Abstract:

Background: Urinary tract infection (UTI) is one of the common infectious diseases prevalent in both males and females. Affecting more than 150 million people globally with a financial burden of $6 billion worldwide each year. Data distribution of urinary tract infection shows that >50% of women and <12% of men experience UTIs with a lifetime prevalence of 32.12% within Sub Saharan Africa, whereas Mwanza contributes with a burden prevalence of 27.4% affecting the entire population. There are several diagnostic methods for the diagnosis UTI which involves the use of microscopic pyuria, dipstick urinalysis technique and urine culture, though the culture method remains the gold standard for the diagnosis of UTI its expensive technique makes a challenge for it to be performed in lower health facilities, with increased turnaround time for the patient results. Therefore, this study has established the use of microscopic pyuria and its effectiveness in the diagnosis of UTIs by comparing the role of centrifuged and uncentrifuged urine samples. Which can be used as the potential tool in the diagnosis of UTIs in lower health centers in Mwanza Tanzania.

Methodology: This research study was a cross sectional hospital-based study which was conducted at 2 health centers between Igoma and Buzuruga health centers in Mwanza, Tanzania. Different diagnostic tests of urinary tract infection (UTI) are in clinical practices. A reliable test can increase the efficiency of the healthcare system, especially in a developing country like Tanzania, reducing cost and time for patient intervention. Thus, use of microscopic pyuria in diagnosing the UTIs using both centrifuged and uncentrifuged urine samples done by the wet mount preparation method, followed by urine culture by a semi-quantitative method as the confirmatory method. Urine culture is a gold standard for the diagnosis of UTI, but it takes up to 72hrs for final reporting thus increasing the TNT. Using microscopic urinalysis allows starting antimicrobial treatment 24 hours sooner than waiting for culture results. Microscopic urinalysis can thus be a useful test for the rapid diagnosis of UTI among the symptomatic patients.

Results: A total of 317 urine samples were collected and analyzed from Igoma and Buzuruga health centers from May to July 2024, with 208(65.6%) urine samples from female patients and 109(34.3%) urine samples from male patients. The prevalence of urinary tract infection was measured to be 24.6%, whereby female showed a prevalence of 16.8% meanwhile male contributed to a prevalence of 7.8% By comparing both the uncentrifuged and centrifuged urine sample results there was a variation in results for the prevalence of UTIs.The prevalence of UTIs by the use of uncentrifuged urine samples using culture as the gold standard was found to be 13.2% while that of centrifuged urine sample showed the prevalence to be 15.1%.

Conclusion and Recommendations: From the research data obtained the centrifuged urine sample shows to have higher sensitivity and low sensitivity compared to that of uncentrifuged urine samples. Therefore the utility of microscopic pyuria shows to be effective as initial screening of symptomatic UTIs patients.
Centrifugation improves the utility of urine microscopic pyuria in the diagnosis of UTIs, based on this research study findings the microscopic pyuria should be done using centrifuged urine samples due to the fact that centrifuged urine shows high sensitivity.