Urinary tract infections and associated factors in HIV infected pregnant women at a tertiary hospital in Lusaka, Zambia

Abstract

Introduction: urinary tract infections (UTIs) remain among significant causes of morbidity and mortality in pregnant women in sub-Saharan Africa. Zambia shares this burden disproportionately compared to other countries and it is unknown to what extent HIV affects UTIs. This study investigated the prevalence of UTIs and associated factors among HIV infected pregnant women attending antenatal care at a tertiary hospital in Zambia. Methods: we conducted a retrospective review of medical records of Zambian HIV infected pregnant women who attended antenatal care at the women and newborn hospital between 1^st January 2017 and 31^st December 2017. We used a structured data extraction tool to extract data from the patient medical records using simple random sampling without replacement. Medical records of patients with known, diabetes and renal transplant were excluded. A logistic regression model was used to establish factors associated with UTIs. Results: we reviewed 380 medical records of pregnant women with a median age of 29 years (IQR: 22, 34). UTIs prevalence was 16.5%, (95% CI: 13.0, 20.7). Women with UTIs had lower gestational age than those without UTI (difference 3 weeks, P<0.0001). Gestational age was independently associated with UTI (AOR: 0.96, 95% Cl: 0.91-0.99). Conclusion: the burden of UTIs in this population was high compared to global estimates and gestational age predicts UTIs. Public health interventions should be directed at promoting an early screening of UTIs during pregnancy, preferably to educate HIV positive women to book for antenatal visits early, so that screening could commence.