Determinants of puerperal sepsis among post-partum mothers in Mekelle city public hospitals, Tigray, Ethiopia, 2021: a case control study.

backgroundPuerperal sepsis is among the leading causes of preventable maternal death not only in developing countries but also in developed countries which is usually reported as the third or fourth common direct cause of maternal death. Although the prevalence of puerperal sepsis is low, it is the significant cause of maternal mortality, morbidities and other long-term complications like secondary infertility. The aim of this study was to assess the determinants of puerperal sepsis among post-partum mothers at Mekelle city public hospitals.

methodInstitution based unmatched case control study was conducted among 444 total sample size (111 cases and 333 controls) in Mekelle city public hospitals from March 21, 2021 to April 20, 2021. Consecutive sampling for the cases and systematic sampling for the controls was used. Pretested structured questionnaire was used to collect data and the data was entered into Epi data version 4.1 then cleaned, coded and edited and exported to SPSS version 23 statistical software for analysis. Logistic regression was done and variables with a P-value of < 0.25 on Binary logistic regression were taken to multiple logistic regression analysis. At 95% confidence interval, a P-value of < 0.05 was used as cut-off point to declare the association with the dependent variable.

resultsMultiple logistic regression analysis revealed that rural residence (AOR: 3, 95% CI: 1.50-5.90), no ANC follow up (AOR: 2.7, 95% CI: 1.08-6.71), duration of rupture of membrane > 24 h (AOR: 4.1, 95% CI: 1.60-10.58), duration of labor > 24 h (AOR: 4.3, 95% CI: 1.86-9.92), number of vaginal examination >  = 5 (AOR: 2.8, 95% CI: 1.26-6.26), cesarean section mode of delivery (AOR: 2.8, 95% CI: 1.48-5.20) and no PNC follow up (AOR: 3.9, 95% CI: 1.60-9.36) were the determinant factors of puerperal sepsis in this study.

conclusionThe determinants of puerperal sepsis in this study were rural residence, not having antenatal care, prolonged duration of rupture of membrane, prolonged duration of labor, frequent number of vaginal examination, cesarean section and not having postnatal care. It is recommended that strengthening provision of health education on danger signs of pregnancy, parthograph utilization and avoiding of frequent vaginal examinations.