RAPID SCREENING OF ASYMPTOMATIC BACTERIURIA IN PREGNANCY : COST-EFFECTIVE ANALYSIS.

Objective: To assess the cost-effectiveness of rapid screening tests for detecting asymptomatic bacteriuria in pregnancy. Patients and Method: This study was conducted among the apparently healthy pregnant mothers attending for their routine antenatal care at the Antenatal Clinic of Rajshahi Medical Collage Hospital Rajshahi, Bangladesh. A total of 600 apparently healthy pregnant mothers were selected by random sampling. Data were processed using SPSS for windows. Receiver Operative Characteristic (ROC) curve was applied to assess the effectiveness of the screening tests to identify the asymptomatic bacteriuria. Cost-effectiveness of each of the screening tests was determined by calculating the incremental patient cost of obtaining an additional asymptomatic bacteriuric mother. Results: The prevalence of asymptomatic bacteriuria was 4%. Staphylococcus saphrophyticus was the commonest causative agent (41%). Leukocyte count / HPF by routine microscopic urine examination, which is the common practice to detect asymptomatic bacteriuria in pregnancy during antenatal care in Bangladesh, efficiently detect the healthy mothers as healthy but fail to detect asymptomatic bacteriuric mothers as bacteriuric in majority of cases. Bacteria count / OIF in Gram stained smear of uncentrifuged urine is the most cost-effective screening test for detecting asymptomatic bacteriuria in pregnancy. Discussion and Conclusion: Bacteria count in gram stained smear of uncentrifuged urine may be integrated during the routine antenatal check up as the screening approach for detecting asmptomatic bacteriuric mothers in Bangladesh. [ABSTRACT FROM AUTHOR]