South Africa ranks highest for urinary tract infections

ACCORDING to a study published in the Journal of Health and Biological Sciences [1], South Africa ranked highest for urinary tract infections (UTIs) among eight other sub-Saharan African countries. Overall, the prevalence of UTIs in sub-Saharan Africa is 32.12%, with the highest prevalence (67.6%) recorded in SA, followed by Nigeria (43.65%) and Zambia (38.25%).

In SA, UTIs are common, especially among women. Factors like compromised immunity, diabetes and poor personal hygiene – exacerbated by poor sanitation, limited access to clean water and inadequate healthcare infrastructure – increase a woman’s risk of contracting UTIs.

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Elani van Zyl, critical care product manager for Pharma Dynamics, says 25–30% of women between the ages of 20 and 40 experience recurrent infections. “Getting two UTIs in six months or three in a year is considered having recurrent UTIs.

“Bladder infections (cystitis) occur when tiny microbes travel up the urethra and into the bladder, causing an uncomfortable and painful infection in the lower urinary tract. While easily treatable, UTIs can spread into your upper urinary tract and cause a host of problems, which is why a proper diagnosis early on is important.”

She points out that anatomically, women are more prone to UTIs since women have a shorter urethra than men. This shorter distance between the bladder and the external environment makes it easier for bacteria to travel up the urethra and reach the bladder, leading to infections.

“Sexual activity can also introduce unwanted bacteria into the urinary tract since the urethra in women is much closer to the anus than in men, which makes it easier for bacteria to wind up in the bladder.

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 “Mechanical contraception – spermicides, diaphragms and cervical caps – can also increase the risk of UTIs by altering the balance of bacteria in the vagina or by causing irritation to the urinary tract.”

In men, prostate problems can increase their risk of UTIs.

Van Zyl says that a swollen prostate can affect different parts of the urinary system, making it harder for urine to flow through the narrow tube. This can cause inflammation, which increases the risk of bacterial infection, leading to cystitis and/or prostatitis in men.

While more than 80% of UTIs are caused by E. coli, other bacteria, such as Klebsiella pneumoniae and Staphylococcus aureus are also responsible for the disease, although to a lesser degree.

She notes while the best treatment for UTIs is antibiotics, preventing urinary tract infections is crucial in the fight against antibiotic resistance and in ensuring that these medications remain effective for treating bacterial infections in the future.

“Preventing bladder infections or UTIs involves adopting healthy lifestyle habits and practices that reduce the risk of bacterial growth and infection in the urinary tract.”

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Here are some preventive measures:

1. Stay hydrated: Drinking plenty of water helps flush bacteria out of the urinary tract, reducing the risk of infection. Aim for around 6–8 glasses of water a day unless otherwise advised by a healthcare professional.
2. Maintain good hygiene: Women should wipe from front to back after using the bathroom to prevent the spread of bacteria from the anus to the urethra. Keeping the genital area clean and dry helps prevent bacterial growth.
3. Urinate when needed: Don’t hold urine for long periods as this can allow bacteria to multiply in the urinary tract. Empty your bladder regularly, especially after sexual intercourse.
4. Practice safe sex: Using condoms during sexual intercourse can help reduce the risk of introducing bacteria into the urinary tract. Urinating before and after intercourse may also help flush out bacteria.

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5. Avoid irritating products: Certain feminine hygiene sprays, douches or scented products may irritate the urethra and increase the risk of UTIs. Opt for mild, unscented products instead. Also change nappies or incontinence pads promptly once soiled.

6. Wear breathable clothing: Tight-fitting clothing, especially synthetic materials, can create a warm and moist environment that encourages bacterial growth. Wear breathable cotton underwear to help keep the genital area dry.

7. Boost your immune system: A healthy immune system helps fight off infections. Maintain a balanced diet, exercise regularly and get adequate sleep to support your immune system.

8. Manage underlying conditions: Conditions like diabetes can increase the risk of UTIs. Properly managing underlying health conditions can help lower the risk of infections.

“Practising good hygiene, staying hydrated and following preventive measures can help reduce the risk of UTIs in both men and women,” she says. 

If you frequently experience UTIs or have specific risk factors, it’s advisable to consult with a healthcare professional who can provide personalised guidance and recommendations to help prevent recurrent UTIs.

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