INTRODUCTION:

“Adolescence is the time in life when girls quit believing in fairy tales and starts to believe in fairy tales and starts to believe in love.” C. S. Lewis, 1990

Today increasing emphasis is placed on health promotion, wellness, and self- care. Health is seen as resulting from a lifestyle that is oriented towards wellness. The result has been the evolution of a wide range of health promotion strategies, including life time health monitoring programmes, environmental health programmes, risk reduction and nutrition, and health education. Dissemination of health information is one of the ways of increasing knowledge on health and modification of behavior, which is directed towards promotion of health and prevention of disease.¹

Adolescence is a period is marked by the termination of childhood at one end and the beginning of adulthood at the other end. According to WHO the adolescent period is from 10- 19 years, the second decade of life. It is characterized by rapid change in physical, biological and hormonal changes resulting in to psychosocial, behavioral and sexual maturation. Healthy adolescents are needed to develop the healthy nation.²

The Urinary System (also called the excretory system) is the organ system that produces, stores, and eliminates urine. In humans it includes two kidneys, twoureters, the bladder and urethra. The female and male urinary system are very similar, the differ only in the length of the urethra. The kidneys are bean-shaped organs that lie in the abdomen retroperitoneal to the organs of digestion, around or just below the ribcage and close to the lumbar spine. The kidneys main role is to filter water soluble waste products from the blood. Other roles of kidneys are concentrating urine, regulating electrolytes and maintaining acid-base homeostasis. Humans produce about 2.9 liters of urine over 24 hours, although this amount may vary according to circumstances.

Because the rate of filtration at the kidney is proportional to the glomerular filtration rate, which is related to the blood flow through the kidney, changes in body fluid status can affect kidney function. Urinary tract infection is a general term referring to the infection anywhere in the urinary tract. It is generally accepted that infection of the upper urinary tract places in patient at risk for kidney damage.³

Acute uncomplicated UTI is more prevalent among adolescent girls and is the fourth main reason for out-patient visit among this group.

It is estimated that 150 million UTIs occur yearly on a global basis, resulting in more than six billion dollars in direct health care expenditures. The infection in the urinary tract will produce the signs and symptoms like, fever, dysuria, urgency and suprapubic pressure or discomfort, flank pain, chills, etc.⁴

In India, the National Family Health Survey 2000 reported the prevalence of urinary tract infection among adolescent girls (10-19 years) as 16.6 and the risk of bacteremia developing in adolescent girls as 5-10%. Common risk factors for adolescent UTI are poor hygiene, dysfunctional voiding patterns, use of synthetic underwear and panty hose, tight jeans, wet bathing suits, allergens/irritants, famine hygiene sprays, bubble baths, perfumed toilet paper, sanitary napkins and soaps may aid in the development of cystitis. Lack of adequate knowledge and practices related to maintenances of health leads to various genitourinary infections during adolescence. Thus, it is very essential to initiate health intervention measures for the prevention and control of UTI among adolescents.⁴

Infection of the Genito urinary tract is one of the most common condition of childhood. Up to 10% of children will have a febrile urinary tract infection during the first two years of life.

Adolescence is an important segment of our society with one fifth of them constituting the population. As per WHO (1986) defined adolescent as the period of transition from childhood to adulthood in the age range of 10-20 years. Thus it is the largest ever generation in human history. In India 21% of the total population comprises of adolescents. (National youth policy 2000). Adolescence is a stage between child hood and manhood / womanhood. Lack of adequate knowledge may lead to various genitourinary diseases among adolescent girls.⁵

This is a crucial period in the adolescent life because alteration in the physical and physiological functions takes place in the body. In this stage of their life the adolescents should take care of themselves in various aspects like personal hygiene, nutrition, exercise and periodic health check-ups⁶.

