Effect of Time and Utility of Leukocyte Esterase in Detection of Urinary Tract Infections Using Culture as A Gold Standard Among Symptomatic Patients at Buzuruga Health Center in Mwanza, Tanzania.
- Mwanza, Tanzania | Catholic University of Health and Allied Sciences [CUHAS-Bugando] | 2024.
- 58 Pages Includes References
Abstract:
Background: Urinary tract infection (UTI) is a major health problem affecting about 150 million people worldwide annually. Leucocyte esterase (LE) is an enzyme released by the granulocytes and is a promising marker for detecting UTIs with high sensitivity, however the effect of time on its detection is unclear. This study aimed on determining the effect of time and utility of leucocyte esterase in UTI symptomatic patients attending at Buzuruga health center.
Methodology: A hospital based cross sectional study conducted among all non-pregnant adult outpatients. The study included patients with at least two symptoms of urinary tract infection (UTI). It was conducted at Buzuruga health Centre between May to July in 2024. Clean catch midstream urine was collected and processed. Pretested questionnaire and laboratory log book were used for data collection .Urine analysis was performed by dipstick for detection of leucocyte esterase, and culture method was used as a gold standard. Data were analyzed using a two by two table and STATA software version 15.0.
Results: A total of 317 urine samples were collected from adults patients, whereby majority were female 233(73.5%), the median age (IQR) was 36(26-55) years. The most common participants were married 208(65%) with primary education 163(51.4%). The predominant presented symptom was fever 220(69.40%). The leucocyte esterase was detected in 82(25.9%), 76(24%) and 67(21.1%) at zero hour, two hours and four hours, respectively. The prevalence of UTI by culture was 22.10% (70, n=317). The sensitivity of leucocyte esterase in detection of UTI at 0, 2 and 4 hours was 55.7%, 47.6%, and 41.4%, respectively while the specificity was 82.6%, 83% and 84.6%, respectively. The positive predictive value was 47.6%, 44.7% and 43.3%, at 0,2 and 4 hours, respectively. The negative predictive value was 86.8%, 85.1% and 83.6% at 0, 2 and 4 hours, respectively.
Conclusions: The proportion of sample with leucocyte esterase decreases with time hence affect its sensitivity. Delayed processing of urine results to poor ability of detecting leucocytes by dipstick however it increases the ability of the test to rule out un-diseased individual. The study recommend immediate test of leucocyte esterase among patient with clinical diagnosis of UTI.
Wurzburg Road 35, Premises, Post Code: 33102 | P. O. Box 1464 Mwanza, Tanzania | Phone: (255) 28-298-3384 | Fax: (255) 28-298-3386 | Email: vc@bugando.ac.tz | Website: www.bugando.ac.tz