A Magnitude and Factors Associated With Post-Cesarean Surgical Site Infection at Hawassa University Teaching and Referral Hospital, Southern Ethiopia Cross-sectional Study

Abstract

BACKGROUND: Surgical site infection (SSI) after cesareansection (CS) increases maternal morbidity, hospital stay andmedical cost. However, in Ethiopia, limited evidence existsregarding the magnitude and risk factors of post-CS woundinfection. The purpose of this study was to determine theprevalence of – and factors associated with the problem amongmothers who gave birth in Hawassa University Teaching andReferral Hospital, Southern Ethiopia.METHODS: Hospital based cross-sectional study was conductedbased on the medical records of 592 women who underwent CSfrom June 2012 to May 2013. Data on the occurrence and factorsassociated with SSIs were extracted. Factors associated with SSIwere identified using multivariate logistic regression analysis. Theoutput of the analysis is presented using adjusted odds ratio (OR)with the corresponding 95% confidence interval (CI).RESULTS: The prevalence of SSI was 11.0% (95% CI: 8.6-13.8%).Mothers with prolonged labor (6.78, 95% CI: 2.54-18.00) andprolonged rupture of membrane (5.83, 95% CI: 2.14-15.89) hadsignificantly increased odds of SSI. Compared to mothers who hadno digital vaginal examination, those who had 1-4 and 5 or moreexaminations were at higher risk with OR of 2.91 (95% CI: 1.21-6.99) and 8.59 (95% CI: 1.74-42.23), respectively. Prolongedduration of surgery (12.32, 95% CI: 5.46-27.77), woundcontamination class III (9.61, 95% CI: 1.84-50.06) andpostoperative anemia (2.62, 95% CI: 1.21-5.69) were alsosignificant predictors. CS conducted by junior practitioners is likelyto be followed by infection.CONCLUSION: Post-CS SSI is relatively common in the hospital.Thus, it should be averted by implementing infection preventiontechniques.