NEED FOR THE STUDY:

Urinary tract infection is predominantly a female disease. From infancy until age of 25 years the frequency of urinary tract infection in girls about 8% with 1/3^rd of these infections being asymptomatic. After an initial episode of bacteriuria, approximately 80% of adolescent girls have one or more recurrences; 8% of these recurrences are due to reinfections rather than relapses of sequestrated deep infections.5-6% of school girls have at least one episode of urinary tract infection between the age of 5 and 18 years, and 20% of school girls with bacteriuria have demonstrated vesico-urethral reflux that leads to urinary tract infection. Adolescent girls the incidence and prevalence of bacteriuria are related to age, dietary pattern, hygienic measures etc.⁶

Urinary tract infection is the second most commonly seen bacterial infection in the health care sector Each year, more than 8 million people are diagnosed with urinary tract infections. According to the National ambulatory medical survey, urinary tract infection accounted for nearly 7 million office visits and 1 million emergency room visits, resulting in 1,00,00 hospitalizations.⁷

Incidence of urinary tract infection globally include 34% of adult below 20yr and also 794 per 10,000 adults aged below 20 yrs have at least one occurrence of urinary tract infection.⁷ The prevalence of urinary tract infection globally include 1 in 5 women will develop urinary tract infections in their life time.34% of adults below 20 self reported having at least one occurrence of urinary tract infection.53.5% of adults aged 13-19 years who self reported having urinary tract infection.⁸

The incidence of urinary tract infection in India include, India is the second peak commonly occurring infection in adolescent girls. The prevalence of urinary tract infection in India includes, upto 8% of girls in India are getting urinary tract infection during adolescent period and the rates vary from 3-5% and up. In India the higher prevalence of urinary tract infection is in adolescent girls.⁹

The above research study showed the need of education regarding urinary tract infection among adolescent girls. The study is regarding the self-reported incidence and cost of urinary tract infection with the purpose to estimate the annual incidence cumulative probability of presumed urinary tract infection by age and the social costs. The method used in this study was analysis of a random digit dialing survey of 2000 women in the United States. The result of this study was about 10.8% of women aged below 18 and older reported at least one presumed urinary tract infection during the past 12 months. The conclusion of this study was if a vaccine were developed that would prevent either initial or recurrent urinary tract infection in all genders especially females of age group13-25years.¹⁰

The above research study showed the epidemiology of urinary tract infection incidence, morbidity and economic costs to obtain the incidence and morbidity due to urinary tract infection. The sample of this study was 100,000 hospitalized patients. The study results that women are significantly more likely to experience urinary tract infection often during adolescent and older age. Nearly 1 in 3 women will have had at least 1 episode of urinary tract infection requiring antimicrobial therapy by the age of 24 years. Almost half of all women will experience urinary tract infection during their lifetime. Urinary tract infections are the second most common form of infection, accounting for nearly 25 % of all infections. The result obtained from this study was in then on obstructed, non-pregnant female adult, acute uncomplicated urinary tract infection is believed to be a benign illness with no long-term medical consequences.¹¹

Various diagnostic measures of urinary tract infection include routine and culture examination, sensitivity testing, some imaging studies for example intravenous pyelogram, abdominal computerized tomography scan etc. once the causative organism has been diagnosed appropriate antimicrobial therapy which include antibiotics should be initiated. Prophylactic or suppressive antibiotics are sometimes administered to patients who experience repeated urinary tract infections.¹²

A cross-sectional study was carried out among 181 adolescent and preadolescent girls aged between 10-19 years in the rural district of karimnagar, AP on urinary tract infections among adolescents. A pre- designated, structured interview-based questionnaire was used which contained Questions related to puberty, hygiene and urinary tract infection. There was significant association between prevalence of UTI and improper perineal washing technique (CI=95%, P<0.001), malnutrition (CI=95%, P<0.001), presence of vaginal discharge (CI=95%, P<0.001) and use of sanitary pads during menses (CI=95% P<0.001).The researcher concluded that misconceptions included not taking bath during periods and not eating certain foods. Low socioeconomic status was chiefly responsible for frequent use of same piece of cloth as sanitary pads during menstrual bleeding leading urinary tract infection.¹³

