Document Type : Original Article
Authors
1 Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
2 Department of Microbiology, Nursing Service, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
Abstract
BACKGROUND: Urinary tract infections (UTIs) are more common in females than males and
predominantly based on their unhealthy practices in their day to day lives. This study is trying to
assess the occurrence of UTI and strategies used by female student to prevent UTI.
MATERIALS AND METHODS: A cross‑sectional descriptive study carried out in a tertiary care
teaching institute. A total of 338 conveniently selected B. Sc. Nursing and MBBS Medical students
were surveyed. The data were collected by using a pretested, a self‑structured questionnaire
related to occurrence and practices to prevent UTI along with necessary demographic details.
Descriptive (frequency, percentage, mean and standard deviation) and inferential (Chi‑square test)
statistics was used to compute the data.
RESULTS: The result of this study shows that 10.05% female students reported of having UTI. The
proportion was higher in nursing students (67.6%) than medical (32.4%) but did not show a significance
difference (P = 0.61). Age, duration of hostel life, and marital status were significantly associated
with the status of UTI (P = 0.001). To prevent UTI, students were using commercial product with
Tea Tree Oil, soap, drinking 3–4 l water/day, increased frequency of peri‑wash during menstruation
period, and use of Citrus Fruits. The use of western toilet was also significantly associated with
status of UTI (P = 0.04).
CONCLUSION: The occurrence of UTI was more among nursing students. Most of the perineal
hygienic practices by the female students were associated with occurrence of UTI; hence, it is
necessary to emphasize on preventive practices to minimize re‑occurrence.
Keywords
- Kant S, Lohiya A, Kapil A, Gupta SK. Urinary tract infection
among pregnant women at a secondary level hospital in Northern
India. Indian J Public Health 2017;61:118‑23.
2. Ojo OO, Anibijuwon II. Urinary tract infection among female
students residing in the campus of the University of Ado Ekiti,
Nigeria. Afr J Microbiol Res 2010;4:1195‑8.
3. Raheela M, Mutahir SK. Recurrent urinary tract infections in
females. Natl Libr Med 2010;60:55‑9. Available from: https://
pubmed.ncbi.nlm.nih.gov/20055283/. [Last accessed on
2020 Oct 26].
4. Matthews SJ, LancasterJW. Urinary tract infections in the elderly
population. Am J Geriatr Pharmacother 2011;9:286‑309. Available
from: http://www.ncbi.nlm.nih.gov/pubmed/21840265. [Last
accessed on 2020 Oct 26].
5. Afoakwa P, Domfeh SA, Afranie BO, Owusu DO, Donkor S,
Sakyi KK, et al. Asymptomatic bacteriuria and anti‑microbial
susceptibility patterns among women of reproductive age.
A cross‑sectional study in primary care, Ghana. Med Sci (Basel)
2018;6:E118.
6. Rejali M, Ahmadi SS, Hassanzadeh A, Yazdani R, Ahmadi SN.
The relationship between weight gain during pregnancy and
urinary tract infections in pregnant women of Shahrekord, by
using the “Nested case‑control study”, in 2013. J Educ Health
Promot 2015;4:84.
7. Rogers J. Understanding the most commonly billed diagnoses in
primary care. Nurse Pract 2020;45:35‑40. Available from: https://
journals.lww.com/10.1097/01.NPR.0000718516.64801.27 [Last
accessed on 2020 Oct 28]. - 8. Lane DR, Takhar SS. Diagnosis and management of urinary
tract infection and pyelonephritis. Emerg Med Clin North Am
2011;29:539‑52. Available from: http://www.emed.theclinics.
com/article/S0733862711000356/fulltext. [Last accessed on
2020 Oct 26].
9. Givler DN, Givler A. Asymptomatic Bacteriuria. 2021 Jul 25. In:
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;
2021 Jan–. PMID: 28722878. Available from: https://pubmed.ncbi.
nlm.nih.gov/28722878/ [Last accessed on 2020 Oct 28].
10. Mackenzie D. UTIs could soon be life‑threatening without new
antibiotics. New Sci 2017;3115. https://www.newscientist.com/
article/2122891-utis-could-soon-be-life-threatening-withoutnew-antibiotics/.
11. Al‑Badr A, Al‑Shaikh G. UTI in CKD. Sultan Qaboos Univ Med
J A 2013;13:359‑67.
12. Aslam S, Albo M, Brubaker L. Recurrent urinary tract infections
in adult women. JAMA 2020;323:658‑9.
13. Sharma R, Negi S, Kunj D, Sharma V, Vardha. Promoting
menstrual hygiene among adolescent girls. Indian J Community
Health 2015;27:376‑80.
14. Wan X, Wu C, Xu D, Huang L, Wang K. Toileting behaviours
and lower urinary tract symptoms among female nurses:
A cross‑sectional questionnaire survey. Int J Nurs Stud 2017;65:1‑7.
