Urinary tract infections among children with spina bifida doing clean intermittent catheterization in eastern Uganda

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.