Burden of Surgical Site Infection Following Cesarean Section in Sub-Saharan Africa: A Narrative Review
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Date
2019
Authors
Sway, Angie
Nthumba, Peter
Solomkin, Joseph
Tarchini, Giorgio
Gibbs, Ronald
Ren, Yanhan
Wanyoro, Anthony
Journal Title
Journal ISSN
Volume Title
Publisher
Dove Medical Press Limited
Abstract
Cesarean section (CS) is the most common operative procedure performed in
sub-Saharan Africa (SSA), accounting for as much as 80% of the surgical workload. In contrast
to CSs performed in high-income countries, CSs performed in SSA are accompanied by high
morbidity and mortality rates. This operation is the most important known variable associated
with an increased probability of postpartum bacterial infection. The objective of this review
was to assess surgical outcomes related to CS in SSA. PubMed (including Medline), CINAHL,
Embase, and the World Health Organization’s Global Health Library were searched without
date or language restrictions. A total of 26 studies reporting surgical site–infection rates after
CS were identified, representing 14,063 women from 14 countries. The vast majority (76.7%)
of CSs performed were emergency operations. The overall CS rate for women included in this
review was 12.4% (range: 1.0%–41.9%). Only 17 of 26 total studies reported a significant
proportion of women receiving antimicrobials of any kind. The surgical site–infection rate was
15.6% and the wound-infection rate 10.3%.
Description
An Article Published in International Journal of Women’s Health
Keywords
Cesarean section, Maternal mortality, Surgical site infection, Wound infection, Sepsis, Sub-Saharan Africa