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RISK FACTORS FOR POST CESAREAN WOUND INFECTION AMONG MOTHERS AT MULAGO NATIONAL REFERRAL HOSPITAL – UGANDA
Background: Post cesarean surgical wound infection has been identified as a major problem among women of child bearing age. In developing countries, the rate at which post cesarean mothers get surgical wound infection is still high’(Oliver et al., 2009). In Uganda many mothers who deliver by cesarean section get surgical wound infection that led to increased morbidity, mortality, prolonged hospital stay and increased medical costs Objective: The aim of the study was to determine risk factor for post cesarean infection among mothers who had under gone cesarean section on ward 5B Mulago national referral hospital. Methods: This was a case control study that involved post cesarean mothers who were admitted at Mulago national referral hospital between August and October 2015. A total of 186 (93 cases and 93 control) post cesarean mothers were enrolled into the study. Post-operative data was collected using a standardized questionnaire. A data bases was designed for data entry and there after the data set was transported to SPPSS for analysis Results: Eight independent risk factors for post cesarean wound infection were identified in this study by multivariate analysis and these included; primary and tertiary level education (OR: 6.85, 95%CI:1.4-33.46, P =0.018 and OR: 22, 95%CI:4.57-108.6, P= 0.001 respectively), antenatal care attendance ( OR 0.02, 95%CI: 0.003-0.12 , P < 0.001), diabetic mothers ( OR: 0.004, 95%CI: 0.00-0.038, P < 0.001), pre-operative hemoglobin levels less than 7g/dl( OR: 0.12, 95%CI:, 0.03-0.497 P = 0.003) , Vertical type of skin incision( OR: 0.14, 95%CI: 0.03- 0.624, P = 0.010) , duration of labor greater than 12 hours ( OR:0.10, 95%CI:0.02-0.417, P = 0.002), senior surgeons performing the operation (OR: 47.78, 95% CI: 3.078-741.8, P =0.006 ) and spinal type of anesthesia.( OR:25, 95%CI: , 3.33-187.643 P =0.002) . Conclusion: Post cesarean wound infection was associated with multiple factors which included primary and tertiary levels of education, antenatal care attendance, diabetes mellitus, preoperative hemoglobin levels less than 7g/dl, vertical type of skin incision, duration of labor greater than 12hours, senior surgeons performing the operations and spinal type of anesthesia. The need to reduce post cesarean wound infection should currently receive considerable attention and requires more research in order to reduce unnecessary morbidity, mortality and associated socio- economic consequences for the patient and her family. Recommendations: Sensitization of the public on modifiable risk factors for post cesarean wound infection is need and senior surgeons need to perform surgeries more often than concentrating on administrative work.
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