Burden of surgical site infection following cesarean section in sub-Saharan Africa: a narrative review

Angie Sway,1 Peter Nthumba,2 Joseph Solomkin,3 Giorgio Tarchini,4 Ronald Gibbs,5 Yanhan Ren,6 Anthony Wanyoro7 1Medical Writing, World Surgical Infection Society, Cincinnati, OH, USA; 2Plastic, Reconstructive and Hand Surgery, AIC Kijabe Hospital, Kijabe, Kenya; 3Department of Surgery, University o...

Full description

Bibliographic Details
Main Authors: Sway A, Nthumba P, Solomkin J, Tarchini G, Gibbs R, Ren Y, Wanyoro A
Format: Article
Language:English
Published: Dove Medical Press 2019-05-01
Series:International Journal of Women's Health
Subjects:
Online Access:https://www.dovepress.com/burden-of-surgical-site-infection-following-cesarean-section-in-sub-sa-peer-reviewed-article-IJWH
_version_ 1818152864086753280
author Sway A
Nthumba P
Solomkin J
Tarchini G
Gibbs R
Ren Y
Wanyoro A
author_facet Sway A
Nthumba P
Solomkin J
Tarchini G
Gibbs R
Ren Y
Wanyoro A
author_sort Sway A
collection DOAJ
description Angie Sway,1 Peter Nthumba,2 Joseph Solomkin,3 Giorgio Tarchini,4 Ronald Gibbs,5 Yanhan Ren,6 Anthony Wanyoro7 1Medical Writing, World Surgical Infection Society, Cincinnati, OH, USA; 2Plastic, Reconstructive and Hand Surgery, AIC Kijabe Hospital, Kijabe, Kenya; 3Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA; 4Department of Infectious Disease, Cleveland Clinic Florida, Weston, FL, USA; 5Department of Obstetrics and Gynecology, University of Colorado Hospital, Denver, CO, USA; 6Research and Implementation, World Surgical Infection Society, Cincinnati, OH, USA; 7Department of Obstetrics and Gynecology, School of Medicine, Kenyatta University, Nairobi, Kenya 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%. Keywords: cesarean section, maternal mortality, surgical site infection, wound infection, sepsis, sub-Saharan Africa
first_indexed 2024-12-11T14:01:29Z
format Article
id doaj.art-75336bb59d2249f0bd0d70018e8e2d71
institution Directory Open Access Journal
issn 1179-1411
language English
last_indexed 2024-12-11T14:01:29Z
publishDate 2019-05-01
publisher Dove Medical Press
record_format Article
series International Journal of Women's Health
spelling doaj.art-75336bb59d2249f0bd0d70018e8e2d712022-12-22T01:03:50ZengDove Medical PressInternational Journal of Women's Health1179-14112019-05-01Volume 1130931845729Burden of surgical site infection following cesarean section in sub-Saharan Africa: a narrative reviewSway ANthumba PSolomkin JTarchini GGibbs RRen YWanyoro AAngie Sway,1 Peter Nthumba,2 Joseph Solomkin,3 Giorgio Tarchini,4 Ronald Gibbs,5 Yanhan Ren,6 Anthony Wanyoro7 1Medical Writing, World Surgical Infection Society, Cincinnati, OH, USA; 2Plastic, Reconstructive and Hand Surgery, AIC Kijabe Hospital, Kijabe, Kenya; 3Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA; 4Department of Infectious Disease, Cleveland Clinic Florida, Weston, FL, USA; 5Department of Obstetrics and Gynecology, University of Colorado Hospital, Denver, CO, USA; 6Research and Implementation, World Surgical Infection Society, Cincinnati, OH, USA; 7Department of Obstetrics and Gynecology, School of Medicine, Kenyatta University, Nairobi, Kenya 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%. Keywords: cesarean section, maternal mortality, surgical site infection, wound infection, sepsis, sub-Saharan Africahttps://www.dovepress.com/burden-of-surgical-site-infection-following-cesarean-section-in-sub-sa-peer-reviewed-article-IJWHcesarean sectionmaternal mortalitysurgical site infectionwound infectionsepsissub-Saharan Africa
spellingShingle Sway A
Nthumba P
Solomkin J
Tarchini G
Gibbs R
Ren Y
Wanyoro A
Burden of surgical site infection following cesarean section in sub-Saharan Africa: a narrative review
International Journal of Women's Health
cesarean section
maternal mortality
surgical site infection
wound infection
sepsis
sub-Saharan Africa
title Burden of surgical site infection following cesarean section in sub-Saharan Africa: a narrative review
title_full Burden of surgical site infection following cesarean section in sub-Saharan Africa: a narrative review
title_fullStr Burden of surgical site infection following cesarean section in sub-Saharan Africa: a narrative review
title_full_unstemmed Burden of surgical site infection following cesarean section in sub-Saharan Africa: a narrative review
title_short Burden of surgical site infection following cesarean section in sub-Saharan Africa: a narrative review
title_sort burden of surgical site infection following cesarean section in sub saharan africa a narrative review
topic cesarean section
maternal mortality
surgical site infection
wound infection
sepsis
sub-Saharan Africa
url https://www.dovepress.com/burden-of-surgical-site-infection-following-cesarean-section-in-sub-sa-peer-reviewed-article-IJWH
work_keys_str_mv AT swaya burdenofsurgicalsiteinfectionfollowingcesareansectioninsubsaharanafricaanarrativereview
AT nthumbap burdenofsurgicalsiteinfectionfollowingcesareansectioninsubsaharanafricaanarrativereview
AT solomkinj burdenofsurgicalsiteinfectionfollowingcesareansectioninsubsaharanafricaanarrativereview
AT tarchinig burdenofsurgicalsiteinfectionfollowingcesareansectioninsubsaharanafricaanarrativereview
AT gibbsr burdenofsurgicalsiteinfectionfollowingcesareansectioninsubsaharanafricaanarrativereview
AT reny burdenofsurgicalsiteinfectionfollowingcesareansectioninsubsaharanafricaanarrativereview
AT wanyoroa burdenofsurgicalsiteinfectionfollowingcesareansectioninsubsaharanafricaanarrativereview