Maternal caesarean section infection (MACSI) in Sierra Leone: a case–control study
Open Access
- 27 February 2020
- journal article
- research article
- Published by Cambridge University Press (CUP) in Epidemiology and Infection
- Vol. 148, e40
- https://doi.org/10.1017/s0950268820000370
Abstract
Sierra Leone is the country with highest maternal mortality and infections are the underlying cause in 11% of maternal deaths, but the real burden remains unknown. This study aims to determine the incidence and risk factors of surgical site infection (SSI) post-caesarean section (CS) in women admitted to Princess Christian Maternity Hospital (PCMH) in Freetown, Sierra Leone. A prospective case–control (1:3 ratio) study was implemented from 1 May 2018 to 30 April 2019 and 11 women presenting with suspected or confirmed infection post-CS were screened for inclusion as a case. For each case, three patients undergoing CS on the same day and admitted to the same ward, but not presenting with SSI, were selected as controls. The post-CS infection rate was 10.9%. Two hundred and fifty-four clinically confirmed cases were enrolled and matched with 762 control patients. By multivariable analysis, the risk factors for SSI were: being single (odds ratio (OR) 1.48, 95% confidence interval (CI) 1.36–1.66), low education level (OR 1.68, 95% CI 1.55–1.84), previous CS (OR 1.27, 95% CI 1.10–1.52), presenting with premature membranes rupture (OR 1.49, 95% CI 1.18–1.88), a long decision–incision time (OR 2.08, 95% CI 1.74–2.24) and a high missing post-CS antibiotic doses rate (OR 2.52, 95% CI 2.10–2.85).Keywords
This publication has 34 references indexed in Scilit:
- Relationship Between Cesarean Delivery Rate and Maternal and Neonatal MortalityJAMA, 2015
- Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic developmentThe Lancet, 2015
- Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean sectionEmergencias, 2014
- Is there a safe limit of delay for emergency caesarean section in Ghana? Results of analysis of early perinatal outcomeGhana Medical Journal, 2014
- Global causes of maternal death: a WHO systematic analysisThe Lancet. Global Health, 2014
- Retrospective analysis of antimicrobial resistance and bacterial spectrum of infection in Gabon, Central AfricaBMC Infectious Diseases, 2013
- Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in UgandaBMC Research Notes, 2013
- Iron Deposition and Ferritin Heavy Chain (Fth) Localization in Rodent TeethBMC Research Notes, 2013
- Factors affecting “decision to delivery interval” in emergency caesarean sections in a tertiary care hospital: a cross sectional observational studyInternational Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013
- Decision-to-Incision Times and Maternal and Infant OutcomesObstetrics & Gynecology, 2006