Surgical site infection and its associated factors following cesarean section: a cross sectional study from a public hospital in Ethiopia

Abstract

BackgroundA cesarean section is a surgical procedure in which incisions are made through a woman's abdomen and uterus to deliver her baby. Surgical site infections are a common surgical complication among patients delivered with cesarean section. Further it caused to increase maternal morbidity, stay of hospital and the cost of treatment.MethodsHospital based cross-sectional study was conducted to assess the magnitude of surgical site infection following cesarean Site Infections and its associated factors at Lemlem Karl hospital July 1, 2013 to June 30, 2016. Retrospective card review was done on 384 women who gave birth via cesarean section at Lemlem Karl hospital from July 1, 2013 to June 30, 2016. Systematic sampling technique was used to select patient medical cards. The data were entered by Epi info version 7.2 then analyzed using Statistical Package for Social Sciences windows version 20. Both bivariate and multivariate logistic regression was done to test association between predictors and dependent variables. P value of < 0.05 was considered to declare the presence of statistically significantly association.ResultsAmong 384 women who performed cesarean section, the magnitude of surgical site infection following cesarean section Infection was 6.8%. The identified independent risk factors for surgical site infections were the duration of labor AOR=3.48; 95%CI (1.25, 9.68), rupture of membrane prior to cesarean section AOR=3.678; 95%CI (1.13, 11.96) and the abdominal midline incision (AOR=5.733; 95%CI (2.05, 16.00).ConclusionsThe magnitude of surgical site infection following cesarean section is low compare to other previous studies. The independent associated factors for surgical site infection after cesarean section in this study: Membranes rupture prior to cesarean section, duration of labor and sub umbilical abdominal incision. In addition to ensuring sterile environment and aseptic surgeries, use of WHO surgical safety checklist would appear to be a very important intervention to reduce surgical site infections.

Surgical site infection and pathogens in Ethiopia: a systematic review and meta-analysis

“…Among these, 705 disregarded due to qualitative study, abstracts, conference abstracts, and titles. Of 15 eligible studies, identified for SSI were 13 studies [14,15,[23][24][25][26][27][28][29][30][31][32][33] with 7786 study participants. Studies identified for pathogens were Five studies [15,25,28,34,35] with 629 subjects.…”

“…These five studies conducted on patients who already developed surgical site infections. Finally, this meta-analysis includes a total of 15 studies with 8418 subjects [14,15,[23][24][25][26][27][28][29][30][31][32][33][34][35] (Fig. 1).…”

“…Surgical site infection continues a global burden of infectious diseases. Particularly, it is common infectious diseases in resource-limited countries including Ethiopia [14,15].…”

“…Four regions and Addis Ababa, the capital city of Ethiopia was the settings studies found. Five in Southern Nation, Nationalities, and People Region (SNNPR) [29,30,[33][34][35], three in Addis Ababa [15,23,28], three in Amhara [24,26,27], two in Oromia [31,32], and two in Tigray region [14,25]. All included studies were done by using the cross-sectional study design ( Table 1).…”

“…In Ethiopia, different studies had conducted to find the prevalence of SSI and pathogens. The prevalence of SSI found in the range between 6.4 to 75.5% [14,15] in the Ethiopian setting. Hence, discrepancies between studies make difficult to represent the national prevalence.…”