Factors Influencing Caesarean Surgical Site Infections In The Tema Metropolis In The Greater Accra Region Of Ghana

ABSTRACT Introduction: Caesarean section is one of the regular procedures in obstetric practices in Ghana. Caesarean surgical site infection is one of the commonest complications associated with caesarean delivery in developing countries. In order to prevent and decrease the occurrence of the caesarean surgical infections in our health facilities, there is the need to assess the risk factors associated with caesarean surgical site infections. Objectives: To determine the incidence of caesarean surgical site infections, the days the infections were detected post operatively and the factors influencing caesarean surgical site infections among the patients who have undergone caesarean sections in the Tema Metropolis. Methods: This research was a quantitative study. Consecutive sampling method was used to select 160 respondents from the two health facilities out of which 3 were lost to follow up. A prospective study was conducted in the Obstetrics and Gynaecology departments of Tema General Hospital and Tema Polyclinic from May to June, 2018. Socio-demographic factors, duration of surgery, type of surgery whether elective or emergency, cadre of surgeon, preexisting medical conditions such as diabetes mellitus and HIV were some the risk factors that were assessed in this research. Data was collected using semi-structured questionnaire and data abstraction form. Data analysis was done using STATA version 15.0. Descriptive statistics was used to describe the risk factors associated with caesarean surgical site infections by summarizing findings into percentages and frequencies. Bivariate analysis and multiple logistic regression were done to test for association between the dependent and independent variables. Factors were said to be significant if p-value was less than 0.05. Results: Total of 157 women aged between 17 and 45 years were recruited after undergoing caesarean section in Tema General Hospital and Tema Polyclinic. Mean age of women was 30.6 ± 4.6 years. Women with parity less than 3 were 111/157 (70.7%), 40/157 (36.7%) women obese and diabetes was found in 5/157 (3.1%). The incidence rate of caesarean SSI after a two-week follow-up was 9.6%; 95% CI: 5.0%-14.0%. Distribution showed that 10 (66.6%) women had superficial incisional infection following caesarean section, 5(33.3%) women had deep incisional and none had organ/space infection. Most (80%) infections were detected on POD 7 and 10. Religion was found to be statistically significant to the development of caesarean SSI (OR 5.58; 95% CI, 1.29- 24.14; p