An Assessment of Current Management of Childhood Urinary Tract Infections Amongst Private Medical Practitioners In Benin City, Nigeria

Abstract

Private Medical Practitioners (PMPs) manage substantial number of children with urinary tract infection (UTI) in Benin City, Nigeria. Evaluating the management of this condition is considered worthwhile because of sequele of improper treatment. The study was conducted through use of questionnaire amongst PMPs in two Local Government Areas of Egor and Ikpoba– Okha. Subjects comprised 133 (80.1%) males and 33(19.9%) females. Twenty-three (13.6%) respondents had postgraduate qualifications, while majority (72.9%) graduated between 1991 – 2000. Majority of respondents preferred early morning and mid stream urine for patients' evaluation. Escherichia coli, Staphylococcus aureus and Proteus mirabilis were the commonest isolates listed. Their knowledge of predisposing factors and complications following UTI was appreciable. A third would give chemoprophylaxis for repeat infection(s) in females while only 6% would refer such patients to specialists. Reasons that warranted referral varied from inability to pay fees to appearance of complication(s) in the course of treatment. Half of the respondents preferred use of multiple antibiotics because of need to ensure adequate anti-microbial coverage, effective therapy, prevention of resistance and cost effectiveness. Ampicillin, cotrimoxazole and unexpectedly, quinolones plus tetracycline featured as first line drugs amongst 34% of respondents. In conclusion the knowledge and attitude of the average PMP to childhood UTI is at best fair. However, some practices are clearly at variance with current recommendations. Continuing Medical Education is recommended for bridging the gap between current practices and accepted norm amongst PMPs to enhance patients' care.


Key Words : UTI, Children , Private Medical Practitioners, Benin.


Nigerian Medical Practitioner Vol.45(5) 2004: 72-75