Urinary tract infection is the second most commonly seen bacterial infection in the health care sector each year, more than 8 million people are diagnosed with urinary tract infections. According to the National ambulatory medical survey, urinary tract infection accounted for nearly 7 million office visits and 1 million emergency room visits, resulting in 1,00,00 hospitalizations.¹⁴

Bacterial infections of the lower urinary tract, bladder and urethra are very common, especially in adolescent girls. It is estimated that 5% to 6% of girls will have had at least one episode of bacteriuria between the time they enter first grade and graduate from high school. The recurrence rate is 50% or greater in girls. About 6-7 million young women see physicians for UTI, s each year.¹⁵

Adolescence, which literally means, “to grow into maturity”, is generally regarded as the psychologic, social, and maturational process initiated by the pubertal changes. Health promotion for this adolescent age group mainly consists of teaching and guidance to avoid risk-taking activities and health-damaging behaviors. Adolescent period provides an opportunity to incorporate healthy lifestyle behaviors that will benefit them not only during the teenage years, but also throughout the life span. The preventive measures for urinary tract infection among females especially among adolescent girls include maintaining good hygiene, proper emptying of bladder, maintain adequate fluid intake etc. Since the adolescent girls are more prone to get the infectious diseases like urinary tract infection due to poor personal hygiene, irregular bladder preventive measures adolescents are the best sample to do the study regarding the knowledge and preventive measures regarding urinary tract infection.¹⁶

The adolescent girls are going to become the matured adult women in future. If we are educating the adolescent girls regarding urinary tract infection that will help them to prevent the occurrence and they can educate the other members also. So the researcher got interest to select adolescent girls as the sample of this study.

STATEMENT OF PROBLEM:

A study to assess the effectiveness of structured teaching programme on knowledge regarding prevention of urinary tract infection among adolescent girls in selected high schools at Bangalore.

OBJECTIVE OF THE STUDY:

1. To assess the pretest knowledge regarding prevention of urinary tract infections among adolescent girls.

2. To evaluate the effectiveness of structured teaching programme on prevention of urinary tract infection among adolescent girls.

3. To find out the association between pretest knowledge score of adolescent girls and selected demographic variables.

OPERATIONAL DEFINITION OF TERMS:

· Assess: in this study, it refers to process of detecting the subjects’ knowledge in preventing urinary tract infection.

· Effectiveness: Refers to the extent to which structured teaching programme has achieved the desired result as evidenced from gain in knowledge score regarding prevention of urinary tract infection among adolescent girls.

· Structured teaching programme: Refers to systematically developed teaching programme designed for group teaching of 45-60 minutes using lecture cum discussion method with essential A.V.aids to impart knowledge regarding prevention of urinary tract infection among adolescent girls.

· Knowledge: Refers to the level of information regarding urinary tract infection among adolescent girls measured through the correct response to the test items in structured knowledge questionnaire regarding prevention of urinary tract infection and expressed in terms of scores.

· Prevention: Any action directed towards avoidance of getting urinary tract infection.

· Urinary tract infection: urinary tract infection is a non specific term used to describe acute infections involving the kidney, ureters, bladder and urethra.

· Adolescent girls: In the study adolescent girls refer to the girls between the age group of 13-16 in a selected school.

ASSUMPTIONS:

The study assumes that, Adolescent girls have inadequate knowledge regarding urinary tract infections and its prevention.

The structured teaching programme will improve the knowledge of adolescent girls on prevention of urinary tract infections.

HYPOTHESIS:

H1: There will be a significant difference in the mean pretest and posttest knowledge score regarding prevention of urinary tract infection among adolescent girls.

H2: There will be significant association between pretest knowledge level of adolescent girls and their selected demographic variables on prevention of urinary tract infection.

DELIMITATION:

· Only adolescent girls who are in the age between 13-16 years.

· Those who are willing to participate in the study.

· Those who are present at the time of study.

PROJECT OUTCOME:

· The study will increase in the knowledge on urinary tract infections and its prevention.

