Every year, hundreds of millions of people worldwide suffer from urinary tract infections (UTIs). Yet in Sub-Saharan Africa, most of them never receive a proper diagnosis. This is not because the disease is rare — it is because diagnosing it correctly is far more difficult than it seems.
What exactly is a UTI?
A urinary tract infection occurs when bacteria — most commonly Escherichia coli — enter and multiply in the urinary system, which includes the bladder, kidneys, ureters, and urethra. The infection can range from a mild bladder inflammation (cystitis) to a severe kidney infection (pyelonephritis) or even life-threatening blood poisoning (urosepsis).
UTIs are among the most common bacterial infections on the planet. According to a 2025 study published in Scientific Reports based on the Global Burden of Disease 2021 data, the number of UTI cases worldwide grew by over 66% between 1990 and 2021, reaching an estimated 4.49 billion cases globally.
Women are disproportionately affected due to anatomical factors, but men, children, elderly people, and immunocompromised patients are also highly vulnerable. In low- and middle-income countries, the burden falls heaviest on populations with the least access to healthcare.
Why is diagnosis so difficult in Africa?
The standard method for diagnosing a UTI involves urine culture: a laboratory test that identifies which bacteria are causing the infection and which antibiotics can effectively treat it. This test requires trained laboratory staff, sterile equipment, reliable electricity, temperature-controlled storage, and delivers results in 24 to 72 hours. In many healthcare facilities across Sub-Saharan Africa, these conditions simply do not exist.
As a result, most UTIs in the region are diagnosed clinically — based on symptoms alone — or with basic dipstick tests that detect the presence of white blood cells or nitrites in urine. These methods are fast and inexpensive, but they are also imprecise: they cannot identify the specific bacteria causing the infection, nor determine whether that bacteria is resistant to common antibiotics.
This gap has serious consequences. When clinicians cannot identify the exact pathogen, they must prescribe broad-spectrum antibiotics empirically — meaning they treat by best guess. This contributes directly to the rise of antimicrobial resistance (AMR), one of the gravest global health threats of our time.
Antimicrobial resistance: a crisis fuelled by diagnostic gaps
The World Health Organization (WHO) identified AMR as one of the top ten global public health threats in 2019. Its 2025 Global Antibiotic Resistance Surveillance Report — based on over 23 million bacteriologically confirmed cases from 110 countries — confirms that resistance to commonly used antibiotics continues to rise at alarming rates, particularly in low-resource settings.
For UTIs specifically, data published in 2024 in the JAC-Antimicrobial Resistance journal found that over 50% of bacteria isolated from UTI patients in East Africa were multidrug-resistant. Among Escherichia coli, the most common UTI pathogen, the multidrug-resistant proportion reached 52.2%. Among Staphylococcus species, it was 60.3%.
Without access to proper diagnostics, clinicians have no reliable way to know which antibiotic will work. Treatments fail. Patients return sicker. Resistance spreads further.
What UTI-Diag is doing about it
UTI-Diag is a European Union-funded research consortium bringing together 11 partners from Africa and Europe — including research institutions, universities, public health agencies, and clinical sites in Senegal, Cameroon, Tanzania, Uganda, and beyond — with a shared mission: to develop, validate, and implement innovative diagnostic tools adapted to Sub-Saharan African healthcare realities.
Rather than transplanting expensive laboratory technology from high-income countries, UTI-Diag focuses on point-of-care solutions — diagnostic tools that can be used at or near the patient, within the same consultation, without specialized infrastructure. These approaches aim to give clinicians accurate, actionable results in minutes, enabling targeted antibiotic prescription and reducing the unnecessary use of broad-spectrum drugs.
Field missions conducted in Senegal and Cameroon in November 2025 reinforced the urgency of this work: communities need tools that fit their context, not scaled-down versions of instruments designed for fully equipped laboratories.
Why this matters for everyone
AMR does not respect borders. Resistant bacteria that emerge in one country can spread across continents through travel, trade, and migration. The United Nations General Assembly’s 2024 Political Declaration on AMR set a target of reducing human deaths related to bacterial AMR by 10% by 2030.
According to the WHO, drug-resistant infections could claim 39 million lives by 2050 and impose an annual economic burden of up to USD 412 billion if urgent action is not taken. Improving UTI diagnostics in Africa is not merely a regional health challenge. It is a global imperative.
References
- He Y. et al. (2025). Epidemiological trends and predictions of urinary tract infections in the global burden of disease study 2021. Scientific Reports, 15, 4702. https://doi.org/10.1038/s41598-025-89240-5
- WHO (2025). Global Antibiotic Resistance Surveillance Report 2025. https://www.who.int/publications/i/item/9789240116337
- Maldonado-Barragán A. et al. (2024). Predominance of multidrug-resistant bacteria causing UTI in East Africa. JAC-Antimicrobial Resistance, 6(1). https://doi.org/10.1093/jacamr/dlae019
- WHO (2025). Global Call to Action to Address Antimicrobial Resistance. https://www.who.int/publications/m/item/global-call-to-action-to-address-antimicrobial-resistance
- UN General Assembly (2024). Political Declaration on Antimicrobial Resistance. United Nations, 79th Session.
Contact
UTI-Diag Communication
info@utidiag.org
www.utidiag.org
This project is funded by the European Union through Global Health EDCTP3 and by UK Research and Innovation (UKRI).