Table of Contents
Abstract. 2
CHAPTER ONE.. 5
INTRODUCTION.. 5
1.1 Background of the Study.. 5
1.2 Statement of the Problem... 7
1.3 Objectives of the Study.. 8
1.4 Research Questions. 8
1.5 Research Hypothesis. 9
1.6 Significance of the Study.. 9
1.7 Scope of the Study.. 10
1.8 Limitations of the Study.. 10
1.9 Organization of the Study.. 10
1.10 Definition of Terms. 11
CHAPTER TWO.. 15
REVIEW OF RELATED LITERATURE.. 15
2.1 Introduction.. 15
2.2 Theoretical Review.. 15
2.2.1 Physiological Changes Theory. 15
2.2.2 Health Belief Model 16
2.2.3 Behavioral Theory of Screening. 16
2.3 Conceptual Review.. 16
2.4 Empirical Review.. 20
2.5 Summary of Chapter. 22
Chapter Three.. 24
Research Methodology.. 24
3.1 Introduction.. 24
3.2 Research Design.. 24
3.3 Study Population.. 24
3.4 Sampling Technique.. 25
3.5 Data Collection Methods. 25
3.6 Data Analysis. 26
3.7 Ethical Considerations. 26
3.8 Limitations of the Study.. 27
3.9 Conclusion.. 27
CHAPTER FOUR.. 29
DATA ANALYSIS AND INTERPRETATION.. 29
4.1 Preamble.. 29
4.2 Socio-Demographic Characteristics of Respondents. 29
TABLES BASED ON RESEARCH QUESTIONS.. 34
4.3 Analysis of the Respondents’ Views on Research Question one:. 34
4.4 Testing Hypothesis. 48
Discussion of Findings. 50
CHAPTER FIVE.. 53
SUMMARY CONCLUSION AND RECOMMENDATIONS.. 53
5.1 Summary of Findings. 53
5.2 Conclusion.. 53
5.3 Recommendations. 54
References. 56
Research Questionnaire for the study titled "SCREENING AND PREVALENCE OF URINARY TRACT INFECTION ON PREGNANT WOMEN IN OSUN (A CASE STUDY OF A PRIVATE HOSPITAL IN OSUN STATE).". 60
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Urinary tract infections (UTIs) are one of the most common bacterial infections affecting women, and the prevalence is notably higher during pregnancy. The physiological and anatomical changes that occur during pregnancy, such as ureteral dilation and increased bladder volume, create a conducive environment for bacterial growth, thereby increasing the risk of UTIs. Understanding the prevalence and effective screening of UTIs in pregnant women is crucial due to the potential complications, including preterm labor, low birth weight, and increased maternal morbidity (Schneeberger et al., 2014). Asymptomatic bacteriuria (ASB), a condition where bacteria are present in the urine without causing symptoms, is particularly concerning in pregnancy and requires regular screening to prevent adverse outcomes (Smaill & Vazquez, 2019).
The prevalence of UTIs in pregnant women varies widely, with studies indicating that 2-10% of pregnant women may experience a UTI during their pregnancy (Foxman, 2014). The heightened risk is attributed to both hormonal and mechanical changes during pregnancy, which promote bacterial ascension from the lower to the upper urinary tract (Delzell & Lefevre, 2000). These infections are predominantly caused by Escherichia coli, accounting for approximately 70-90% of cases, followed by other pathogens such as Klebsiella pneumoniae and Proteus mirabilis (Macejko & Schaeffer, 2007). Accurate and timely screening can significantly reduce the incidence of symptomatic UTIs and subsequent complications, emphasizing the need for standardized screening protocols.
Screening for UTIs in pregnant women typically involves routine urine culture tests, which are considered the gold standard for detecting ASB and symptomatic infections (Nicolle, 2014). The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant women should be screened for ASB at their first prenatal visit and periodically throughout pregnancy if they are at high risk (ACOG, 2008). Despite these guidelines, adherence to screening protocols can vary, leading to discrepancies in detection rates and management practices (Kazemier et al., 2015). Ensuring that pregnant women receive appropriate and timely screening can help in mitigating the risks associated with UTIs and improving maternal and neonatal health outcomes.
In conclusion, the prevalence and screening of UTIs in pregnant women are critical areas of focus in prenatal care due to the significant health implications for both the mother and the fetus. The anatomical and physiological changes during pregnancy increase the susceptibility to UTIs, making regular screening essential. Evidence-based guidelines and protocols play a pivotal role in the early detection and management of these infections. Continued research and education are needed to enhance screening practices and reduce the burden of UTIs in this vulnerable population, ultimately improving pregnancy outcomes and maternal health.
1.2 Statement of the Problem
The screening and prevalence of urinary tract infections (UTIs) in pregnant women present a significant challenge in prenatal care, with serious implications for maternal and fetal health. Despite established guidelines recommending routine screening for asymptomatic bacteriuria (ASB) during pregnancy, adherence to these protocols remains inconsistent. This inconsistency leads to varying detection rates and can result in untreated infections, increasing the risk of complications such as pyelonephritis, preterm labor, and low birth weight (Schneeberger et al., 2014; Nicolle, 2014). The prevalence of UTIs during pregnancy is estimated to be between 2-10%, with a significant proportion of these cases being asymptomatic (Smaill & Vazquez, 2019). The lack of uniform screening practices exacerbates the problem, as many cases go undetected and untreated, posing a serious health risk.
