Factors Influencing Prevalence of Surgical Site Infections among Mothers Undergoing Ceaserean Section in Iganga Hospital, Uganda

Abstract

Caesarean Section as a mode of delivery is the most commonly done surgical procedure in maternity departments all over the world. Surgical site infection complicates about one-third to two-thirds of caesarean sections in low-income countries which is about 9 times higher compared with the high-resource countries. Surgical Site Infection is associated with increased maternal morbidity, prolonged hospital stay and increased medical costs. The development of post-caesarean surgical site infection is hung on a complex interplay of many factors not limited to wound class, immune status, maternal age, hypertensive disorders, ASA classification, number of vaginal examinations, the virulence of the microorganisms, maternal weight, surgical techniques and premature rupture of membrane. The study employed a descriptive cross-sectional and quantitative approach to study the factors influencing the prevalence of surgical site infections among mothers undergoing caesarean section in Iganga Hospital. A sample size of 288 participants were enrolled using a random sampling technique and close-ended questionnaires were employed to obtain the data from participants. Data analysis was done using SPSS version 20 and statistical significance was set at a P-value less than 0.05 at 95% confidence interval. A total of 288 post-caesarean mothers were studied from October – November 2021 in Iganga Hospital. The majority of the participants were married 255(88.8%) and had a secondary level of education 142(49.3%). The mean age of the participants were 25.6 years with 21 as the modal age. The prevalence of surgical site infection among post-caesarean mothers at Iganga Hospital was 20.5% (59 out of 288) and the factors which were statistically influencing the SSI included early rupture of membranes of more than 18 hours (aOR 23.715 95% C.I 5.976-94.117, P 0000) and postoperative haemoglobin (aOR 15.109 95% C.I 3.494-65.333, P 0.000) There’s a high burden of SSI among post-caesarean mothers in Iganga Hospital. Earlyrupture of membranes more than 18 hours and post-operative haemoglobin less than 11g/dl are key contributory factors. Aggressive prophylactic and post-operative antibiotic therapy should be considered in mothers with early rupture of membranes and post-operative anaemia. Keywords: Caesarean Section, Maternal morbidity, Surgical Site Infection, Post-caesarean mothers, Vagina examination. IN