Master of Medicine in Pediatrics and Child Health

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http://hdl.handle.net/20.500.12493/14841

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Browsing Master of Medicine in Pediatrics and Child Health by Author "Gloria Nakalema"

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    Prevalence, predictors and susceptibility patterns of bacterial urinary tract infections among febrile children under-five years of age at Kampala International University Teaching Hospital
    (Kampala International University, 2021-07) Gloria Nakalema
    Background: Accurate and reliable diagnosis of UTI in children is critical because they are usually underdiagnosed or over-diagnosed especially in children under five years of age. Antimicrobial susceptibility results are key to effective intervention. Objective: This study was done to determine the prevalence, predictors, and susceptibility patterns of bacterial urinary tract infections among febrile children aged less than 5 years presenting at Kampala International University Teaching Hospital. Methods: A hospital-based cross-sectional study was conducted in entry points of the pediatric ward of KIU-TH between December 2020 and March 2021. The study enrolled a total of 350 children 2-59 months by consecutive enrolment. Urinalysis and urine culure was done, clinical and demographic data was collected using questionnaires and data analysed using SPSS version 27 with significance at 95% confidence interval. Results: Out of 350 children studied, 97 (27.7%) had a UTI. E.coli was the most commonly isolated uropathogen (56.7%). Isolates had a sensitivity pattern to Imipenem of 93.4%, Ciprofloxacin (85.4%), Amikacin (77.4%) and were extremely resistant to Cotrimoxazole (83.3%), Amoxicillin (80.0%) and Ampicillin (74.4%). Factors that were independently predictive of a UTI were age less than 24 months (p 0.002), male children (p 0.010), undernutrition (p 0.012), diarrhea (p 0.032), vomiting (p 0.005). Children who were wiped back to front after defecation (p 0.021), diapers use (p 0.014). Among the laboratory urinalysis predictors, Children with nitrites and those with more than 5 white blood cells at urine microscopy were 17.875(p <0.001) and 6.505(p<0.001) times more likely to suffer from Urinary tract infection respectively. Conclusion: There is a high intra hospital prevalence of bacterial UTIs among febrile children under five years of age with with E.Coli as the predominant causative organism and there is a high resistance to commonly used antibiotics thus need to review the treatment protocols of UTI.