title: Diagnostic accuracy of rapid urine dipstick test to predict urinary tract infection among pregnant women in Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia.
abstract: BACKGROUND
  Untreated bacteriuria during pregnancy has been shown to be associated with low birth-weight and premature delivery. Therefore, routine screening for bacteriuria is advocated. The decision about how to screen pregnant women for bacteriuria has always been a balance between the cost of screening versus the sensitivity and specificity. This study was designed to evaluate the diagnostic accuracy of the rapid dipstick test to predict urinary tract infection in pregnancy against the gold standard urine culture.
  
  
  METHODS
  A total of 367 mid stream urine samples were collected, inoculated on MacConkey, Manitol salt agar (MSA) and blood agar and incubated aerobically at 37°C for overnight. Specimens were classified as "positive" for urinary tract infection (UTI) if the growth of the pathogen(s) was at a count ≥ 10(5) colony-forming units per milliliter (cfu/mL) of urine and classified as "negative" with growth of <10(5) cfu/mL. Urine samples were tested for the presence of nitrite and leukocyte esterase using dipstick rapid test in accordance to the manufacturer's instructions.
  
  
  RESULTS
  From the total study participants, 37 pregnant women were symptomatic and the remaining 330 pregnant women were asymptomatic. The sensitivity and specificity of dipstick tests of leukocyte esterase was 50% and 89.1% for pregnant women with asymptomatic UTI(ABU) and 71.4% and 86.7% for symptomatic UTI respectively and for nitrite 35.7% and 98.0% for ABU and 57.1% and 96.7% symptomatic UTI.
  
  
  CONCLUSIONS
  This study revealed that the use of dipstick leukocyte esterase and nitrite for screening UTI particularly asymptomatic bacteriuria was associated with many false positive and negative results when it was compared against the gold standard culture method. The low sensitivity and positive predictive value of urine dipstick test proved that culture should be used for the diagnosis of UTI.
authors: Tazebew
authors: T
authors: Demilie
authors: Getenet
authors: G
authors: Beyene
authors: Selabat
authors: S
authors: Melaku
authors: Department of Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University, P,O,Box 79, Bahir Dar, Ethiopia. wondewosentsg@gmail.com.
authors: Wondewosen
authors: W
authors: Tsegaye
mesh_terms: D000293:Adolescent; D000328:Adult; D001437:Bacteriuria / Q000175:diagnosis / Q000652:urine; D002265:Carboxylic Ester Hydrolases / Q000652:urine; D003710:Demography; D005002:Ethiopia; D005260:Female; D006801:Humans; D009573:Nitrites / Q000652:urine; D011247:Pregnancy; D011933:Reagent Kits, Diagnostic; D012017:Referral and Consultation; D012680:Sensitivity and Specificity; D016482:Urinalysis / Q000379:methods*; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000652:urine*; D055815:Young Adult
chemical_list: D009573:Nitrites; D011933:Reagent Kits, Diagnostic; C021443:leukocyte esterase; D002265:Carboxylic Ester Hydrolases