UTI the latest health headache in Tanzania

Dar es Salaam. The government will research the efficacy of diagnosis and treatment of urinary tract infections (UTI).

This follows signs that the causative bacteria are either developing resistance to drugs, or diagnosis is defective.

“There are signs that UTI might be antimicrobial resistant (AMR) because most patients going to hospital for treatment are diagnosed with UTI and prescribed with UTI medications. I think something is wrong somewhere,” Health minister Ummy Mwalimu said at the launch of the newly appointed National Institute for Medical Research (NIMR) council in Dar es Salaam last weekend.

She said it was possible that UTI had developed AMR, and directed the new NIMR council to conduct research and come up with scientific evidence that would make it possible for the magnitude of the problem to be established.

“The way UTI is tested could be one of the reasons why many people continue to be diagnosed with the disease. Urine test results usually come out within an hour. I believe if you conduct culture tests you will be better placed to know if the causative agents have developed resistance or not. I therefore request you to conduct UTI culture tests,” Ms Mwalimu said.

NIMR director general Yunus Mgaya told The Citizen that from their observation, there was a problem with the diagnosis and treatment of UTI.

“It is possible that people could be consuming a lot of antibiotics, and this could result in drug resistance,” he said, noting that NIMR would conduct a study as directed by the minister.

Prof Mgaya added that NIMR would propose a better way of diagnosing UTI, unlike the current situation whereby it takes less than an hour for results to come out.

“We will determine how long it should take for UTI tests to bring reliable results. We will only be able to achieve that by conducting culture tests to identify which type of bacteria cause UTI.

“It is possible that people are taking antibiotics even for ailments that don’t require the use of such medicines,” he said.

A community health expert, Dr Faustine Ndugulile, said the way malaria and UTI were being tested in Tanzania could be the reason behind the high number of people being diagnosed with the diseases.

“To be sure of the type of bacterium causing UTI, you would need at least 24 hours of testing, and another 24 hours to determine the specific antibiotics to treat that type of bacterium. This procedure is currently not used, leading to over-diagnosis of UTI, and improper use of medication,” he said.

In addition, antibiotics prescribed for patients might not be working effectively or even increase the severity of the disease as the body tries to protect itself.

“Antibiotics are made to target a specific bacterium, so the moment you give a patient an antibiotic you are not sure of, you run the risk of letting the bacterium know that there is something foreign that wants to fight it, hence it shields itself, and eventually develops resistance against that antibiotic,” said Dr Ndugulile, a former Health deputy minister.

Contrary to the widespread notion that only prolonged direct use of antibiotics is responsible for resistance, he said the use of antibiotics to treat livestock and poultry was another cause of resistance.

Dr Ndugulile said severity of diseases, leading to death or increase in the cost of treatment, are some of the implications of misuse of antibiotics.