Prevalence Of Urinary Tract Parasites In Patients Attending Federal Medical Center Makurdi

Prevalence Of Urinary Tract Parasites In Patients Attending Federal Medical Center Makurdi

Abstract

The prevalence of urinary tract parasites in patients attending Federal Medical Center Makurdi was examined in this study. Parasitic infections are important part of infectious disease. However in this context, the possible interactions between the microorganisms in the urinary tract remain unknown. Among 300 microbilogical urines tests that have been performed from patients of Federal Medical Centre, Makurdi, the study showed a frequency of 57.77% for Trichomonas vaginalis and 42.22 % for Schistosoma haematobium bacteria. Regarding sex and parasitic infections, the study found a prevalence of 52.63% for and S. haematobium in males and 47.36% in females. While T. vaginalis showed a 100% prevalence in the females (P>0.05). This could be because of geographical specificity promoting schistosomiasis infections, the prevalence of Schistosoma haematobium and Trichomonas vaginalis remain high in such setting. It was recommended based from the study that 28% and 5% prevalence rates of asymptomatic bacteriuria and parasitic UTI respectively observed in this present study underscores the importance of routine and regular mass screening for asymptomatic UTI be carried out since untreated cases may lead to pylonephritis, renal scaring and even kidney failure.

Chapter One

1.0 Introduction

In biology/ecology, parasitism is a non-mutual symbiotic relationship between species, where one species, the parasite, benefits at the expense of the other, the host. Traditionally parasite (in biological usage) referred primarily to organisms visible to the naked eye, or macro-parasites (such as helminths). Parasites can be micro-parasites, which are typically smaller, such as protozoa, (Bartel et al., 2011) viruses, and bacteria (Claude, 2005). Examples of parasites include the plants mistletoe and cuscuta, and animals such as hookworms. Parasites inhabit living organisms and therefore face problems that free-living organisms do not. Hosts, the only habitats in which parasites can survive, actively try to avoid, repel, and destroy parasites (Claude, 2005). Unlike predators, parasites typically do not kill their host, are generally much smaller than their host, and will often live in or on their host for an extended period (Bartel et al., 2011).

Urinary tract infections (UTIs) constitute serious health problem affecting millions of people each year and rank high among the common hospital acquired infections. It indudes diseases that affect kidneys, (pyelonephritis), urethra (urethritis) and urinary bladder (cystitis) (Obeaguet al., 2015). The “Urinary tract” consists of the various organs of the body that reduce, store and excrete urine. The kidneys remove excess and wastes from the blood in the form of urine; narrow tubes Ureters carry urine from the kidneys to the bladder. Urine is in the bladder and emptied through the urethra. Normal urine sterile, it contains fluids, salts and waste products, but it is free from bacteria, viruses and fungi (National Institute of Health (NIH), 2003).

The urinary tract is comprised of the kidneys, ureters, bladder, and urethra. A urinary tract infection (UTI) is an infection caused by pathogenic organisms (for example, bacteria, fungi, or parasites) in any of the structures that comprise the urinary tract. However, this is the broad definition of urinary tract infections; many authors prefer to use more specific terms that localize the urinary tract infection to the major structural segment involved such as urethritis (urethral infection), cystitis (bladder infection), ureter infection, and pyelonephritis (kidney infection). Other structures that eventually connect to or share close anatomic proximity to the urinary tract (for example, prostate, epididymis, and vagina) are sometimes included in the discussion of UTIs because they may either cause or be caused by UTIs (Komala and Kumar, 2013).

Urinary tract infections (UTIs) are among the most common conditions requiring medical treatment with 6-10% of all young females demonstrating bacteriuria (Raz, 2001). UTIs occur as a result of interactions between the uropathogen and host and their pathogenesis involves several processes. Initially the uropathogen attaches to the epithelial surface; it subsequently colonises and disseminates throughout the mucosa causing tissue damage. After the initial colonisation period, pathogens can ascend into the urinary bladder resulting in symptomatic or asymptomatic bacteriuria. Further progression may lead to pyelonephritis and renal impairment. Specific virulence factors residing on the uropathogen’s membrane are responsible for bacterial resistance to the normally effective defence mechanisms of the host. Recently, bacterial adhesins and their associated epithelial binding sites have been identified and natural antiadherence mechanisms are currently under investigation. An understanding of pathogenic and anti-adherence mechanisms may allow physicians to develop appropriate strategies for UTI prevention and adequate management protocols (Niall and Hugh, 2011).

1.1 Problem of the Study

Infection rates of urinary tract infections (UTIs) between men and women are similar with women being symptomatic, while infections in men are usually asymptomatic. Transmission usually occurs via direct, skin-to-skin contact with an infected individual, most often through vaginal intercourse. The World Health Organization has estimated that 160 million cases of infection are acquired annually worldwide (Harp and Chowdhury, 2011). The ability to characterize this parasites and monitor anti-parasitic susceptibility patterns is important for clinicians, formulation of public healthcare policies, and providing useful information on the global surveillance of this parasites. Data on the anti-parasitic susceptibility patterns of this parasites in the middle belt Nigeria are inadequate. It was against this backdrop that this study seeks to determine the prevalence of parasitic UTI among the patients of Federal Medical center Makurdi.

1.2 Objectives of the Study

The main objective of this research study is as follows:

1. To determine the prevalence of parasitic UTI among the patients of Federal Medical center Makurdi
2. To determine the most common parasitic aetiologic agent of UTI among the patients of Federal Medical center Makurdi
3. To determine the prevalence of significant parasite infection. This will help in the choice of antimicrobial nor anti-parasitic drugs among the patients of Federal Medical center Makurdi

1.3 Scope of the Study

In the study context, few data regarding the co-infection prevalence in the urinary tract are available. Thus, this is a retrospective study that aims to assess the bacterial and parasitic profile in urine samples collected from 2000 to 2010 at the Federal Medical Center Makurdi as well identifying possible co-infections.

Chapter Five

5.0 Conclusion and Recommendations

5.1 Conclusion

Bacteria, particularly the enterobacteria, remain far the main causes of urinary tract infections. Nevertheless, because of its geographical specificity promoting schistosomiasis infections, the prevalence of Schistosoma haematobiumandTrichomonas vaginalisremain high in such setting. The bacterial and parasitic co-infection might lead to interactions able to influence the pathology of urinary tract infection. Certain factors such as increase in promiscuity, facilities for travel and easy availability of birth control method amongst others have been documented as accounting for the high incidence of Schistosoma haematobiumandTrichomonas vaginalis(Hoosen, 1987; Nwosu et al., 2015). Incidence of 42.22% and 57.77 respectively for Schistosoma haematobiumandTrichomonas vaginalis was recorded in this study. However, studies in women have documented a high prevalence of up to 50% in both symptomatic and asymptomatic cases (Hoosen, 1987; O’farret, 1989; Nwosu et al., 2015).

5.2 Recommendations

The following recommendations are made from the study:

1. 28% and 5% prevalence rates of asymptomatic bacteriuria and parasitic UTI respectively observed in this present study underscores the importance of routine and regular mass screening for asymptomatic UTI be carried out since untreated cases may lead to pylonephritis, renal scaring and even kidney failure.
2. The state government should be made aware of the poor sanitary conditions of most hostels which tends to increase the transmission of this infections. Therefore facilitate the construction of better hostel accommodations.
3. Seminars should be organized in the school from time to time, to educate the students on how to prevent UTIs.
4. Further investigations need to be conducted for better understanding of the interactions between bacteria and parasites in the urinary tract infections.

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