· The finding of the study will help to confirm the importance of teaching program regarding urinary tract infections and its prevention.

RESULTS:

This chapter deals with the analysis and the interpretation of the data collected in order to evaluate the effectiveness of structured teaching program regarding prevention of urinary tract infections among adolescent girls in selected school at Bangalore. The data collected were tabulated, analyzed and presented based on the objectives and the hypothesis by using descriptive and inferential statistics as follows.

The major objectives in the study were,

1. To assess the pretest knowledge regarding prevention of urinary tract infections among adolescent girls.

2. To evaluate the effectiveness of structured teaching programme on prevention of urinary tract infection among adolescent girls.

3. To find out the association between pretest knowledge score of adolescent girls and selected demographic variables.

The data obtained by organized in master sheet for tabulation. The analysis of the data is organized and presented under following sections.

Section I: Demographic characteristics of respondents.

Section II: Distribution of respondents based on the pre test and post test knowledge on prevention of urinary tract infections.

Section III: Association between knowledge levels and demographic variables on prevention of urinary tract infections

Section I: Analysis of sample characteristics are described in terms of age, religion, type of family, area of residency, position of the individual, family income, source of information etc.

Table: 1 Frequency and Percentage distribution of adolescent girls based on demographic variables n=60

S. No	Demographic Data	Frequency	Percentage
1	Age in years
	13-14	40	67%
	14-15	13	22%
	15-16	7	12%
2	Religion
	Hindu	52	87%
	Christian	8	13%
	Muslim	0	0%
3	Education
	8^th std	37	62%
	9^th std	8	13%
	10^th std	15	25%
4	Position of individual
	First born	37	62%
	Second born	12	20%
	Third born	11	18%
5	Type of family
	Nuclear	46	77%
	Joint	14	23%
6	Family income in rupees
	<5000	12	20%
	5000- 10000	30	50%
	15000- 20000	13	22%
	>20000	5	8%
7	Area of residency
	Urban	34	57%
	Rural	26	43%
8	Source of Information gained regarding urinary tract infection
	Mass medias	16	27%
	Mother	17	28%
	Other sources	27	45%

Table-1 shows the percentage distribution of respondents based on demographic variables,

· Based on the age group, out of 60 samples, majority of the samples 40(67%) were in the age group of 13-14 years, 13(22%) were in the age group of 14-15 years and 7(12%) were in the age group of 15-16 years.

· Based on the religion, out of 60 samples, majority of 52(87%) were Hindus and 8(13) were in Christians.

· Based on the Education, out of 60 samples, majority of 37(62%) were 8^th std, 8(13) were 9^th std and 15(25) were 10^th std.

· Based on the Position of individual, out of 60 samples majority of respondents 37 (62%) were first born, whereas 12 (20%) were second born and 11(18%) were third born.

· Based on the type of family, out of 60 samples majority of respondents 46 (77%) were nuclear family, whereas 14 (23%) were joint family.

· Based on the family income, out of 60 samples majority of respondents 30 (50%) were getting 5000-10000 rupees, 13 (22%) were getting 15000-20000 rupees and 12 (20%) were getting less than 5000 rupees and 5(8%) were getting more than 20000 rupees as their income.

· Based on the area of residency, out of 60 samples majority of respondents 34(57%) were from urban area and 26 (43%) were from rural area.

· Based on the Source of information gained regarding urinary tract infection, out of 60 samples majority of respondents 27(45%) came to know about urinary tract infection through other sources, 17 (28%) through mother and 16 (27%) through mass medias.

Section II: Distribution of Respondents Based on the Pre-Test and Post- Test Knowledge on urinary tract infection

Table: 2 Percentage distributions of respondent’s knowledge level regarding prevention of urinary tract infections among adolescent girls.

