The occurrence of urinary tract infection and determinant factors among diabetic patients at Dessie Referral Hospital, South Wollo, Northeast Ethiopia

Abstract

Introduction: Diabetic patients have a higher tendency of developing all infections, especially infections of the genitourinary tract. Urinary tract infections cause considerable disorders in diabetic patients, and if complicated, can cause renal failure. In Ethiopia, the magnitude of diabetes mellitus-associated urinary tract infections increased from 7.1% in 2005 to 33.9% in 2019. The successful management of patients suffering from urinary tract infections in diabetic patients depends upon the identification of risk factors. This study aimed to determine the magnitude and factors affecting the urinary tract infections among diabetic patients which enable professionals to prevent infections and manage them effectively. Methods: Hospital-based cross-sectional study was conducted with 365 diabetic patients selected by systematic sampling technique from March to April 2020. Data were collected by trained BSc nurses via face-to-face interview and patient chart review. Urine microscopy was done to diagnose urinary tract infections. Data were coded and entered using Epi data version 3.1 and exported to Statistical Package of Social Sciences version 26 for analysis. Variables with p-value < 0.25 in bivariable logistic regression were included multivariable logistic regression and variables with a p-value < 0.05 were considered statistically significant. Results: The magnitude of urinary tract infections was 22.3% (95% confidence interval: 18–27). The odds of being infected by urinary tract infections were significantly higher in diabetic females (adjusted odds ratio: 2.46; 95% confidence interval: 1.40–4.32), duration of diabetes mellitus diagnosis of ⩾5 years (adjusted odds ratio: 1.98; 95% confidence interval: 1.05–3.72), with comorbidity (adjusted odds ratio: 4.87; 95% confidence interval: 2.76–8.59) and khat chewer (adjusted odds ratio: 1.84; 95% confidence interval: 1.04–3.24) compared with their counter. Conclusion and recommendation: Urinary tract infections were high among diabetic patients. Predictors like sex, duration of diagnosis, comorbidity, and khat chewer were found to be associated with urinary tract infections. Improvement of the regular screening of patients with diabetes mellitus for urinary tract infections will provide more effective measures in prevention and management.

Outbreak of drug resistance Escherichia coli phylogenetic F group associated urinary tract infection

“…A possible explanation for the elevated UTI in diabetes individuals is nerve damage induced by hyperglycemia, which affects the tissue bladder's capacity to perceive the presence of urine, allowing urine to remain in the stream for longer periods of time, which encourages bacteria to proliferate and propagate, raising infection ( 25 ). Other studies have corroborated similar conclusions to our study ( 21 , 22 , 26 ), reporting that UTIs are particularly common in diabetes patients. While kidney disease is one of the risk factors for UTIs, the patient's immune system is weakened, making them more susceptible to UTIs ( 21 , 22 , 27 ).…”

Prevalence and Associated Factors of Urinary Tract Infections among Diabetic Patients: A Study at Kiryandongo Hospital, Uganda

“…Patients with a history of UTI might be more cautious to seek medical attention when UTI symptoms emerge, which is a possible explanation. The current study further found an increased risk of UTI among patients with diabetes for more than five years, which is in line with a study in Ethiopia [2]. This could be due to the long-term effects of diabetes, such as neuropathy and an impaired immune system.…”

“…Globally, it is estimated that about 150 million individuals are affected by urinary tract infections (UTIs) annually, with a significant number of those affected being diabetics [1][2][3]. The 2016 WHO report has shown that there is a marked increase in the number of people affected by diabetes, and this trend is scheduled to grow in geometric proportions in the next couple of decades [4].…”

Prevalence of urinary tract infections and risk factors among diabetic patients in Ethiopia, a systematic review and meta-analysis

“…We examined numerous study to assess the association of sex with UTI in diabetic patients. Accordingly, female sex was reported to be a factor with UTI by four primary studies included in this review [ 35 , 38 , 41 , 43 ]. A total of 1071 subjects were included to analyze the association of female sex with UTI.…”

“…Besides, all the included studies was conducted in institutional bases. Four in Addis Ababa [30][31][32][33], Four in Amhara [34][35][36][37], Three in Southern Nations Nationalists and Peoples Region (SNNP) [38][39][40], two in Oromia [41,42], and one study in Harari [43]. All studies in this review adopted a cross-sectional design.…”