Asymptomatic bacteriuria in pregnant mothers: A valid and cost-effective screening test in Bangladesh

Abstract

In Bangladesh, a number of screening tests for asymptomatic bacteriuria in pregnancy are in practice. The objective of this study was to assess the validity and cost-effectiveness of these screening tests. A total of 600 apparently healthy pregnant mothers were included in this study. The validity of the screening tests was calculated against the urine culture as ‘gold standard’. Incremental cost-effective ratio between the screening test methods and the least costly method (microscopic urine analysis) was calculated. Bacterial count/oil-immersion field in Gram-stained smear of urine was the most sensitive (91.7%) and specific (97.2%). Incremental cost per additional positive cases of bacterial count, leukocyte esterase and combination of leukocyte esterase and nitrite were US$3, US$25 and US$23, respectively. Gram staining may be the alternative approach to traditional routine urinalysis for the screening of asymptomatic bacteriuria during pregnancy in clinical practice in Bangladesh, as well as other developing countries.

Keywords::

• Asymptomatic bacteriuria in pregnancy
• Bangladesh
• cost-effective screening test
• validity

Acknowledgements

We would like to express our gratitude to Bangladesh Medical Research Council authority for sponsoring this study.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.