Abstract
Urine examination has been employed in clinical practice as the most common screening laboratory method for early detection of urinary tract infections (UTIs) or renal disorder. This study was undertaken to ascertain the usefulness of urine macroscopy and microscopy as vital screening procedure for diagnosing UTI among antenatal patients in a teaching hospital in Awka, Nigeria. Freshly voided midstream urine specimens of 269 pregnant women were collected and examined using macroscopic, microscopic and culture methods. The sensitivity, specificity, positive predictive value and negative predictive value of urine colour, and microscopic features were compared with urine culture in diagnosis of UTI. Statistical analysis was done using SPSS and Epi info® and P-value was set at <0.05 significant level. One hundred and seven specimens showed positive urine cultures. Out of these 107 specimens, 60 (56.1%) also had deviation from normal urine colour and 77(72%) were positive on urine microscopy. Macroscopic examination showed that a significant relationship exists between urine colour and positive urine culture (p=0.0001). The sensitivity and specificity of urine colour with respect to UTI were 56.7% and 67.9% respectively. Urine microscopy revealed that the positive features had a significant relationship with positive urine culture (p= 0.000). Pyuria alone showed the specificity and positive predictive value of 100% each. The sensitivity, specificity, positive predictive value and the negative predictive value of combination of positive microscopic features were 72%, 64.8%, 57.5% and 77.8% respectively. Examination of colours and microscopic features of urine are therefore vital in predicting urinary tract infection.
Highlights
Urinary tract infection (UTI) can be caused by the presence and growth of microorganisms in the urinary tract (Fazeela et al, 2015)
Macroscopic analysis of urine samples conducted in this study showed urine colours that ranged from pale yellow, amber to red which is in line with the findings of some other researchers (Agbagwa and Ifeanacho, 2015; Kabugo et al, 2016)
There is a significant relationship between urine colour, urine microscopy, and positive urine cultures in urinary tract infection (UTI)
Summary
Urinary tract infection (UTI) can be caused by the presence and growth of microorganisms in the urinary tract (Fazeela et al, 2015). UTI can be classified into lower urinary tract infection involving the bladder and urethra and upper urinary tract infection involving the kidney, pelvis, and ureter (Parveen et al, 2011). Urinary tract infections could be acquired from hospitals (nosocomial infections), among patients admitted in hospitals and from community settings (Willey et al, 2008; Boye et al, 2012). UTI may be symptomatic, commonly manifested as urethritis, cystitis (inflammation of the bladder) or pyelonephritis (kidney inflammation); or it may remain asymptomatic (Parveen et al, 2011; Boye et al, 2012). In Nigeria, the prevalence of UTI among antenatal patients has been reported in Benin, Ebonyi and Nassarawa State as 13.8%, 55% and 62.67% respectively (Alfred et al, 2013; Onuoha and Fatokun, 2014; Ajide et al, 2016)
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