Knowledge score	Mean	S.D	Poor		Average		Good
Knowledge score	Mean	S.D	No. of adolescent girls (f)	%	No. of adolescent girls(f)	%	No. of adolescent girls (f)	%
Pre test	13.37	2.36	25	42%	35	58.%	0	0%
Post test	23.95	2.15	0	0%	12	20%	48	80%
Enhancement	10.58	0.2111	-	-	-	-	-	80%

The table-2 depicts that in pre test, 42% of the adolescent girls having poor knowledge, 58% are having average knowledge and 0% is having good knowledge regarding urinary tract infection. Similarly in post test 0% of the adolescent girls having poor knowledge, 20% are having average knowledge and 80% are having good knowledge. Therefore the enhancement of the good knowledge of the adolescent girls is 80%. poor knowledge decreasing in post test is 0% from 42%.

Table: 3 Paired ‘t’ test value between pre test and post test knowledge score

H01: There will be no significant difference in the mean pretest and posttest knowledge score regarding prevention of urinary tract infection among adolescent girls.

n= 60
Knowledge score	Maximum	Range	Mean	S.D	Paired 't'
Pre test	19	8 -19	13.37	2.36	32.15
Post test	28	20 -28	23.95	2.15	P<0.001 Highly significant

The data presented in the table-3 shows the overall mean of the post test knowledge score (23.95) is apparently higher than overall mean of pre test score (13.37). The mean difference is (10.58). The paired‘t’ value at df (59) obtained is 32.15 significant at 0.05 level. Therefore research hypothesis is accepted,and null hypothesis is rejected. Therefore the teaching programme is effective.

Section III: Association between the Pre Test and Post Test Mean Knowledge Scores with Selected Demographic variables.

Table: 4 Association between demographic variables and pre test knowledge scores regarding prevention of urinary tract infections among adolescent girls.

Demographic Variables	Category	Respondents knowledge						Total	χ2 value	Critical value
		Poor		Average		Good
		f	%	f	%	f	%
Age in years	13-14	1	3%	26	65%	13	33%	40	9.78*	χ2 4d.f, 5% los = 9.49
	14-15	2	15%	11	85%	0	0%	13
	15-16	0	0%	4	57%	3	43%	7
Religion	Hindu	3	5%	39	68%	15	26%	57	0.21	χ2 2d.f, 5% los = 5.99
Religion	Christian	0	0%	2	67%	1	33%	3	0.21	χ2 2d.f, 5% los = 5.99
Education	8^th std	2	5%	22	59%	13	35%	37	5.53	χ2 4d.f, 5% los = 9.49
	9^th std	0	0%	8	100%	0	0%	8
	10^th std	1	7%	11	73%	3	20%	15
Position of individual	First born	3	8%	29	78%	5	14%	37	19.21*	χ2 4d.f, 5% los = 9.49
	Second born	0	0%	3	25%	9	75%	12
	Third born	0	0%	9	82%	2	18%	11
Type of family	Nuclear	3	7%	30	65%	13	28%	46	7.23*	χ2 2d.f, 5% los = 5.99
Type of family	Joint	0	0%	11	79%	3	21%	14	7.23*	χ2 2d.f, 5% los = 5.99
Family income in rupees	<5000	0	0%	10	83%	2	17%	12	13.76*	χ2 6d.f, 5% los = 12.49
	5000- 10000	3	10%	19	63%	8	27%	30
	10000- 15000	0	0%	8	62%	5	38%	13
	>20000	0	0%	4	80%	1	20%	5
Area of residency	Urban	3	9%	21	62%	10	29%	34	3.01	χ2 2d.f, 5% los = 5.99
Area of residency	Rural	0	0%	20	77%	6	23%	26	3.01	χ2 2d.f, 5% los = 5.99
Source of information gained regarding urinary tract infection	Mass medias	0	0%	10	63%	6	38%	16	4.53	χ2 4d.f, 5% los = 9.49
	Mother	2	12%	10	59%	5	29%	17
	Other sources	1	4%	21	78%	5	19%	27

*Significant at 0.05 level of significance. n=60

H02: There will be no significant association between pretest knowledge level of adolescent girls and their selected demographic variables on prevention of urinary tract infection.

