Factors Associated With the Nosocomial Infection of Surgical Wounds in the Maternity of Lubumbashi Public Hospitals in the Democratic Republic of the Congo

Abstract

Introduction: In Africa, up to 20% of women who have had a caesarean section contract a nosocomial infection of surgical wounds, compromising their health and ability to care for their children. In the DRC the field of hospital hygiene is of little interest to researchers, so it is difficult to analyze the problem when it is a thorny public health problem. Methods: We conducted a cross-sectional study whose study population consisted of women, whose delivery was associated with surgery, including a caesarean section or an episiotomy. The data collection was exhaustive and one nosocomial case of surgical wounds was defined according to the WHO definition. Associated factors were evaluated by the prevalence ratio at the significance level p ˂ 0.05. Results: We obtained 443 surgical cases; of which 253 were caesarean sections 57.1% and 190 or 42.9% were episiotomies and the prevalence of nosocomial surgical wound infections was 9.9%. The risk of developing a nosocomial surgical site infection was 6.8 times high at the Congo Railroad Hospital (SNCC) and 5.0 times at Jason Sendwe General Referral Hospital than at the Hospital. The GeneralReference Hospital (HGR) of Kenya and its association were statistically significant (p = 0.0022). A statistically significant difference was observed between the rate of nosocomial infections of surgical wounds and the age group of pregnancy between 32 to 34 WS, parturient who gave birth in this age group was 4 times at the risk of developing nosocomial infection surgical wounds. Long stay of more than 10 days (p=0.0010), delivery by caesarean section (p=0.0481), parturient carrying the indwelling catheter (p = 0.0162) and taking antibiotics were associated with the onset of nosocomial infection of surgical wounds. Conclusion: The factors associated with nosocomial infections of surgical wounds in maternity wards of public hospitals in Lubumbashi are related to the state of the structures, to the health care administered to clients. It is necessary to improve the hygiene conditions of the maternities, to train the personnel on the measures of hygiene and to apply a good policy of use of the antibacterial ones.