INTRODUCTION:

According to WHO, one of the leading cause of morbidity among all ages is UTI. It also increases the health care expenditures. About 50% of women report having UTI during their lives. About 8.3 millions office visits per year with more than 1 million hospitalizations, for an overall cost more than $1billion¹.

It is estimated that about 1/5th million UTI’s occur every year on a global basis resulting more than six dollars in direct health care expenditure.²

Urinary tract infections is the invasion of pathogens in the urinary tract which may lead to upper or lower tract infections of the kidneys, bladder and urethra. Urinary tract infections are usually symptomatic and the common clinical features found in older children include dribbling of urine, prolonged voiding, crying during micturition and poor urinary stream which indicate an abnormality of the distal urinary tract. The other features of UTI are fever, chills and rigors and flank pain.³

A wide variety of complications may be related with UTI. The most common being interference with normal voiding pattern which leads to impairment of flushing bacteria from genito-urinary tract, ureteric or urethral strictures, urolithiasis, pelvicalyceal obstruction, diverticulae, tumours of the urinary tract and renal cyst.⁴

A non-experimental descriptive study was conducted by Kripa, C K et al. on Knowledge on prevention of UTI among 30 adolescent girls of Ashwini College of Nursing, Kerala. The study revealed that majority i.e.27(93%) of the adolescent girls had average knowledge whereas about 3(7%) had inadequate knowledge. But non had adequate knowledge on prevention of urinary tract infection. Association was not found between knowledge on prevention of urinary tract infection with selected variables.⁵

The prevalence of UTI among female are because of the proximity of their urethral and anus, short length of urethral and warm and wet environment of perineal.⁶Records on urinary infection during childhood are considered as predisposing factors to infection .⁷ A quarter of women who reported urinary tract infections for the first time would be reinfected in less than three months .⁸

A descriptive study was conducted by R.Bokolia on Knowledge of urinary tract infection among 307 school going adolescent girls aged 12 to 16 years in selected schools of Ahemdabad, India .The results reviewed that out of 307 students, 202(66%) had no knowledge on UTI whereas 105(34%) had knowledge of UTI. The study findings conclude that there was an urgent need for providing educational talks periodically about Urinary Tract Infections.⁹

A study by P Shanti on Prevention of Reproductive Tract Infection among married Women Residing at Puducherry showed that (11.67 %) had adequate knowledge. The study revealed that there was a relationship between the knowledge with variables like occupation, educational level, the age at the marriage and monthly family income of the married women. This study concluded that there was a requirement to impart teaching programme to increase knowledge among married women.¹⁰

Prevention and management of genito- urinary tract infection includes improving knowledge on reasons of genito-urinary infection, complication, good personal hygiene, drinking adequate water, emptying bladder completely on urge or at least once in three hours, wearing cotton underwear which do not trap moisture and good perineal hygiene with changing sanitary pads frequently during menstruation.¹¹

Thus, with this view, the investigators felt the need to conduct the survey in the related areas on the prevention of UTI in the rural areas of community.

MATERIAL AND METHODS:

Research approach – Non experimental survey

Research design: Descriptive co- relational survey

Research setting: Central Pendam

Population: adolescent girls

Sampling technique: Non probability convenience sampling

Sample size – 100

Sampling criteria:

Adolescent girls

· who have given consent.

· who have attained menarche.

· who can understand Nepali, English.

Ethical Consideration

Ethical permission was taken from:

· The Institutional Ethics Committee, SMIMS.

· Written informed consent was taken from the individual participants.

Statistics:

Descriptive and inferential statistics was used

RESULT AND DISCUSSIONS:

Section1:

Table 1: Frequency percentage distribution of Demographic Performa of adolescent girls. N=100

Sl. No	Variable	Frequency (f)	Percentage (%)
1.	Age 10 to 13	13	13
	14 to 16	61	61
	17 to 19	26	26
2.	Marital status
	Single	100	100
	Married	0	0
3.	Religion
	Buddhist	8	8
	Christian	19	19
	Muslim	0	0
	Hindu	73	73
4.	Type of family
	Nuclear	55	55
	Joint	38	38
	Extended	7	7
5.	Age of menarche
	10 to 12	32	32
	13 to 15	61	61
	16 to 18	7	7
	19 and above	0	0
6.	Educational qualification
	No formal education	0	0
	Primary	4	4
	Secondary	82	82
	Senior secondary	9	9
	Higher secondary	5	5
7.	Educational qualification of mother
	No formal education	22	22
	Primary	49	49
	Secondary	27	27
	Graduate	2	2
	Post Graduate	0	0
8.	*Monthly income of family*
	less than 5000	25	25
	5001 to 10000	55	55
	10001 to 20000	9	9
	> 20000	11	11
11.	Family history of UTI No	83	83
	Yes	17	17
12.	*Personal history of UTI*
	Yes	11	11
	No	89	89
13.	*Heard of UTI* Yes No	36 64	36 64
14.	*Source of information*		n =36
	Book	7	7
	Multimedia	3	3
	Health programmes	24	24
	Newspaper	2	2

Section 2: Findings related to knowledge scores regarding prevention of UTI among adolescent girls of selected rural areas of Sikkim N=100

Fig 1: Frequency percentage distribution of knowledge scores on preventive measures of UTI.

The above Fig. 1 reflects the frequency percentage distribution of knowledge scores on preventive measures of UTI where 88 (88%) had moderate knowledge and 12(12%) had low knowledge and none of participants had high knowledge.

