Abstract:
Background: Urinary tract infections (UTIs) are a common childhood bacterial infection
globally. Despite the use of urinary catheters, studies have reported a high prevalence of UTIs in
children. This study investigates the prevalence, antibiotic susceptibility, and associated factors
of UTIs among children with Spina Bifida using clean intermittent catheterization (CIC) in
Eastern Uganda.
Methods: A cross-sectional study employing quantitative and qualitative methods was
conducted at CURE children’s Hospital among children with Spina Bifida doing CIC. The
purposive simple-random sampling strategy was used to collect data using interviewer
administered questionnaires for quantitative and Key informant interviews for qualitative data
collection. All the data collection tools used were pretested and validated. Urinalysis test was
done for all samples to identify a UTI; the samples with the UTI were cultured on CLED and
MacCkonkey agar and incubated for 24 hours to identify the bacteria causing the UTI, following
the clinical Laboratory Standards Institute guidelines. The quantitative data collected was entered
in Microsoft Excel then exported to STATA 14 for statistical analysis. Qualitative data was
organized and analyzed thematically by inductive coding method using Nvivo 12 software.
Results:
In this study, 235 children with Spina Bifida doing CIC participated, the majority of whom were
children of age range 20-31months and 20 care-takers. The study found a high prevalence of
UTIs (62.55%, 95% CI: 56.14%-68.55%) among children with Spina Bifida doing CIC. The
most common isolates were E. coli (33.33%) and S. Aureus (20.0%). A high sensitivity to
Levofloxacin (71.1%) for gram-positive isolates and Gentamycin (62.2%) for gram-negative
isolates was found. However, caregivers' knowledge on CIC and urinary catheter care was
limited.
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Conclusion:
This study highlights the high prevalence of UTIs among children with Spina Bifida using CIC
in Eastern Uganda. Our findings emphasize the need for healthcare workers to educate caregivers
on proper CIC techniques and urinary catheter care, regardless of their experience. This
education can help reduce the incidence of UTIs and improve the quality of life for these
children.
