The diagnosis of urinary tract infections among pregnant women in rural Tanzania; Prevalences and correspondence between diferent diagnostic methods

Abstract

Background To assess the prevalence of dysuria, dipsticks positive on nitrite and leukocyte esterase and positive Uricult® dip slides among pregnant women in rural Tanzania. Methods. 3715 pregnant women were examined for dysuria and had their urine tested with nitrite and leukocyte esterase dipsticks and Uricult® dipslides, at their first antenatal visit in 1995-96. Results. The prevalences of positive symptoms and tests were as follows: dysuria 32%, nitrite 40.3%, leukocyte esterase 65.6%, and Uricult® dip slides 16.4%. A general log-linear model where all four variables were analyzed simultaneously showed poor correspondence between the diagnostic methods. Odds ratio with 95% confidence intervals were as follows: dysuria vs. nitrite [1.6 (1.4-1.8)], dysuria vs. leukocyte esterase [1.2 (1.0-1.4)], nitrite vs. leukocyte esterase [4.2 (3.6-4.9)], and leukocyte esterase vs. Uricult® [1.4 (1.1-1.7)]. Dysuria and nitrite were not associated with Uricult® dipslide. Conclusion. A high prevalence of positive tests, but a poor correspondence between the methods was found, emphasizing the need for more attention to the problem of urinary tract infections among pregnant women in developing countries, and the need for better screening tests for urinary tract infections in these countries.