15. Kontiokari T, Laitinen J, Järvi L, Pokka T, Sundqvist K, Uhari M.
Dietary factors protecting women from urinary tract infection.
Am J Clin Nutr 2003;77:600‑4.
16. Singh A, Gupta V, Agrawal D, Goyal P, Singh M, Lukhmana S.
A Cross‑sectional study to investigate the impact of focused
group discussion on menstrual hygiene among rural school girls
of Southern Haryana, India. J Educ Health Promot 2020;9:260.
17. Mehta M, Bhardwaj S, Sharma J. Screening of urinary isolates for
the prevalence and antimicrobial susceptibility of enterobacteria
other than Escherichia coli. Int J Life Sci Pharm Res 2013;3:100‑4.
18. Foxman B. Urinary tract infection syndromes occurrence,
recurrence, bacteriology, risk factors, and disease burden. Infect
Dis Clin N Am 2014;28:1‑13.
19. Gupta S, Malakar M, Kalita P, Pandey FK. Bacterial profile and
antibiograms in urinary tract infection. Al Ameen J Med Sci
2019;12:192‑6.
20. Liao YM, Yang CY, Kao CC, Dougherty MC, Lai YH, Chang Y,
et al. Prevalence and impact on quality of life of lower urinary
tract symptoms among a sample of employed women in Taipei:
A questionnaire survey. Int J Nurs Stud 2009;46:633‑44.
21. Vyas S, VarshneyD, SharmaP, JuyalR, Nautiyal V, Shrotriya V. An
overview of the predictors of symptomatic urinary tract infection
among nursing students. Ann Med Health Sci Res 2015;5:54‑8.
22. Vati S, Prabhakaran N. Prevalence of symptoms of urinary tract
infection and its risk factors among unmarried female medical and
dental students in a tertiary care hospital, Kannur. IOSR J Dent
Med Sci 2020;19:30‑6. Available from: https://www.iosrjournals.
org. [Last accessed on 2020 Dec 17].
23. Sample Size Calculator by Raosoft, Inc.; 2004. Available from:
http://www.raosoft.com/samplesize.html. [Last accessed on
2020 Jul 23].
24. Wani RT. Socioeconomic status scales‑modified Kuppuswamy
and Udai Pareekh’s scale updated for 2019. J Family Med Prim
Care 2019;8:1846‑9.
25. Vati S, Prabhakaran N, Madhusoodanan KV, Sneha S, Devika MR.
Prevalence of symptoms of urinary tract infection and its risk
factors among unmarried female Medical and dental students in
a tertiary care hospital, Kannur. IOSR J Dent Med Sci 2020;19:30‑6.
26. Vyas S, Sharma P, Srivastava K, Nautiyal V, Shrotriya VP. Role
of behavioural risk factors in symptoms related to UTI among
nursing students. J Clin Diagnostic Res 2015;9:LC15‑8.
27. Gebremariam G, Legese H, Woldu Y, Araya T, Hagos K,
GebreyesusWasihun A. Bacteriological profile, risk factors and
antimicrobial susceptibility patterns of symptomatic urinary
tract infection among students of Mekelle University, Northern
Ethiopia. BMC Infect Dis 2019;19:950.
28. Scholes D, Hooton TM, Roberts PL, Stapleton AE, Gupta K,
Stamm WE. Risk factors for recurrent urinary tract infection in
young women. J Infect Dis 2000;182:1177‑82.
29. Zalina N, Aruku N, Azura N, Shahida N, Akhmarina N, Dian F.
Prevalence of lower urinary tract symptoms (LUTS) among young
age medical population. IIUM Med J Malaysia 2011;10(1):7-15.
30. Almukhtar SH. Urinary tract infection among women aged (18‑40)
years old in Kirkuk city, Iraq. Open Nurs J 2019;12:248‑54.
31. Muthulakshmi M, Gopalakrishnan S. Study on urinary tract
infection among females of reproductive age group in a rural
area of Kancheepuram district, Tamil Nadu. Int J Community
Med Public Health. 2017 Sep 22;4(10):3915–21.
32. Choi EP, Lam CL, Chin WY. The health‑related quality of life of
Chinese patients with lower urinary tract symptoms in primary
care. Qual Life Res 2014;23:2723‑33.
33. Koh JS, Cho KJ, Kim HS, Kim JC. Twelve‑month medication
persistence in men with lower urinary tract symptoms suggestive
of benign prostatic hyperplasia. Int J Clin Pract 2014;68:197‑202.
34. Loose M, Pilger E, Wagenlehner F. Anti‑bacterial effects of
essential oils against uropathogenic bacteria. Antibiot (Basel,
Switzerland) 2020;9:358.
35. Swamy MK, Akhtar MS, Sinniah UR. Antimicrobial Properties of
Plant Essential Oils against Human Pathogens and Their Mode of
Action: An Updated Review. Evid Based Complement Alternat
Med. 2016;2016. Available from: https://pubmed.ncbi.nlm.nih.
gov/28090211.
