Post-caesarean surgical site infection: an incidence and associated determinants study at Kiryandongo General Hospital

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Kampala International University, School of Health Sciences
Prevalence of surgical site infections has risen with increased Caesarean section rates. Global estimates for post-CS SSIs range between 3 – 15% (highest rates in resource-poor countries) (Zuarez-Easton, Zafran, Garmi, & Salim, 2017). Surgical Site Infections (SSIs) cause significant morbidity among post-CS mothers. Many factors have been associated with post-CS SSIs although little data exist on the matter in Kiryandongo. Therefore, the study was about the prevalence, factors and outcomes of Post-Caesarean Section Surgical Site Infections at Kiryandongo General Hospital. A descriptive cross sectional study was used which involved record and surgical notes review of 320 women delivered through caesarean section. 40 (12.5%) of the women developed surgical site infections. Strong significance was seen in rural residence, Chorioamnionitis, emergency CS and DM/prediabetes and post-CS SSIs. Other factors were obesity, smoking, HIV/AIDS coinfection, nulliparity and unsatisfactory prenatal care. Singleton pregnancy was also significant while corticosteroid use and hypertension had no significance. Bacteraemia/sepsis and wound dehiscence were the main complications seen. The prevalence of post-caesarean section surgical site infection in Kiryandongo General Hospital was 12.5%, a value high enough to warrant urgent intervention. Risk factors for post-caesarean surgical site infections were rural residence, Chorioamnionitis, DM/pre-diabetes, extremes of maternal age, obesity, tobacco use, HIV/AIDS coinfection, nulliparity, unsatisfactory prenatal care and emergency caesarean sections. Corticosteroid use and hypertension were not significant whereas singleton (rather than twin) gestation was found to be significant. Prolonged post-op hospital stay with rise in cost of care were the outcomes necessitated by complications that mainly included bacteraemia/sepsis and wound dehiscence
A research report submitted to the Faculty of Clinical Medicine and Dentistry in partial fulfillment of the requirements for the award of a degree of Bachelor of Medicine and Surgery of Kampala International University
Surgical Site Infection, Caesarean Section, Post-caesarean surgical site infection, Kiryandongo General Hospital