the 20th century, there was increase development in the historical cryoscopy into modern days Urinalysis and Culture techniques which are the cornerstones for UTIs diagnosis. Imagine technologies like: Nuclear imagine, Magnetic resonance and Computerized tomography have been helpful in diagnosing complicated UTIs. Non pharmacological therapies like: Noninvasive shock wave lithotripsy and percutaneous drainage of kidney abscesses were equally used. Still in the 20th century, there was the discovery of antimicrobial agent with Nitrofurantoin being the first effective antimicrobial therapy for UTIs though the spectrum of its activities were limited. Then Amoxicillin was introduced in the 1970s but due to its broad used, there was development of antimicrobial resistance thus, leading to the introduction of trimethoprim/Sulfamethoxazole (TMP/SMX) as the first line therapy for UTIs. However, the wide used of this medication also resulted to antimicrobial resistance thereby limiting the clinical usefulness of this therapy in the modern management of UTIs. Fluoroquinolones was then introduced and the American and European guidelines recommend that, this medication be used in areas where there is the resistance of TMP/SMX to about 10% or higher. (The Journal of Urology 2005). It is estimated globally that, the prevalence of community associated UTIs is 0.7% with main risk factors being: history of UTIs, age, sexual activities and diabetes all caused by the bacteria Escherichia coli (E. coli). (Tandogdu et al, 2016).  A similar study carried out on the prevalence of UTIs proved that, UTIs were the most common outpatient infections especially in young women age 14-24 years. Women over 65 years are estimated to have UTIs prevalence of 20% compared to about 11% of men of the overall population (Martha et al,2005). In Accra Ghana, there was an investigation on community acquired UTIs among adults including their risk factors, etiology, and antibiotics resistance. A sample size of 307 patients was collected and diagnosed clinically at Korle and Mamprobi polyclinics and results based on the criteria laboratory confirmed 31(10.1%) out of the 307 specimens collected to have UTIs. (Eric et al, 2019). To crown it all, an etiology profile and antimicrobial susceptibility of community acquired UTIs was also carried out in two Cameroon towns (Buea and Bamenda). A urine culture of 235 specimens was collected and tested and the entail result was estimated to have a prevalence of 65.9% UTIs infected persons in Buea and 54% of total cases in Bamenda. (Jane et al, 2012). Therefore, the prevalence of UTIs is not only a problem Worldwide but also a call for concern in Africa and Cameroon inclusive. Thus, the topic, assessing young adult’s knowledge age 18-35 years on the prevalence of UTIs.

 1.2 Problem Statement

UTIs is an infection in any part of the urinary system be it the kidney, bladder, ureters and urethra. Most of these infections involves the lower urinary tract (bladder and urethra) with women having a greater risk of acquiring this infection at one point in their lives. (Komala et al, 2013). Most adults are at risk of this infection due to their high involvement in sexual activities, oral contraceptive, spermicide use and voiding dysfunction (The Lancet Infectious Disease 2004). UTIs when poorly manage can lead to complications like: bladder dysfunction, recurrent UTIs, urethra narrowing, increases risk of preterm birth, low birth weight in pregnancy, permanent kidney damage and sepsis (Jerry Kennard 2021). It is therefore necessary to assess the knowledge of young adults on the prevalence of UTIs so as to better manage and prevent these complications.                    

 1.3 Rationale

This study is aimed at improving on young adult’s health and reducing morbidity/ mortality rate by providing information that can be used to facilitate the realization of these goals. It will further help policy makers to develop and plan strategies to increase awareness and promote wellbeing of young adults.

1.4 Research Questions

1. What are the causes/ risk factors of UTIs among young adults in the Ndongo community?
2. What preventive methods are used against UTIs by young adults in the Ndongo community?
3. What are the possible solutions to manage the prevalence of UTIs among young adults in the Ndongo community?

1.5.1 General Objective

To assess the knowledge of young adults aged 18-35 years on the prevalence of UTIs in the community.

1.5.2 Specific Objectives

• To find out the causes/risk factors of UTIs among young adults aged 18-35 years in the Ndongo community.
• To find out the preventive methods used against UTIs by young adults aged 18-35 years in the Ndongo community.
• To bring out possible solutions in the management of UTIs among young adults aged 18-35 years in the Ndongo community.