Asymptomatic bacteriuria among pregnant women in a tertiary care hospital in Rwanda Ref.No.SSTCRC2551
1. Introduction
Asymptomatic bacteriuria (ASB) is a common yet often overlooked condition in pregnancy, with significant implications for both maternal and fetal health. Urinary tract infections (UTIs) are particularly prevalent among pregnant women, posing significant risks to both maternal and fetal health. The global prevalence of ASB in pregnancy ranges from 2% to 10%. In African countries such as Ghana, the prevalence rate is 15.9%, in Senegal 4.5%, and 12.3% in Nigeria. In Rwanda, about 70.40%.
Asymptomatic bacteriuria (AB), characterized by the presence of bacteria in the urine without symptoms, is common during pregnancy due to physiological and immunological changes in the urinary tract. ASB in pregnancy is predominantly caused by Escherichia coli and other Uropathogens such as Klebsiella pneumoniae and Staphylococcus saprophyticus, which are commonly found in the lower urinary tract. Also, hormonal and anatomical changes during pregnancy, such as urinary stasis and increased bladder pressure, facilitate bacterial growth. A study identified that physiological changes in the renal system, alongside compromised immunity, make pregnant women more susceptible to bacteriuria, even in the absence of symptoms. The potential adverse effects of untreated ASB in pregnancy are significant. Studies have shown that ASB increases the risk of pyelonephritis, preterm labor, low birth weight, and even intrauterine growth restriction. In Rwanda, maternal infections are a leading cause of poor neonatal outcomes, which emphasizes the importance of addressing ASB as a public health priority.
2. Objective
The aim is to determine the prevalence of asymptomatic bacteriuria in the first, second, and third trimesters of pregnancy.
-To determine the prevalence of Asymptomatic Bacteriuria in the first, second, and third trimesters of pregnancy and any associated maternal or fetal morbidity.
-To assess the risk factors of asymptomatic bacteriuria in pregnant women admitted to the Department of Gynecology and Obstetrics in a maternal and childcare hospital in Kigali, Rwanda.
-To provide recommendations and implications that will be used in the future in the prevention and management of asymptomatic bacteriuria.
3. Research Plan
Research questions
-What is the prevalence of Asymptomatic Bacteriuria in the first, second, and third trimesters of pregnancy, and any associated maternal or fetal morbidity?
-What are the risk factors of asymptomatic bacteriuria in pregnant women admitted to the Department of Gynecology and Obstetrics in a maternal and childcare hospital in Kigali, Rwanda?
-What are recommendations and implications that will be used in the future in the prevention and management of asymptomatic bacteriuria?
4. Significance of the study
Many reasons led us to conduct this study on asymptomatic bacteriuria in pregnancy in a tertiary care hospital in Rwanda. The reasons are the negative impacts of asymptomatic bacteriuria on maternal and fetal health (such as its serious consequences among others: complicated urinary tract infections and urogenital tract infections, prematurity, and neonatal infections), a better understanding of the prevalence of asymptomatic bacteriuria in a specific context, results of this study may provide data to develop specific management strategies to reduce complications associated with asymptomatic bacteriuria in pregnancy, the findings of this study will help to influence health policies while emphasizing methods of prevention and management of this clinical condition to improve maternal and child health outcomes and the better understanding of Asymptomatic Bacteriuria will raise awareness among healthcare professionals and improve their training on the management of this clinical condition during pregnancy.
5. Expected outcomes
The expected results of this study could include estimation of the percentage of pregnant women with asymptomatic bacteriuria in the tertiary hospital; demographic characteristics of pregnant women with asymptomatic bacteriuria, such as age, socio-economic status, and level of education; identification of significant risk factors associated with asymptomatic bacteriuria, such as history of urinary tract infections, comorbidities (e.g. diabetes), and socioeconomic factors; identification of the most common bacterial species responsible for asymptomatic bacteriuria among participants; analysis of the potential impact of asymptomatic bacteriuria on pregnancy outcomes, such as obstetric complications.