Urinary Tract Infection: Prevalence, Malaria Co-Infection and Significance for Febrile Under-Fives in Jos North, Nigeria

Abstract

Background: Urinary tract infections (UTI) are common causes of fever in children frequently misdiagnosed in malaria-endemic, resource-poor regions. Objectives: This study assessed the prevalence of UTI, and UTI-malaria co-infection, and associated factors, among febrile children aged 2 to 59 months in Jos North, Plateau state, Nigeria. Materials and methods: This was a cross-sectional study of 247 children presenting with fever to healthcare facilities in Jos north. Participants' data were collected using a semi-structured questionnaire. Diagnosis of UTI was based on urine culture while malaria detection utilized rapid diagnostic tests. Results: The prevalence of UTI was 18.2% and the most common pathogens were Escherichia coli (62.2%) and Klebsiella species (22.2%). UTI-malaria co-infection occurred in 4.5% of the participants, accounting for 24.4% of the UTI cases. Significant associations were found between the occurrence of UTI, female gender and predominant breastfeeding type. UTI occurred more frequently than malaria as an isolated cause of fever (13.8% vs 4.9%). Conclusion: This study indicates a substantial burden of UTI among febrile under-five children, which may go unrecognized in favour of malaria diagnosis. Gender differences inform implications for diagnostic focus and healthcare practices. Breastfeeding appeared protective against UTI, and co-infection with malaria highlights the need for comprehensive febrile illness management to prevent potential complications.