Determinants of puerperal sepsis among postpartum women at public hospitals of Hawassa city, Southern Ethiopia: Institution-based unmatched case-control study

Tesfaye, Talelign; Samuel, Serawit; Lera, Temesgen

doi:10.1016/j.heliyon.2023.e14809

Cited by 7 publications

(6 citation statements)

References 15 publications

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“…The current study revealed that the odds of developing puerperal sepsis were 5 folds greater among postpartum women who gave birth by cesarean delivery compared to those who delivered by spontaneous vaginal delivery. This result is comparable with different studies from the Oromia region, Ethiopia [ 16 ], Tigray region, Ethiopia [ 17 ], Hawassa City, Ethiopia [ 18 ], Northwest, Ethiopia [ 19 ], Gondar University referral hospital, Ethiopia [ 20 ], a systematic review and meta-analysis of seven studies in Ethiopia [ 3 ]. Studies done in Nigeria [ 31 ], Kenya [ 32 ],Tanzania [ 33 ], India [ 34 ], Germany [ 35 ], Scotland [ 36 ], Ireland [ 37 ] and systematic review and meta-analysis of six studies [ 38 ] also indicated a comparable finding.…”

Section: Discussionsupporting

confidence: 88%

Determinants of puerperal sepsis among postpartum women at a tertiary care hospital in Ethiopia: an unmatched case-control study

Seboka,

Gurara,

Bekele

et al. 2024

Contracept Reprod Med

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Background Puerperal sepsis, is a significant factor in maternal morbidity and mortality, especially in regions with lower income levels where maternal mortality rates are highest. However, it can be largely avoided if detected in time. Recognizing and dealing with the root causes early is essential in addressing this problem. Therefore, this study aimed to identify the determinants of puerperal sepsis among postpartum women at a tertiary care hospital in Ethiopia. Methods An institutional-based unmatched case-control study was conducted among 266 postpartum women (88 cases and 178 controls) from October 1, 2023 to November 30, 2023. For each case, two controls were chosen using a systematic random sampling approach. Data were collected using an interviewer-administered, structured questionnaire and medical record review. The collected data were entered into Epi Info version 7.2 and analyzed using SPSS version 27. Binary logistic regression analysis was used to model the association between puerperal sepsis and independent variables. variables that had a crude association in the bivariable analysis (p < 0.25) were entered and analyzed by a multivariable binary logistic regression model to identify statistically significant factors. In the final model, Adjusted odds ratios with their 95% confidence intervals were calculated to determine the strength of the association. Statistical significance was declared at p < 0.05. Result Rural residence (AOR = 6.9; 95% CI:2.77–17.10), having no formal education (AOR = 3.8; 95% CI: 2.55, 10.76), cesarean section delivery (AOR: 5.1; 95% CI: 1.30, 11.00) and complication during pregnancy (AOR: 4.6, 95% CI: 1.96, 11.10) were independent determinants of puerperal sepsis. Conclusion Place of residence, maternal education level, mode of delivery, and complication during pregnancy were determinants of puerperal sepsis. It is crucial to implement education and awareness initiatives aimed at mothers, ensure universal access to healthcare services, advocate for evidence-based delivery protocols, and conduct comprehensive antenatal screenings.

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Section: Discussionsupporting

confidence: 88%

Determinants of puerperal sepsis among postpartum women at a tertiary care hospital in Ethiopia: an unmatched case-control study

Seboka,

Gurara,

Bekele

et al. 2024

Contracept Reprod Med

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“…Similarly, one study in Nigeria found an association among PROM, prolonged labor, and poor maternal health outcomes, including an increased risk of puerperal sepsis, which presented with postnatal fever in 90.5% of the women [ 30 ]. Another study in Ethiopia found that those who experienced prolonged labor were three times more likely to develop puerperal sepsis, which was similar to the rate of fevers in this study [ 31 ].…”

Section: Discussionsupporting

confidence: 86%

Prevalence of Maternal Fever and Associated Factors among Postnatal Women at Kawempe National Referral Hospital, Uganda: A Preliminary Study

