DETERMINANTS OF PUERPERAL SEPSIS AMONG POST PARTUM WOMEN WHO WERE ADMITTED TO HARAR TOWN PUBLIC HOSPITALS, EASTERN ETHIOPIA: - A CASE CONTROL STUDY

Abstract

Background: Puerperal sepsis is a major public health concern as it contributes high number of maternal mortality. It is characterized commonly with fever and other symptoms like pelvic pain, foul smelling vaginal discharge and delayed reduction of the uterine size. As puerperal sepsis is among the top leading causes of maternal morbidity and mortality in Ethiopia, addressing the determinants of puerperal sepsis will have an important contribution to minimize maternal mortality and morbidity. However there is limited information about the determinants of puerperal sepsis in the study area. Objective: This study aimed to identify the determinants of puerperal sepsis among postpartum women who were admitted to Harar town public hospitals, eastern Ethiopia from June 15 to July 15, 2022 Method: A hospital-based retrospective unmatched case-control study design was conducted on 423(106cases and 317 controls) study subjects. The subjects were selected from medical registration numbers by simple random sampling method. The data was extracted by using a structured questioner adapted from different literatures. Data was cleaned manually, coded, and entered into Epi-Data version 3.1 and analyzed by SPSS version 25 statistical software. Bivariable and multivariable logistic regression analyses was employed to identify the determinants of puerperal sepsis. Variables with p-value less than 0.25 in bivariable analysis, was considered for multivariable analysis. Then adjusted odds ratio with a 95% confidence interval was carried out to estimate the direction and strength of the association. Statistical significance was declared at a p-value of less than 0.05. RESULTIS: Determinants of puerperal sepsis were found to be cesarean section delivery [AOR=2.32 95% CI (1.24, 4.33)], rupture of membrane more than 24 hours [AOR=4.34, 95% CI (1.93, 9.76)], duration of labor >24 hours [AOR=2.91, 95% CI (1.11, 7.62)], experiencing more than 4 number of vaginal examinations [AOR=3.02, 95 % CI (1.32, 6.92)], and being referred from other health institutions [AOR=2.48, 95 % CI (1.42, 4.36)]. Conclusion: mode of delivery, duration of labor, number of vaginal examination, ruptured of membrane and referral system were determinants of puerperal sepsis. Strengthen aseptic techniques during labor and delivery and organizing effective referral system through collaborating with different stakeholders.