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dc.contributor.authorNgonzi, Joseph
dc.contributor.authorBebell, Lisa M.
dc.contributor.authorFajardo, Yarine
dc.contributor.authorBoatin, Adeline A.
dc.contributor.authorSiedner, Mark J.
dc.contributor.authorBassett, Ingrid V.
dc.contributor.authorJacquemyn, Yves
dc.contributor.authorgeertruyden, Jean-Pierre Van
dc.contributor.authorKabakyenga, Jerome
dc.contributor.authorWylie, Blair J.
dc.contributor.authorBangsberg, David R.
dc.contributor.authorRiley, Laura E.
dc.date.accessioned2022-01-13T09:35:54Z
dc.date.available2022-01-13T09:35:54Z
dc.date.issued2018
dc.identifier.citationNgonzi, J., Bebell, L. M., Fajardo, Y., Boatin, A. A., Siedner, M. J., Bassett, I. V., ... & Riley, L. E. (2018). Incidence of postpartum infection, outcomes and associated risk factors at Mbarara regional referral hospital in Uganda. BMC pregnancy and childbirth, 18(1), 1-11.en_US
dc.identifier.urihttp://ir.must.ac.ug/xmlui/handle/123456789/1151
dc.description.abstractBackground: There is a paucity of recent prospective data on the incidence of postpartum infections and associated risk factors in sub-Saharan Africa. Retrospective studies estimate that puerperal sepsis causes approximately 10% of maternal deaths in Africa. Methods: We enrolled 4231 women presenting to a Ugandan regional referral hospital for delivery or postpartum care into a prospective cohort and measured vital signs postpartum. Women developing fever (> 38.0 °C) or hypothermia (< 36.0 °C) underwent symptom questionnaire, structured physical exam, malaria testing, blood, and urine cultures. Demographic, treatment, and post-discharge outcomes data were collected from febrile/hypothermic women and a random sample of 1708 normothermic women. The primary outcome was in-hospital postpartum infection. Multivariable logistic regression was used to determine factors independently associated with postpartum fever/ hypothermia and with confirmed infection. Results: Overall, 4176/4231 (99%) had ≥1 temperature measured and 205/4231 (5%) were febrile or hypothermic. An additional 1708 normothermic women were randomly selected for additional data collection, for a total sample size of 1913 participants, 1730 (90%) of whom had complete data. The mean age was 25 years, 214 (12%) were HIV-infected, 874 (51%) delivered by cesarean and 662 (38%) were primigravidae. Among febrile/hypothermic participants, 174/205 (85%) underwent full clinical and microbiological evaluation for infection, and an additional 24 (12%) had a partial evaluation. Overall, 84/4231 (2%) of participants met criteria for one or more in-hospital postpartum infections. Endometritis was the most common, identified in 76/193 (39%) of women evaluated clinically. Twenty-five of 175 (14%) participants with urinalysis and urine culture results met criteria for urinary tract infection. Bloodstream infection was diagnosed in 5/185 (3%) participants with blood culture results. Another 5/186 (3%) tested positive for malaria. Cesarean delivery was independently associated with incident, in-hospital postpartum infection (aOR 3.9, 95% CI 1.5–10.3, P = 0.006), while antenatal clinic attendance was associated with reduced odds (aOR 0.4, 95% CI 0.2–0.9, P = 0.02). There was no difference in in-hospital maternal deaths between the febrile/hypothermic (1, 0.5%) and normothermic groups (0, P = 0.11). Conclusions: Among rural Ugandan women, postpartum infection incidence was low overall, and cesarean delivery was independently associated with postpartum infection while antenatal clinic attendance was protective.en_US
dc.description.sponsorshipFogarty International Centeren_US
dc.language.isoen_USen_US
dc.publisherBMC pregnancy and childbirthen_US
dc.subjectIncidenceen_US
dc.subjectRisk factorsen_US
dc.subjectPostpartumen_US
dc.subjectUgandaen_US
dc.subjectResource limiteden_US
dc.subjectPregnant womenen_US
dc.subjectLaboren_US
dc.subjectAfricaen_US
dc.subjectInfectionen_US
dc.subjectPuerperal sepsisen_US
dc.titleIncidence of postpartum infection, outcomes and associated risk factors at Mbarara regional referral hospital in Ugandaen_US
dc.typeArticleen_US


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