36. Khalil NS, Ibrahim A, Abdelazeem RM. Effect of Body Wash
with Tea Tree Oil on the Prevention of Methicillin-Resistant
Staphylococcus aureus in Critically Ill Patients at a university
hospital in Egypt. Iris J Nurs Care. 2019;1(4):1–5.
37. DasP, Baker KK, DuttaA, SwainT, Sahoo S, DasBS, et al. Menstrual
hygiene practices, wash access and the risk of urogenital infection
in women from Odisha, India. PLoS One 2015;10:e0130777.
38. Moustafa MF, Makhlouf EM. Association between the hygiene
practices for genital organs and sexual activity on urinary tract
infection in pregnant women at women’s health center, at Assiut
University Hospital. J Am Sci 2012;8:512‑22.
39. Ruiz C, Giraldo PC, Sanches JM, Reis V, Beghini J, Laguna C, et al.
Daily genital cares of female gynecologists: A descriptive study.
Rev Assoc Med Bras 2019;65:171‑6.
40. Lahme AM, Stern R, Cooper D. Factors impacting on menstrual
hygiene and their implications for health promotion. Glob Health
Promot 2018;25:54‑62.
41. Sivakami M, Maria van Eijk A, Thakur H, Kakade N, Patil C,
Shinde S, et al. Effect of menstruation on girls and their schooling,
and facilitators of menstrual hygiene management in schools:
Surveys in government schools in three states in India, 2015.
J Glob Health 2019;9:010408.
42. Sevil S, Kevser O, Aleattin U, Dilek A, Tijen N. An evaluation
of the relationship between genital hygiene practices, genital
infection. Gynecol Obs 2013;3:1‑5.
43. Yaliwal RG, Biradar AM, Kori SS, Mudanur SR, Pujeri SU,
Shannawaz M. Menstrual morbidities, menstrual hygiene,
cultural practices during menstruation, and wash practices at
schools in adolescent girls of north Karnataka, India: A crosssectional prospective study. Obstet Gynecol Int. 2020;2020.
Available from: https://pubmed.ncbi.nlm.nih.gov/33133193.
44. Moradpour S, Shahnazi H, Hassanzadeh A. Predictability of
constructs of theory of planned behavior in adopting urinary
tract infection prevention behaviors among pregnant women. J
Educ Health Promot. 2021;10(1):233.
45. Moore EE, Hawes SE, Scholes D, Boyko EJ, Hughes JP, Fihn SD.
Sexual intercourse and risk of symptomatic urinary tract infection
in post‑menopausal women. J Gen Intern Med 2008;23:595‑9.
46. Tian Y, Cai X, Wazir R, Wang K, Li H. Water consumption and urinary tract infections: An in vitro study. Int Urol Nephrol
2016;48:949‑54.
47. Khalil NS, Dead AI, Abdelazeem RM. Effect of body wash
with tea tree oil on the prevention of methicillin‑resistant
staphylococcus aureus in critically Ill patients at a university hospital
in Egypt. Iris J Nurs Care 2019;1:1‑5.
48. Hooton TM, Vecchio M, Iroz A, Tack I, Dornic Q, Seksek I, et al.
Effect of increased daily water intake in premenopausal women
with recurrent urinary tract infections: A randomized clinical
trial. JAMA Intern Med 2018;178:1509‑15.
49. Scott AM, Clark J, Del Mar C, Glasziou P. Increased fluid
intake to prevent urinary tract infections: Systematic review and
meta‑analysis. Br J Gen Pract 2020;70:E200‑7.
50. Ali J, Das B, Saikia T. Antimicrobial activity of lemon peel (citrus
limon) extract. Int J Curr Pharm Res 2017;9:82. Available from:
http://creativecommons.org/licenses/by/4.0/. [Last accessed
on 2021 Jan 08].
51. Das S. Natural therapeutics for urinary tract infections‑a review.
Futur J Pharm Sci 2020;6:64.
52. Basak T, Kok G, Guvenc G. Prevalence, risk factors and quality
of life in Turkish women with urinary incontinence: A synthesis
of the literature. Int Nurs Rev 2013;60:448‑60.
53. Dimmer C, Martin B, Reeves N, Sullivan F. Squatting for the
Prevention of Haemorrhoids? Townsend Lett Dr Patients.
1996;(159):66–70. Available from: https://documents.uow.edu.
au/~bmartin/pubs/96tldp.html.
54. Parasuraman S, Wen L, Sam A, Christapher P, Kumar K.
Analysis of correlation between defecation posture and risk of
urinary tract infections among adolescent populations. Environ
Dis 2016;1:82. Available from: http://www.environmentmed.
org/text.asp?2016/1/2/77/185305. [Last accessed on
2021 Jan 07].