Magnitude, Associated Risk Factors, and Trend Comparisons of Urinary Tract Infection among Pregnant Women and Diabetic Patients: A Systematic Review and Meta-Analysis

Abstract

Urinary tract infection (UTI) remains the most common bacterial infection that affects millions of people around the world, especially pregnant women (PW) and people with diabetes mellitus (DM). This systematic review and meta-analysis was aimed at finding the pooled prevalence of UTI and its associated risk factors among PW and DM patients. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, Google Engine, and University Library Databases. “Prevalence,” “urinary tract infection,” “associated factors,” “pregnant women,” “diabetic patients,” and “Ethiopia” were search terms used for this study. For critical appraisal, PRISMA-2009 was applied. Heterogeneity and publication bias were evaluated using Cochran’s <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"><a:mi>Q</a:mi></a:math> , inverse variance ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"><c:msup><c:mrow><c:mi>I</c:mi></c:mrow><c:mrow><c:mn>2</c:mn></c:mrow></c:msup></c:math> ), and funnel plot asymmetry tests. A random effect model was used to calculate the pooled prevalence of UTI and its associated factors among both patients, along with the parallel odds ratio (OR) and 95% confidence interval (CI). For this meta-analysis, a total of 7271 participants were included in the 25 eligible studies. The pooled prevalence of UTI in Ethiopia among both patients was 14.50% (95% CI: 13.02, 15.97), of which 14.21% (95% CI: 12.18, 16.25) and 14.75% (95% CI: 12.58, 16.92) were cases of DM and PW, respectively. According to the subgroup analysis, the highest prevalence was observed in the Oromia region (19.84%) and in studies conducted from 2018 to 2022 (14.68%). Being female (AOR: 0.88, and 95% CI: 0.11, 1.65, <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"><e:mi>P</e:mi><e:mo>=</e:mo><e:mn>0.01</e:mn></e:math> ) and having an income <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"><g:mtext>level</g:mtext><g:mo>≤</g:mo><g:mn>500</g:mn><g:mtext>ETB</g:mtext></g:math> (AOR: 4.46, and 95% CI: -1.19, 10.12, <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"><i:mi>P</i:mi><i:mo>=</i:mo><i:mn>0.03</i:mn></i:math> ) were risk factors significantly associated with UTI among patients with DM and PW, respectively. Furthermore, a history of catheterization ( <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"><k:mtext>AOR</k:mtext><k:mo>=</k:mo><k:mn>5.58</k:mn></k:math> and 95% CI: 1.35, 9.81, <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"><m:mi>P</m:mi><m:mo>&lt;</m:mo><m:mn>0.01</m:mn></m:math> ), urinary tract infection (AOR: 3.52, and 95% CI: 1.96, 5.08, <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"><o:mi>P</o:mi><o:mo>&lt;</o:mo><o:mn>0.01</o:mn></o:math> ), and symptomatic patients (AOR: 2.32, and 95% CI: 0.57, 4.06, <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"><q:mi>P</q:mi><q:mo>&lt;</q:mo><q:mn>0.01</q:mn></q:math> ) were significantly associated with UTI in both patients. Early diagnosis and appropriate medication are necessary for the treatment of UTI in patients with DM and PW.