Dipstick Screening for Urinary Tract Infection in Adolescent School Girls: Evaluation of Self Screening Ability

Abstract

Introduction: Urinary Tract Infection (UTI) is a significant health problem in young women and adolescent females. Microscopic analysis and/or urine culture are costly, labour intensive laboratory-based tests. For many individuals, access and affordability for such care can be difficult specially in India rural settings have limited resources for this. The concept of selfscreening for UTI by urine dipstick bedside method and benefits of adopting it as a regular school health programme is relatively new in our country. Aim: To evaluate the ability of self screening for UTI by urine dipstick method in the adolescent school girls. Materials and Methods: In this cross-sectional study the ability to self screen for UTI in 374 participants, including 184 girls from a rural school and 190 girls together from two urban schools was evaluated. At each school, the participants were educated about UTI and the objectives and methodology of the study. The participants reported to the school (to the investigators) within one hour of collecting first-morning, clean-voided, midstream urine sample in a sterile labelled container. The ability to self-interpret for UTI by the participants using dipstick method was evaluated. The interpretation by the investigator was considered the gold standard. Sensitivity, specificity and predictive values were calculated to assess the ability to self screen for UTI. The association between UTI and contributory factors was calculated using Chi-square tests. Results: The overall self screening ability of the participants for UTI was found to have sensitivity, specificity, positive and negative predictive values of 81.82%, 96.7%, 42.86% and 99.43%, respectively. The UTI was significantly associated with water intake (χ2 =11.196, p<0.01), habit of holding urine (χ2 =5.92, p<0.05) and method of perineal cleaning (χ2 =16.591, p<0.01). The prevalence of UTI among urban and rural adolescent school girls was 2.1% and 3.8% respectively with an overall prevalence of 2.9%. Conclusion: The results show that regular self screening of school girls for asymptomatic bacteriuria is feasible on a large scale at low cost.

Keywords

• glucose test
• leukocyte esterase test
• nitrite test