Claudette Mukamana, 30, is six months pregnant. She waits for the doctor patiently at Dr. Kanimba Hospital in Kigali. It is clear Mukamana is very worried and I make it a point to find out why.

"I have miscarried twice previously and I have never really understood why. On both occasions, I experienced symptoms such as lower abdominal pains and frequent urination but never sought medical attention because I thought it was normal for expectant women to feel that way,” she narrated, adding that she later learnt that she had a urinary tract infection (UTI).

That bitter experience taught Mukamana to be more serious with her life by visiting the hospital more regularly.

"Since I conceived for the third time, I have been making various trips to the hospital, just to make sure it doesn’t happen again,” Mukamana says.

Mukamana is just one of many women who have UTIs. Dr John Muganda, a gynecologist at Dr Kanimba Hospital, explains that although UTIs affect everyone, they are more common in women.

"Out of 20 patients I attend to daily, 40 percent of them have UTI problems - the main cause is bacterial infection.

Women are more exposed to them because they have shorter urethra than men. This makes it easier for the bacteria to enter inside the bladder and survive,” says Muganda.

What’s UTI?

Dr Rachna Pande, a specialist in internal medicine at Ruhengeri Hospital, says UTI is an infection of the kidney, ureters or urinary bladder (body parts involved in preparation and expulsion of urine). It’s more common in women because of the shortness of the urethra (the tube connecting the bladder to the exterior) which makes it easy for germs to ascend and infect urinary organs.

"Passage of blood during menstruation makes a woman more susceptible to UTI because blood provides rich medium for the microbes to grow,” says Pande.

How to manage it

Bacterial infection is the main cause of UTI.

"UTI is caused by a bacterium known as Escherichia coli (E.coli). It’s also due to sexually transmitted infections; poor perineal hygiene also augments the risks of developing UTI,”Pande says.

She adds that in young men, UTI is caused mainly due to STDs, while in elderly men, it’s common because of enlarged prostate since large prostate presses on the urinary bladder, preventing incomplete evacuation, and the retained residual urine becomes a source of infection.

Muganda explains that those with other diseases such as diabetes and HIV infection are most likely to contract UTI.

"Because of their weak immune system, sometimes their body may not be able to fight against all the germs hence increasing the chances of developing UTI.

Symptoms such as urgency of urination, burning pain during passing urine, lower abdominal pain and back pains and sense of incomplete evacuation are clear signs of UTI.

"It’s very hard to recognize these signs especially when pregnant since most people mistake them for the pregnancy ones,” he explains.

"When they come for their checkups, after a blood test, when I realize that they may be having infections, I quickly give them the right medication, just to avoid further complications and also to save the life of the unborn, because prevention should come first before cure,” he explains.

How to go about it

According to Dr Iba Mayele of Dr Plaza at Kimironko, prevention depends on one’s hygiene. "One should drink a lot of water in order to avoid constipation. Always empty your bladder after sexual intercourse and avoid tight under garments which can result into transpiration because in the long run it creates a conducive environment for the bacteria to develop,” says Mayele.

Treatment is by taking full course of sustainable antibiotics.

"First, we have to determine which kind of bacteria is involved and symptoms, like lower back pain, pain when urinating and so on. We then choose an antibiotic depending on the bacteria that has caused the infection,” Mayele explains.

"Constipation also increases the chances of contracting UTI because when the food is not digested well, it’s forced to remain in the bowel for a long time which increases the multiplication of the bacteria in the bowel. The bacteria then easily moves to the urethra causing UTIs,” he says.

He advises that one should eat plenty of vegetables and greens in order to manage UTI. Also, avoid sex with multiple partners.

Untreated UTI can lead to chronic kidney failure; sepsis is yet another risk with persistent UTI.