title: Evaluation of the prevalence of urinary tract infection in rural Panamanian women.
abstract: OBJECTIVE
  Urinary tract infection (UTI) is the most common non-intestinal infection worldwide. In the developed world, incidence and prevalence of UTI would be similar owing to the relatively short duration of illness experienced by women with ready access to healthcare services. We hypothesize that, in the developing world, factors limiting access to care and those which may increase the likelihood of developing UTI, result in increased morbidity. This difference is reflected in an increased prevalence of UTI in regions where women suffer the effects of UTI for extended periods of time.
  
  
  METHODS
  This study represents a cross sectional analysis of UTI prevalence in rural western Panama conducted over the course of a 3-day medical mission. All women 18-45 years of age reporting to the medical brigade clinic were tested for UTI by dipstick urinalysis and a brief history regardless of whether they themselves were presenting with a complaint.
  
  
  RESULTS
  UTI was diagnosed clinically by providers in 29.8% of the women tested although only 21.15% of these same women met the evidence-based study criteria. This prevalence of 21.15% is seven times greater than reported by the Panamanian Ministry of Health. When comparing the effectiveness of clinical diagnosis relative to urinalysis by dipstick, a Kappa coefficient revealed only low moderate agreement (0.42; SE 0.0955).
  
  
  CONCLUSIONS
  The prevalence of UTI in rural western Panama is greater than would be expected based on prevalence data from either the US or Panamanian Ministry of Health and may represent an opportunity for targeted interventions, including educational programming about UTI prevention.
authors.affiliation: School of Nursing, Samuel Merritt University, Oakland, California, United States of America. saugust@samuelmerritt.edu
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: August
authors.forename: Michael J
authors.initials: MJ
authors.lastname: De Rosa
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006801:Humans; D008875:Middle Aged; D010176:Panama / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000652:urine