Browsing by Author "Omara Samuel"

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    Incidence of post cesarean surgical site infection, and factors associated with wound severity patterns among women delivering in Mubende Regional Referral Hospital
    (Kampala International University, 2023-12) Omara Samuel
    Background: Post caesarean surgical site infection (PCSSI) is a significant major concern in maternal health, contributing to increased morbidity, mortality and high healthcare costs in Sub-Saharan Africa where Uganda is not exempted and this attributed to poor patient preventive and follow up measures in different setups. Therefore, this study aimed to investigate the incidence of PCSSI and explore factors associated with wound severity patterns among women who underwent caesarean delivery at Mubende Regional Referral Hospital. Methods: A prospective cohort study was conducted involving 204 participants who underwent caesarean section at the hospital. Participants' demographic, obstetrical, and interventional characteristics were recorded. The Southampton wound severity score was used to assess wound severity patterns and culture done on those who developed post-caesarean surgical site infections. Statistical analysis, including chi-square tests and relative risk calculations, were employed to identify significant associations. Results: The study revealed incidence rates of PCSSI was high at 16.18%. Wound severity pattern was assessed by the use of Southampton wound grading system; grade 0 (53.27%), grade 1 (10.05%), grade 2 (11.06%), grade 3 (9.05%), grade 4 (10.5%), and grade 5 (6.53%). Southampton wound grade 4 and 5 are the grades with wound severity pattern. Factors such as education level(aRR=1.85; p-value=0.002), income level(aRR=0.08; p-value=0.008), referral status(aRR=2.02; p-value<0.001), obstructed labor(aRR=2.97; p-value<0.001), prolonged labor(aRR=1.37; p-value=0.012), chorioamnionitis(aRR=2.73; p-value<0.001) PROM(aRR=2.05; p-value=0.003), preoperative antibiotics use(aRR=0.77; p-value<0.001) and WBC counts(aRR=17.7; p-value=0.004) were statistically significant and independently associated with wound severity patterns. Most predominant pathogen isolated was E. coli (42.42%), followed by K. Pneumoniae (36.36%) then S. aureus (21.21%). Conclusion: The incidence of Post caesarean surgical site infection at Mubende Regional Referral Hospital was high, Southampton wound score grade 4 and 5 were the wound severity pattern and identifies key factors influencing wound severity were education level, income level, referral status, obstructed labor, prolonged labor, Chorioamnionitis, PROM, preoperative use of antibiotics and raised white blood cell counts. The most common pathogen isolated from mothers who had developed severity pattern was E. coli followed by K. pneumoniae and S. aureus.