Determinants of Puerperal Sepsis among Postpartum Women Admitted to Public and Private Hospitals in Dire Dawa City Administration, Eastern Ethiopia: Unmatched Case- Control Study

Abstract

Introduction: Puerperal sepsis is an infection of the genital tract occurring at any time from 2 to 42 days of puerperium. Maternal sepsis was responsible for 10.7% of the 295,000 maternal deaths worldwide. Various efforts are undertaken, but its burden remains as the third cause of maternal mortality in developing countries, including Ethiopia. However, there is a scarcity of data on determinants of puerperal sepsis in Ethiopia generally and not in the study area particularly. Objective: This study aimed to assess determinants of puerperal sepsis among postpartum women admitted to public and private hospitals in Dire Dawa city administration from September to October 2022. Methodology: A hospital-based unmatched-case control study was used among 600 postpartum women (150 cases and 450 controls). Cases (postpartum women with puerperal sepsis) and controls (postpartum women without puerperal sepsis) were selected by a systematic sampling technique. Data was collected using an interviewer-guided structured questionnaire and medical record review. The data was entered and cleaned by EPI DATA (Version 3.1) and analyzed using SPSS (Version 22) software. Bivariate and multivariate logistic regression, as well as odds ratios with 95% confidence intervals, were used to examine the effect of each independent variable on the outcome variable, and a P-value of 0.20 for transferring to multivariable analysis and a P-value of 0.05 for multivariable analysis were considered statistically significant. Results: The determinants of puerperal sepsis were housewives (AOR = 2.24, 95% CI: 1.13-4.45), merchants (AOR = 2.98, 95% CI: 1.47-6.03), rural residence (AOR = 3.97, 95% CI: 2.34-6.74), home deliveries (AOR = 2.61, 95% CI: 1.02-6.70), cesarean deliveries (AOR = 2.40, 95% CI: 1.43-3.99), vaginal examinations (AOR = 3.50, 95% CI: 1.50-8.20), and prolonged rupture of membranes (AOR=1.91, 95%CI: 1.02-3.60) Conclusion and recommendation: The majority of determinants of puerperal sepsis were related to obstetrics, along with occupation and residence. As a result, interventions involving coordinated and combined efforts to improve institutional delivery and use standard procedures during the labor and delivery process might take these factors into account.

Determinants of puerperal sepsis among postpartum women: a case–control study in East Shoa Zone public hospitals, Central Ethiopia

“…Puerperal sepsis is genital tract infections occurring at any time between the rupture of membranes or labour and the 42 day post partum in which two or more of the following are present: pelvic pains, fever (ie, oral temperature 38.5°C or higher on any occasion), abnormal vaginal discharge (example pus), abnormal smell or foul odour of discharge, delay in the rate of involution of the uterus (less than 2 cm per day during the first 8 days). 22 Figure 1 Schematic presentation of sampling procedure for the determinants of puerperal sepsis (PS) among study participants at public hospitals in East Shoa, Ethiopia, 2023. Based on the number of postpartum women each hospital managed in the preceding 2 months, proportionate allocations were made to each hospital.…”