The table-4 depicts the demographic variables like age, type of family, family income versus knowledge level is significant and other demographic variables are not significant. Regarding age, the obtained χ2 value was 9.78 at df (4) it was significant at 0.05 level. This inferred that there is a significant association between knowledge and age. In order to find out the association between pre-test knowledge and religion, the obtained χ2 value was 0.21 at df (2) which was insignificant at 0.05 level. It shows that there is no association between knowledge and religion. In order to find out the association between pre-test knowledge and education status, the obtained χ2 value was 5.53 at df (4) which was insignificant at 0.05 level. It shows that there is no association between knowledge and education. In order to find out the association between pre-test knowledge and position of individual, the obtained χ2 value was 19.21 at df(4)) which was insignificant at 0.05 level. It shows that there is no association between knowledge and position of individual. Regarding type of family, the obtained χ2 value was 7.23 at df (2) which was significant at 0.05 level. It shows that there is association between knowledge and type of family. To find out the association between pre-test knowledge and family income, the obtained χ2 value was 13.76 at df (6) which was significant at 0.05 level. It shows that there is association between knowledge and family income. Regarding area of residency, the obtained χ2 value was 3.01 at df (2) which was insignificant at 0.05 level. It shows that there is no association between knowledge and area of residency. In order to find out the association between pre-test knowledge and source of information, the obtained χ2 value was 4.53 at df (4) which was insignificant at 0.05 level. It shows that there is no association between knowledge and source of information.

CONCLUSION:

The primary aim of the study was to find out the existing knowledge of school students regarding urinary tract infections, and to find out the association between socio demographic variables with knowledge regarding urinary tract infections.

The finding of the study:-

· Based on the age group, out of 60 samples, majority of the samples 40(67%) were in the age group of 13-14 years.

· Based on the religion, out of 60 samples, majority of 52(87%).

· Based on the Education, out of 60 samples, majority of 37(62%) were 8^th std. Based on the Position of individual, out of 60 samples majority of respondents 37 (62%) were first born.

· Based on the type of family, out of 60 samples majority of respondents 46 (77%) were nuclear family.

· Based on the family income, out of 60 samples majority of respondents 30 (50%) were getting 5000-10000 rupees.

· Based on the area of residency, out of 60 samples majority of respondents 34(57%) were from urban area. Based on the Source of information gained regarding urinary tract infection, out of 60 samples majority of respondents 27(45%) came to know about urinary tract infection through other sources.

· In pre test, 42% of the adolescent girls having inadequate knowledge, 58% are having moderate knowledge and 0% is having adequate knowledge regarding urinary tract infection. Similarly in post test 0% of the adolescent girls having inadequate knowledge, 20% are having moderate knowledge and 80% are having adequate knowledge. Therefore the enhancement of the adequate knowledge of the adolescent girls is 80%. Inadequate knowledge decreasing in post test is 0% from 42%. The overall mean of the post test knowledge score (23.95) is apparently higher than overall mean of pre test scores (13.37). The mean difference is (10.58). The paired‘t’ value at df (59) obtained is 32.15 significant at 0.05 level.

· The pretest- knowledge demographic variables like age, type of family, family income, source of information is significant and other demographic variables are not significant.

RECOMMENDED FOR FURTHER RESEARCH:

· It is suggested to do a comparative study with control group.

· A longitudinal study in the same aspect can be taken up with large samples.

· A teaching module can be developed to impart the knowledge on prevention and control of UTI.

· A survey can be done to determine the participation of nurses and health workers in conducting health education and awareness programme on different section of the population.

MAJOR FINDINGS OF THE STUDY:

· The analysis of knowledge scores reveals that 25 (42%) had inadequate knowledge and 35 (58%) had moderate knowledge and no one adequate knowledge in pre-test. In post -test 12 (20%) had moderate knowledge and 48 (80%) had adequate knowledge and no had inadequate knowledge.