Moreover, the variability in prevalence rates across different populations and healthcare settings highlights the need for more standardized and effective screening protocols. While urine culture remains the gold standard for detecting UTIs, its routine implementation is often hindered by logistical and financial constraints (Foxman, 2014). This leads to a reliance on less accurate screening methods, contributing to false negatives and missed diagnoses. Addressing these challenges requires a comprehensive approach that includes educating healthcare providers, ensuring adherence to screening guidelines, and improving access to diagnostic resources. Enhanced screening and early detection are crucial for reducing the burden of UTIs in pregnant women and mitigating their adverse effects on pregnancy outcomes.
1.3 Objectives of the Study
The main objective of the study is to examine Screening and Prevalence of Urinary Tract Infection on Pregnancy Woman in Osun. Specific objectives of the study are:
- To determine the prevalence of urinary tract infections (UTIs) among pregnant women in Osun State, Nigeria.
- To assess the effectiveness of current screening practices for detecting asymptomatic bacteriuria (ASB) and symptomatic UTIs in pregnant women in Osun State.
- To identify the risk factors associated with UTIs in pregnant women in Osun State, Nigeria.
1.4 Research Questions
To guide the study and achieve the objectives of the study, the following research questions were formulated:
- What is the prevalence of urinary tract infections among pregnant women in Osun State, Nigeria?
- How effective are the current screening practices in detecting asymptomatic bacteriuria and symptomatic UTIs in pregnant women in Osun State?
- What are the risk factors associated with urinary tract infections in pregnant women in Osun State, Nigeria?
1.5 Research Hypothesis
The following research hypothesis was developed and tested for the study:
Ho: There is no significant difference in the prevalence of adverse pregnancy outcomes between pregnant women who undergo routine screening for symptomatic urinary tract infections (UTIs) and those who do not.
1.6 Significance of the Study
The study is important for many reasons. The following are the major stakeholders this paper through its practical and theoretical implications and findings will be of great significance:
Firstly, the paper will benefit major stakeholders and policy makers in the health sector. The various analysis, findings and discussions outlined in this paper will serve as a guide in enabling major positive changes in the industry and sub-sectors.
Secondly, the paper is also beneficial to the organizations used for the research. Since first hand data was gotten and analysed from the organization, they stand a chance to benefit directly from the findings of the study in respect to their various organizations. These findings will fast track growth and enable productivity in the organisations used as a case study.
Finally, the paper will serve as a guide to other researchers willing to research further into the subject matter. Through the conclusions, limitations and gaps identified in the subject matter, other student and independent researchers can have a well laid foundation to conduct further studies.
1.7 Scope of the Study
The study is delimited to Homocare Gracious Hospital, Osogbo in Osun state, Nigeria. Findings and recommendations from the study reflects the views and opinions of respondents sampled in the area. It may not reflect the entire picture in the population.
1.8 Limitations of the Study
The major limitations of the research study are time, financial constraints and delays from respondents. The researcher had difficulties combining lectures with field work. Financial constraints in form of getting adequate funds and sponsors to print questionnaires, hold Focus group discussions and logistics was recorded. Finally, respondents were a bit reluctant in filling questionnaires and submitting them on time. This delayed the project work a bit.
1.9 Organization of the Study
The study is made up of five (5) Chapters. Chapter one of the study gives a general introduction to the subject matter, background to the problem as well as a detailed problem statement of the research. This chapter also sets the objectives of the paper in motion detailing out the significance and scope of the paper.
Chapter Two of the paper entails the review of related literature with regards to corporate governance and integrated reporting. This chapter outlines the conceptual reviews, theoretical reviews and empirical reviews of the study.
Chapter Three centers on the methodologies applied in the study. A more detailed explanation of the research design, population of the study, sample size and technique, data collection method and analysis is discussed in this chapter.
Chapter Four highlights data analysis and interpretation giving the readers a thorough room for the discussion of the practical and theoretical implications of data analyzed in the study.
Chapter Five outlines the findings, conclusions and recommendations of the study. Based on objectives set out, the researcher concludes the paper by answering all research questions set out in the study.
1.10 Definition of Terms
1. Urinary Tract Infection (UTI): An infection that occurs in any part of the urinary system, including the kidneys, ureters, bladder, and urethra. UTIs are commonly caused by bacteria and can lead to symptoms such as frequent urination, pain during urination, and pelvic pain.
2. Asymptomatic Bacteriuria (ASB): The presence of bacteria in the urine without the symptoms commonly associated with a urinary tract infection. ASB is particularly significant during pregnancy due to its potential to cause complications if left untreated.
3. Screening: The process of testing for disease in individuals who do not show symptoms. In the context of UTIs in pregnant women, screening typically involves urine tests to detect the presence of bacteria.
4. Prevalence: The proportion of a population found to have a condition (in this case, UTIs) at a specific time. Prevalence is used to understand how widespread a condition is within a population.
5. Pregnancy: The period during which a woman carries a developing fetus, typically lasting about 40 weeks from the last menstrual period to childbirth. Physiological changes during pregnancy can affect the urinary system and increase the risk of UTIs.
6. Risk Factors: Characteristics or conditions that increase the likelihood of developing a disease or health problem. For UTIs in pregnant women, risk factors can include previous history of UTIs, diabetes, anatomical anomalies, and sexual activity.
7. Adverse Pregnancy Outcomes: Negative health effects that may occur during pregnancy, childbirth, or after delivery. These can include preterm labor, low birth weight, preeclampsia, and maternal morbidity, potentially linked to untreated UTIs or ASB.
