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sinc e direct bladd er s ampling h as been o bserved to give l owe r
bact eriuric r at e s [73].
Des pit e the s e r e ported high pregnan c y bacteriur ia r a t e s ,
litt l e a t t e ntion has been paid t o puerpe r al urina ry t ract
i nfect i o ns i n Af rica a nd no s tud i e s on t he co ndition have be e n
f ou nd for r ev i e.... i n t h i s presentation. Froll west e r n s t udies,
we know t ha t bacteriuria i n p r e gn an cy is us ually carried
f orward int o the puerperium, so that puerperal bac t e r i u r i a
r a tes i n Africa c un be e xpected t o be high . The e xt e nt t o
which labou r also co ntri but es t o i ncrea s ing this a l r e ad y h i g h
pr ev a l e nc e is not kno wn. Also un kn own i s t he proportion of
pue rperal pyr exia which i s d ue to uri na r y t r a c t i nfection.
l8
The pre valenc e of pr ed i sposi ng factors tor urinary t ract
infection a re h i ghe r in Af rica t ha n i n the western world . I n
addition to t he contribut ory fac t or s noted in t he western
world , other pred i s po s i ng f actors also occur in Africa , a nd
many other t ropical c limates. Two not a b l e examples are urinary
schist osomiasis an d t he hemoglobinopathies Whic h
associa t e d with very h i gh r a t es of bac t eria l u r inary tract
i n f e c t i on [7 6 , 89 - 91 ) . The i ncidence o f acut e uri nary t rac t
infect i on , during pr e gn a nc y a nd the puerperi u m i n 78 sickle
cel l pr egnanc i e s reviewed i n I b ada n Ni geria, f o r e xamp-Le wo r e
36% and 19 \ r e spe ctively ( 91 ].
The oc cu r rence o f puerperal urinary t r ac t inf ecti ons is
a s soc i a ted wi t h the pue rp e r a l genital sepsis ( 69) . Unt r eated