· The paired ‘t’ value at df (59) obtained is 32.15 in the knowledge revealed that there is a gain in the knowledge of young adults after introducing STP at 0.05 level significance.

· In pre test the socio demographic variables like age, type of family, family income, source of information is significant and other demographic variables are not significant.

· The study findings showed that the adolescent girls have average level of knowledge regarding prevention and control of UTI. After administration of STP the knowledge has increased considerably.

REFERENCE:

1. Smeltzer C S, Brenda B: Textbook of Medical-Surgical Nursing, 10^th edition. Philadelphia; Lippincott Williams and Wilkins Publications; 2014.Page no 6, 320-1

2. Stammer W E, Hooton T.M: Management of urinary tract infection in adolescents. NEMG J med.2009; Page no 329, 1328.

3. David Wilson, Marilyn J, Hockenberry: Wong’s essentials of pediatric nursing, 8th edition, Noida, Elsevier publications; 2009; Page no: 950,951. Available from www.sciencedirect.com/science.

4. Kunin C.M: Detection, prevention, and management of urinary tract infection, 4th edition, Philadelphia: Leu and Febiger, 2017.

5. M.C Lachine, Meller ST, Vermin Jones: Urinary tract infection in school girls with covert bacteria. Arch Dischild; 2003; page no 50,523. Available from http://www.wrongdiagnosis.com/u/UTIsprevalence-types.htm.

6. Lower UTI: causes and incidence (professional guide to disease), 8^th edition, 2015. Available from http://www.wrongdiagnosis.com/u/UTIs/book-diseases.htm.

7. Foxman B, Barlow R, D’Arcy H, Gillespie B, Sobel J D: Urinary tract infection: Self- reported incidence and associated costs. J. Urol.2007 Jun: 157 (6); 2029-52.

8. Foxman B: Epidemiology of urinary tract infections: Incidence, morbidity and economic costs. J. Urol. 2009. Jan: 189(5): 1896-89.

9. Parul dutta: Pediatric nursing. 2^nd edition, New Delhi: jaypee publications; 2009. Page no: 365.

10. Horowitz M, Cochen I: Review of adolescent urinary tract infections. 2017 Jul: 8(4): 319-23.

11. Spahiv L, Hasbahta V.Most: Frequent causes of urinary tract infections in children. Med Arh. 2010: 64(2): 88-90.

12. Wok W Y, De Kwandstenient M C, Harmsen M, Van Sujilekom-Smit L W, Sxhellevis F G, Vander Wouden J C: Incidence rates and management of urinary tract infections among school children in Dutch general practice; results from a nation-wide registration study. BMC Pediatr. 2016; 4(6): 10.

13. Jha B K, Singh Y. I. Prevalence of asymptomatic bacteriuria in adolescent children in Pokhara Valley. Jha Pediatr. 2015; 692: 75-78.

14. Al-Hassan M N, Eckel-Passow J E, Baddoor L M.: Bacteremia complicating gram negative urinary tract infections: a population-based study. Acta Paediatr. 2010: 99(4): 581-4.E Pub 2010 Jan 5.

15. Rudaitis S, Pundizene B, Jievaltas M, and Uktyeris R, Kevelatis E.: Urinary tract infection in adolescent girls: do dynamic, behavioral and functional abnormalities play a role. Nephrol. 2019; 22(6): 766-73.

16. Takovgang I, Meli J, Fost SO, Angwafo F, Kamajev R, Ndumbe P.M. Hematuria and dysuria in the self diagnosis of urinary tract infection among school-children. Afr J Health Sci. 2014; 11(3-4): 121-7.

17. Gopal M, Northington G, Aryal. Clinical symptoms predictive of urinary tract infection Am J Obstet Gynecol. 2017; 197(1).

Received on 10.09.2025 Revised on 14.10.2025

Accepted on 15.11.2025 Published on 23.02.2026

Available online from February 25, 2026

Int. J. Nursing Education and Research. 2026;14(1):50-56.

DOI: 10.52711/2454-2660.2026.00011

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.