Ainebyona,

Ayebare,

Nabisere

et al. 2024

IJERPH

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Fever is one of the most important signs of infection and can provide useful information for further assessment, diagnosis, and management. Early detection of postnatal fever could reduce severe outcomes, such as maternal mortality due to puerperal sepsis. The purpose of this cross-sectional study was to determine the prevalence of and associated factors of postnatal fever among postnatal women at Kawempe National Referral Hospital. Three hundred postnatal women were recruited. Temperature measurements were conducted and a 29-item questionnaire was completed along with the extraction of health history from the medical records of the participants. The prevalence of maternal fever was 58/300 (19.3%). Multivariable analysis indicated that only four factors—HIV-positive status (AOR = 2.56; 95% CI = 1.02–6.37), labor complications (AOR = 6.53; 95% CI = 2.40–17.71), prolonged labor (AOR = 3.12; 95% CI = 1.11–8.87), and more than 24 h spent in postnatal care (AOR = 5.16; 95% CI = 2.19–12.16)—were found to be significantly associated with postnatal fever. The prevalence of postnatal maternal fever among postnatal women at Kawempe National Referral Hospital was higher than that in other reports in the literature. The factors significantly associated with maternal fever were HIV-positive status, complications during labor, prolonged labor, and more than 24 h spent in postnatal care. Health workers involved in the provision of labor and obstetric services must follow guidelines to assess fever and manage the underlying conditions causing it.

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“…The relatively high number of included studies for neonatal sepsis is a strength. The number of articles included was small for maternal sepsis ( 7 ), which may limit the generalizability of the results. Most of the studies were cross-sectional, which could be a limitation.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis

Traoré,

Sidibé,

Diallo

et al. 2024

Front. Public Health

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ObjectivesThis study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa.MethodsThis systematic review and meta-analysis used the PRISMA guideline on sepsis data in sub-Saharan Africa. The bibliographic search was carried out on the following databases: Medline/PubMed, Cochrane Library, African Index Medicus, and Google Scholar. Additionally, the reference lists of the included studies were screened for potentially relevant studies. The last search was conducted on 15 October 2022. The Joanna Briggs Institute quality assessment checklist was applied for critical appraisal. Estimates of the prevalence of maternal and neonatal sepsis were pooled using a random-effects meta-analysis model. Heterogeneity between studies was estimated using the Q statistic and the I2 statistic. The funnel plot and Egger’s regression test were used to assess the publication bias.ResultsA total of 39 studies were included in our review: 32 studies on neonatal sepsis and 7 studies on maternal sepsis. The overall pooled prevalence of maternal and neonatal sepsis in Sub-Saharan Africa was 19.21% (95% CI, 11.46–26.97) and 36.02% (CI: 26.68–45.36), respectively. The meta-analyses revealed that Apgar score < 7 (OR: 2.4, 95% CI: 1.6–3.5), meconium in the amniotic fluid (OR: 2.9, 95% CI: 1.8–4.5), prolonged rupture of membranes >12 h (OR: 2.8, 95% CI: 1.9–4.1), male sex (OR: 1.2, 95% CI: 1.1–1.4), intrapartum fever (OR: 2.4, 95% CI: 1.5–3.7), and history of urinary tract infection in the mother (OR: 2.7, 95% CI: 1.4–5.2) are factors associated with neonatal sepsis. Rural residence (OR: 2.3, 95% CI: 1.01–10.9), parity (OR: 0.5, 95% CI: 0.3–0.7), prolonged labor (OR: 3.4, 95% CI: 1.6–6.9), and multiple digital vaginal examinations (OR: 4.4, 95% CI: 1.3–14.3) were significantly associated with maternal sepsis.ConclusionThe prevalence of maternal and neonatal sepsis was high in sub-Saharan Africa. Multiple factors associated with neonatal and maternal sepsis were identified. These factors could help in the prevention and development of strategies to combat maternal and neonatal sepsis. Given the high risk of bias and high heterogeneity, further high-quality research is needed in the sub-Saharan African context, including a meta-analysis of individual data.Systematic review registration: PROSPERO (ID: CRD42022382050).

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Determinants of puerperal sepsis among postpartum women at public hospitals of Hawassa city, Southern Ethiopia: Institution-based unmatched case-control study

Cited by 7 publications

References 15 publications

Determinants of puerperal sepsis among postpartum women at a tertiary care hospital in Ethiopia: an unmatched case-control study

Determinants of puerperal sepsis among postpartum women at a tertiary care hospital in Ethiopia: an unmatched case-control study

Prevalence of Maternal Fever and Associated Factors among Postnatal Women at Kawempe National Referral Hospital, Uganda: A Preliminary Study

Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis

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