Factors and Causes of Puerperal Sepsis in Kilimanjaro, Tanzania: A Descriptive Study among Postnatal Women who Attended Kilimanjaro Christian Medical Centre

Abstract

Background: Puerperal sepsis is the major cause of maternal morbidity and mortality worldwide. About 94% of maternal mortality occur in low and middle-income countries including Tanzania. Objective: To estimate the prevalence, document factors and causes of puerperal sepsis among postnatal women who attended postnatal care in Kilimanjaro Christian Medical Centre Hospital in the year 2015. Methodology: A descriptive cross-sectional study was carried out at Kilimanjaro Christian Medical Centre, Tanzania. A total of 183 medical records of attendance in 2015 were used for the study. Information about the isolated organism in culture was retrieved from the Laboratory Information System. Results: The prevalence of puerperal sepsis was 11.5% (21/183). The most common factors and causes of puerperal sepsis included caesarean section 66.7% (14/21), postpartum haemorrhage 57.1% (12/21), moderate to severe anaemia 61.9% (13/21), prolonged labour 76.2% (16/21) and bacterial infection 90.5% (19/21). The difference was significant at p<.05. The most bacteria species isolated among women with puerperal sepsis was Staphylococcus spp 50.0% (7/14), Escherichia 28.6% (4/14) and Streptococcus spp 21.4% (3/14). Conclusion: Puerperal sepsis is prevalent (11.5%) at Kilimanjaro Christian Medical Centre. Staphylococcus spp was found to be a predominant isolate which causes puerperal sepsis followed by E. coli and Streptococcus spp.

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

“…Postpartum women who gave birth via cesarean section were almost two times more likely to develop puerperal sepsis compared to those delivered through instrumental and spontaneous vaginal delivery (SVD) (AOR = 2.40; 95%CI: 1.43-3.99). This was consistent with ndings from Scotland (32), Uganda (5), Kenya (41), Tanzania (45) and Ethiopia (33) studies. Besides, a study in northern Nigeria identi ed caesarean section (C/S) (with OR = 4.99) as a risk factor for puerperal sepsis (42).…”

Incidence and Determinants of Maternal Sepsis in Ghana in the midst of a pandemic

“…Therefore, health professionals should pay more attention to women who have prior CS wound during antenatal visits. This is consistent with previous studies that found a higher risk of maternal sepsis among women with a history of CS (Kajeguka et al, 2020;Muhumuza et al, 2020). On the other hand, a similar study found a lower odds of maternal sepsis associated with CS among Ethiopian women as compared to spontaneous vaginal delivery (Atlaw & Seyoum, 2019).…”

“…The risk was ve folds compared to women without a history of bacterial infections. Similar observations were made in Tanzania, which reported a signi cant association between bacterial infections and puerperal sepsis (Kajeguka et al, 2020). This outlines the need to effectively monitor the cardinal signs and symptoms in pregnancy, through childbirth, and during the postpartum period.…”

Health care workers’ level of adherence to infection prevention and control and its impact on puerperal and neonatal sepsis among delivering women and neonates in Central Tanzania: A protocol for prospective cohort study

“…Evidence is available from previous studies to indicate that exposure to practices of HCWs' that do not adhere to principles of IPC can lead to puerperal sepsis or neonatal sepsis [4,10,24,25]. Nevertheless, puerperal sepsis and neonatal sepsis are stand still problems in the Sub Saharan Africa that take countless lives of maternal women and neonates [2].…”

“…Such situations include inadequate compliance with IPC standards during cesarean section [9]. Others include poor personal hygiene, rural residence, lack of proper equipment sterilization, postpartum hemorrhage, anemia, prolonged labor and bacterial infection to be directly associated with puerperal sepsis [10][11][12]. In addition, inadequate training on IPC and stock out of basic consumables and equipment's such as surgical gloves and elbow tap, have shown to contribute to poor adherence to IPC standards and increase the risk of infection to mothers and their newborns especially in the sub-Saharan Africa [13].…”