A Cross-sectional Study of the Prevalence of Asymptomatic Bacteriuria among HIV-positive and HIV-negative Expectant Mothers in a Tertiary Health Centre in South Eastern Nigeria

Abstract

Background: Asymptomatic Bacteriuria (ASB) in pregnancy is associated with potential urinary and obstetric complications. The diagnosis and management of ASB in expectant mothers is in keeping with safe motherhood initiative. Aim: To determine the prevalence and pattern of ASB among HIV-positive and HIV-negative pregnant women in Enugu State, South Eastern Nigeria. Methods: This was a comparative analytical study among HIV-positive and HIV-negative pregnant women at the University of Nigeria Teaching Hospital, Enugu State. ‘Clean catch’ urine samples of these women collected and analysed. Statistical analysis was performed using the Chi-square and student’s t tests as appropriate. A P-value of less than 0.05 was considered statistically significant. Results: Among the two hundred and forty HIV-positive women, (23.3%) had significant ASB while (10.4%) of an equal number of HIV-negative women had significant ASB. The difference was statistically significant (p=0.013). A higher proportion of HIV-positive women, (22.5%) with CD4 cell count of ≤ 500/mm3 had significant ASB (p=0.015). Escherichia coli was the commonest isolate in both groups of women. The isolates were generally sensitive to amoxicillin-clavullanic acid, nitrofurantoin and cefuroxime in the two groups. The sensitivity to sulfametoxazle-trimethoprim was low; HIV positive (21.5%), HIV negative (16.0%).  Among those treated, none had overt UTI in pregnancy. Conclusion: Screening, treatment and follow up for ASB in pregnancy are necessary especially in HIV positive women with CD4 cell count less than 500/mm3. This should be included during counselling in all antenatal protocols.