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Prevalence of surgical site infection and its associated factors after cesarean section in Ethiopia: systematic review and meta-analysis
Temesgen Getaneh
Debre markos university
Corresponding Author
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Background Surgical site infection (SSI) affects up to one third of patients who have undergone a surgical procedure. It is a significant cause of surgical patient morbidity, mortality and human and financial costs threat. The national prevalence of SSI among mothers who undergo for cesarean section and its risk factors are not well investigated in Ethiopia. Therefore, this systematic and meta-analysis conducted to estimate the pooled prevalence of surgical site infection and its associated factors after cesarean section in Ethiopia.
Methods Original articles were searched in PubMed/MEDLINE, EMBASE, CINAHL, Google Scholar, HINARI portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases), and Cochrane Library. Data were extracted using a standard data extraction checklist that developed according to Joanna Briggs Institute (JBI). The I2 statistic was used to quantify heterogeneity across studies. Funnel plot asymmetry and Egger’s tests were used to check for publication bias. A fixed effect model was used to estimate the pooled prevalence of surgical site infection. Odds Ratio (OR) with 95% Confidence Interval (CI) was also used to determine the association of identified variables with surgical site infection. Statistical analysis was conducted using STATA software.
Result From initial 179 identified articles, 11 were eligible for inclusion in the final meta-analysis. The pooled estimate of surgical site infection after cesarean section in Ethiopia was 9.72% (95%CI: 8.38, 11.05). PROM >12hrs (OR=5.02, 95%CI: 2.65, 9.51), duration of labor>24hrs (OR=3.69, 95%CI: 2.41, 5.65), chorioamnionitis (OR=9.11, 95%CI: 5.21, 15.93), anemia (OR=4.75, 95%CI: 2.42, 9.33) and having vertical skin incision (OR=4.17, 95%CI: 2.90, 6.02) were factors significantly associated with surgical site infection after cesarean section.
Conclusion The prevalence of surgical site infection after cesarean section in Ethiopia was high. Therefore, Minister of Health with its stake holders should emphasis on community and institution based programs in manner to prevent those factors listed above that have significant effect on surgical site infection.
Keywords
Cesarean section, Prevalence, Surgical site infection, Ethiopia
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This preprint is under consideration at BMC Pregnancy and Childbirth. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Prevalence of surgical site infection and its associated factors after cesarean section in Ethiopia: systematic review and meta-analysis
Temesgen Getaneh
Debre markos university
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 5
Posted 11 May, 2020
No community comments so far
Editor assigned
On 26 Apr, 2020
Submission checks complete
On 25 Apr, 2020
Editor invited
On 25 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 21 Apr, 2020
Review #1 received
Received 13 Apr, 2020
Reviewer #1 agreed
On 10 Apr, 2020
Reviewers invited
Invitations sent on 10 Apr, 2020
Editor assigned
On 18 Mar, 2020
Submission checks complete
On 17 Mar, 2020
Editor invited
On 17 Mar, 2020
No comments provided
Editorial decision: Minor revision
On 12 Mar, 2020
Review #1 received
Received 28 Feb, 2020
Reviewers invited
Invitations sent on 25 Feb, 2020
Reviewer #1 agreed
On 25 Feb, 2020
Editor assigned
On 19 Feb, 2020
Submission checks complete
On 18 Feb, 2020
Editor invited
On 18 Feb, 2020
No comments provided
Review #4 received
Received 30 Jan, 2020
Editorial decision: Major revision
On 30 Jan, 2020
Review #3 received
Received 19 Jan, 2020
Reviewer #4 agreed
On 17 Jan, 2020
Review #2 received
Received 14 Jan, 2020
Reviewer #3 agreed
On 05 Jan, 2020
Reviewer #2 agreed
On 04 Jan, 2020
Reviewers invited
Invitations sent on 03 Jan, 2020
Reviewer #1 agreed
On 03 Jan, 2020
Review #1 received
Received 03 Jan, 2020
Editor assigned
On 22 Oct, 2019
Submission checks complete
On 21 Oct, 2019
Editor invited
On 21 Oct, 2019
No comments provided
Editorial decision: Minor revision
On 18 Oct, 2019
Reviewer #4 agreed
On 06 Oct, 2019
Review #2 received
Received 06 Oct, 2019
Reviewer #5 agreed
On 06 Oct, 2019
Review #4 received
Received 06 Oct, 2019
Review #3 received
Received 01 Oct, 2019
Review #1 received
Received 01 Oct, 2019
Reviewer #1 agreed
On 29 Sep, 2019
Reviewer #2 agreed
On 29 Sep, 2019
Reviewer #3 agreed
On 29 Sep, 2019
Reviewers invited
Invitations sent on 27 Sep, 2019
Submission checks complete
On 16 Sep, 2019
Editor assigned
On 10 Sep, 2019
Editor invited
On 09 Sep, 2019
First submitted
On 06 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Surgical site infection (SSI) affects up to one third of patients who have undergone a surgical procedure. It is a significant cause of surgical patient morbidity, mortality and human and financial costs threat. The national prevalence of SSI among mothers who undergo for cesarean section and its risk factors are not well investigated in Ethiopia. Therefore, this systematic and meta-analysis conducted to estimate the pooled prevalence of surgical site infection and its associated factors after cesarean section in Ethiopia.
Methods Original articles were searched in PubMed/MEDLINE, EMBASE, CINAHL, Google Scholar, HINARI portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases), and Cochrane Library. Data were extracted using a standard data extraction checklist that developed according to Joanna Briggs Institute (JBI). The I2 statistic was used to quantify heterogeneity across studies. Funnel plot asymmetry and Egger’s tests were used to check for publication bias. A fixed effect model was used to estimate the pooled prevalence of surgical site infection. Odds Ratio (OR) with 95% Confidence Interval (CI) was also used to determine the association of identified variables with surgical site infection. Statistical analysis was conducted using STATA software.
Result From initial 179 identified articles, 11 were eligible for inclusion in the final meta-analysis. The pooled estimate of surgical site infection after cesarean section in Ethiopia was 9.72% (95%CI: 8.38, 11.05). PROM >12hrs (OR=5.02, 95%CI: 2.65, 9.51), duration of labor>24hrs (OR=3.69, 95%CI: 2.41, 5.65), chorioamnionitis (OR=9.11, 95%CI: 5.21, 15.93), anemia (OR=4.75, 95%CI: 2.42, 9.33) and having vertical skin incision (OR=4.17, 95%CI: 2.90, 6.02) were factors significantly associated with surgical site infection after cesarean section.
Conclusion The prevalence of surgical site infection after cesarean section in Ethiopia was high. Therefore, Minister of Health with its stake holders should emphasis on community and institution based programs in manner to prevent those factors listed above that have significant effect on surgical site infection.
Figure 1
Figure 2
Figure 3
Figure 4