Section 3: Findings Related to Attitude towards Preventive Measures of UTI N=100

Fig: 2: Frequency percentage distribution of attitude score regarding preventive measures of urinary tract infection

The data in the Fig. 2 shows the frequency percentage distribution of attitude score regarding preventive measures of urinary tract infection where majority of the participant i.e.63 (63%) had favorable attitude and about 37(37%) had unfavorable attitude.

Section 4: Findings Related to Frequency Percentage Distribution of Hygienic Practices towards Preventive Measures of UTI among adolescent girls of selected rural area of Sikkim N=100

Fig 3: Frequency percentage distribution of over all hygienic practice among adolescent girls.

The data in the Fig. 3 shows the frequency percentage distribution of overall hygienic practice among adolescent girls where 71(71%) had good hygienic practice, 26(26%) had average hygienic practice and only about 3(3%) had below average hygienic practice.

SECTION 5: Findings Related to Association between Knowledge with Selected Demographic Variables

Table 2: Table showing findings related to association between knowledge with selected demographic variables N=100

*Variables*	*Knowledge score*			x²	df	*Table value*	*Remarks*
	median >13	median <=13
*Age in years*
10 to13	5	8		0.6	2	5.99	Not Significant
14 to 16	24	37
17 to 19	9	17
*Marital status*
Single	38	62		5	1	3.84	Not Significant
Married	0	0
*Religion*
Hindu	29	44		1.44	2	5.99	Not Significant
Buddhist	2	6
Christian	9	10
*Type of family*
Nuclear	27	28	4.04		2	5.99	Not Significant
Joint	11	27
Extended	2	5
*Age of menarche in years*
10 to 14	33	29	3.09		1	3.84	Not Significant
15 to 19	27	11
*Educational qualification*
Less than secondary	48	38	2.55		1	3.84	Not Significant
Higher secondary and above	11	3
*Family monthly income*
Less than 5000	6	19	3.79		2	5.99	Not Significant
5001-10000	24	31
Above 10000	10	10
*Family history of UTI*
Yes	6	11	0.28		1	3.84	Not Significant
No	33	50
*Personal history of UTI*
Yes	8	3	5.5		1	3.84	Significant
No	32	57
*Heard of UTI*
Yes	18	18	0.245		1	3.84	Not Significant
No	31	33
*Source of information n=31*
Books/ Multimedia/ Newspaper	5	8	0.82		1	3.84	Not Significant
Health programmes	13	11

The data in the table 2 shows the findings related to association between knowledge with the selected demographic variables in which the personal history of UTI is associated with the knowledge as the calculated value of x i.e.5.4 is more than the table value which is 3.84 at df 2 and at 0.05 level of significance.

Section 6: Findings related to correlation between knowledge and attitude.

Table 3: Findings related to correlation between knowledge and attitude towards preventive measures of UTI

Variable

Knowledge

2.98

0.33

Attitude

2.45

The data in the table 3 shows that there is a moderately positive correlation between knowledge and attitude towards preventive measures of UTI where the value of r = 0.3. Thus, if the knowledge of the participants are increased; their attitude will be more favourable

CONCLUSION:

The current study finding suggests that majority i.e. 88 % of the participants had moderate knowledge and 63% had unfavorable attitude. Therefore having a good knowledge regarding the preventive measures of urinary tract infection among the adolescent girls plays an important role in bearing favorable attitude in reducing every chance of development of risk, complication associated with UTI

REFERENCES

1. Available from URL: https://www.who.int/gpsc/information_centre/cauda-uti_eccmid.pdf

2. Tanagho, E.A. and Mc.Aninch, J.W. Smith General Urology from McGraw-Hill Medical, New York. 2008; (17)916-925.

3. Srivastava RN and Bagga Arvind. Textbook of Pediatric Nephrology. Jaypee brothers Medical Publishers(P) Ltd. India. 273-287.

4. Nicolle LE. A practical approach to the management of complicated Urinary Tract Infection; International Journal of Drugs and Aging, 2010;18(4): 243-254.

5. C K, Kripa, Rose Maria and Mridula K M, et al. Knowledge on prevention of urinary tract among adolescent girls. International Journal of Recent Scientific Research. 2016; 7(8): 13131-13132.

6. Nicolle LE. Urinary tract infection; Traditional pharmacologic therapies, Disease a month. 2003; 49(2):111-128.

7. Mehnart Kay SA; Diagnosis and management of uncomplicated urinary tract infection. Am Fm Physician. 2005; 72(3): 451-456.

8. Nosseir SB, Lint LR and Winkler HA. Recurrent uncomplicated urinary tract infection in women. Journal of women’s health. 2012; 21(3): 347-354.

9. Bokolia R. Assessment of knowledge of Urinary Tract Infection amongst school going adolescent girls. The Journal of the International society for Pharmacoeconomics and outcomes research. 2016; 19: 631-638.

10. P. Santhi. Knowledge on Prevention of Reproductive Tract Infection among Married Women Residing at Kalapet, Puducherry. Asian J. Nur. Edu. & Research 1(2): April-June 2011; Page 60-63.

11. Brenner and Rector’s: The Kidney. Saunders Elsevier. 8^th edition; volume 2; pp. 1217

Received on 18.02.2021 Modified on 17.09.2021

Int. J. of Advances in Nur. Management. 2022; 10(1):1-5.

DOI: 10.52711/2454-2652.2022.00001

Knowledge, Attitude and Hygienic Practice towards preventive measures of urinary tract infection among adolescent girls of selected rural areas Sikkim