Knowledge And Causes Of Urinary Tract Infection As Perceived By Health Workers
[A CASE STUDY OF KAURA LOCAL GOVERNMENT AREA, KADUNA STATE]

CHAPTER TWO
REVIEW OF RELATED LITERATURE
2.1. Knowledge of Urinary tract infection
Urinary tract infection is a common contagion among men and women but the incidence is quite high among women due to their physiology. In simple terms, it can be referred as a condition which women will certainly encounter during the span of their life time and the prevalence is higher among women during pregnancy. As the name indicates, the infected parts involve the urinary tract comprising of the upper and lower urinary tract. The infection is named after the part that gets infected and is referred to as cystitis (bladder infection) and phylonephritis (kidney infection). The symptoms associated with the bladder and kidney infections are contrasting which includes painful and frequent urination in case of cystitis as a result of bladder infection whereas conditions like high fever and flank pain are commonly experienced in case of kidney contagion which is referred to as phylonephritis. This prevalence of the infection among children and elderly people is not clearly understood and is currently under study. Bacteria are the prime perpetrator responsible for conferring the infection among humans but the role of certain fungi and viruses cannot be over looked. However, the incidence of UTI as a result of viral or fungal infection is considered to be rare phenomena. Though the infection seems to be harmless in the initial stages, the patient shows a variety of symptoms as the stage progresses and can lead to death in severe circumstances. Research studies have defined urinary tract infection as the most common form of bacterial infection [Ai-Achi, A. (2008)]. Urinary tract infection can be a consequence of poor diagnosis and is regarded as the common hospital acquired infection [Ai-Achi, A. (2008)]. The infection encompasses a diverse group of clinical syndromes and diseases that differ in epidemiology, etiology, location severity of the condition [Gutierrez, J. (2002)]. In addition to the above factors, it also vary in expressed local symptoms, frequency of recurrence, extent of damage caused, presence of complicating factors and the risk from their reiterate incidence [Arjonilla, A.; Gutierrez, J. (2002)]. The occurrence of bladder infection is usually followed by kidney infection and results in blood borne infection and in severe circumstances can lead to dire consequences including death. Therefore, UTI is capable of claiming lives under severe circumstances and proper treatment results in quick recovery from the contagion. The onset of the infection is in the 6th week of pregnancy through 24th week [Gutierrez, J. (2002)]. Although the prevalence of bacteriuria during pregnancy is similar to that in non pregnant women, pregnancy enhances the possibility of infection among women. The occurrence of the infection is at its peak during pregnancy which in turn relies on several other factors. Though the higher incidence of UTI during pregnancy cannot be accepted as a universal fact as the concept is under the verge of research and several researchers are attempting to figure out the significance of pregnancy in relation to urinary tract infection. The concept of the predominance of UTI among women during pregnancy is a complex aspect and is yet to be understood and validated. Many researchers have made several attempts in the past and the quest is still going on to derive suitable facts to correlate the prevalence of UTI during pregnancy but nevertheless, pregnancy is considered to be a crucial time and requires various precautionary measures to safeguard the women and unborn child Berrocal,T ; Lopez-Peira,P.; Arjonilla, A.; Gutierrez, J. (2002). In addition to pregnancy; sexual intercourse and family history also has a central role in conferring UTI. The invasion of lower urinary tract by the bacteria which usually comprises the bladder causes cystitis which is trailed by the upper urinary tract infection referred to as phylonephritis. This could be a consequence of blood borne infection. Despite the fact, that 80% of the infection is caused by Escherichia coli, the involvement of other pathogens cannot be denied and one of the perpetrators responsible for conferring UTI are Gram positive cocci. Gram positive cocci are gaining worldwide importance and Staphylococcus species are one of the major pathogens belonging to the cocci group. Pathogens associated with UTI are known to exhibit a property called as biofilm formation which is responsible for causing the infection.