By Joyce Ojanji
The increasing resistance to antibiotics is making it more challenging to treat urinary tract infections (UTIs) in Malawi. Recent studies show that almost half of the women who came to a key referral hospital with UTI symptoms were found to have infections that resisted multiple medications.
The study , carried out by investigators from Mzuzu University and released in the National Library of Medicine , discovered a UTI prevalence of 48.5 percent among women evaluated at Malawi’s Zomba Central Hospital.
"The data indicates a broader public health issue that goes further than anticipated physiological vulnerability during pregnancy," stated Pizga Kumwenda, who led the study and is a senior lecturer of microbiology and immunology at Mzuzu University.
'It suggests larger societal, behavioral, or systematic problems like inadequate sanitation, restricted medical services, or excessive antibiotic use without appropriate diagnosis.'
Kumwenda states that this number is significantly above the worldwide and regional average, which usually ranges from 14-30 percent for expectant mothers.
UTIs are one of the most prevalent infections affecting women worldwide, with approximately 150 million occurrences reported annually.
However, in Malawi and other Sub-Saharan African nations, treating infections has become progressively challenging because of the rampant issue of antimicrobial resistance (AMR).
The research indicates that initial treatment antibiotics like ampicillin and ceftriaxone exhibited concerning levels of drug resistance—87 percent and 77 percent, respectively.
Of particular concern was the rise of multidrug-resistant strains like Serratia marcescens , demonstrating full resilience against multiple antibiotics and exhibiting only limited responsiveness to critical medications such as meropenem and amikacin.
It demonstrated complete resistance to multiple antibiotics. "Drugs typically regarded as last resorts, like meropenem and amikacin, exhibited merely moderate efficacy, serving as an alert for potential challenges in treatment ahead," he stated.
Kumwenda indicates that these discoveries highlight a significant risk to treatment efficacy, particularly as backup antibiotics are also losing effectiveness.
In the retrospective analysis of 340 patient files, researchers concentrated on females between 15 and 45 years old, representing more than fifty percent of urinary tract infection occurrences.
The significant prevalence within this age group of reproductive-aged individuals, combined with increased levels of antibiotic resistance, underscores the necessity for more precise diagnostic procedures and treatment protocols. The researchers argue that we must reconsider our approach to managing UTIs in these patients.
"This encompasses integrating hygiene and sexual health education, assessing contraception usage, and enhancing screenings during prenatal and reproductive health check-ups," they further explain.
Malawi is already facing a significant AMR challenge. The Malawi-Liverpool Wellcome Programme estimates That 27.3 out of every 100,000 individuals in the area experience fatalities due to antibiotic resistance. According to national statistics, as many as 15,700 deaths in Malawi may be associated with infections resistant to drugs.
Victor Mithi, who leads the Society of Medical Doctors in Malawi, states that self-medication is a major contributor to drug resistance within the nation.
"Many patients in Malawi can simply enter a pharmacy and purchase antibiotics over-the-counter without a prescription. Consequently, they tend to use these medications improperly, which leads to a growing concern regarding antibiotic resistance," he explained further.
Mithi warned that failing to treat or inadequately managing urinary tract infections (UTIs) might lead to severe complications like sepsis, especially among young women. To tackle this issue, strict regulations should be implemented regarding the sale of antibiotics only with prescriptions.
"At the regulatory level, I believe we should enhance the measures requiring individuals to possess a valid prescription when they visit any type of pharmacy to obtain prescribed medications," he states.