Determinants and Clinical Patterns of Recurrent Urinary Tract Infections Among Women in Primary Care Settings: A Cross-Sectional Study from Tripoli, Libya

Abstract

Recurrent urinary tract infections (rUTIs) are a common clinical and public health issue among women, associated with morbidity and frequent antibiotic use. Data from low- and middle-income settings remain limited. This study was conducted to assess the prevalence, clinical features, and predictors of rUTI among adult women in outpatient clinics in Tripoli, Libya. A retrospective cross-sectional study included 180 women with UTI symptoms (April–August 2025). Data were collected via structured questionnaires covering demographics, medical history, behavioral factors, recurrence, and treatment. rUTI was defined as ≥3 episodes within 12 months. Associations were tested using chi-square, and logistic regression identified independent predictors (p < 0.05). rUTI prevalence was 39.4%. Most participants were aged 25–34 years (34.4%) and married (57.2%). Dysuria (75.0%) and frequency (60.6%) were the most common symptoms. Antibiotics were prescribed in 86.7%, with 24.4% reporting no improvement. No significant associations were found between rUTI and age, menopausal status, diabetes, sexual activity, contraceptive use, water intake, or prior urinary conditions (all p > 0.05). Logistic regression showed no independent predictors (Nagelkerke R² = 0.038). rUTIs were highly prevalent, with no significant predictors identified. The findings highlight the complexity of recurrence and the need for improved diagnostic accuracy and more individualized management strategies.