Effectiveness of preoperative bath using chloroxylenol antiseptic soap on the incidence of post emergency cesarean section surgical site infection at Mbarara Regional Referral hospital, Uganda: a randomized controlled trial

Introduction

Surgical Site Infections (SSIs) constitute 15%-45% of hospital acquired infections in sub-Saharan Africa. Cesarean section (CS) increases the risk of developing sepsis by 5-20 times and is highest when the operation is emergency. Therefore, the purpose of this study was to measure the effect of chloroxylenol in reducing the incidence of post cesarean SSIs at Mbarara Regional Referral Hospital (MRRH).

Methods

a randomized controlled trial was conducted at MRRH maternity ward and mothers were randomized into either control or intervention arms. The intervention was a complete body bath with chloroxylenol antiseptic soap before the operation, while the control arm participants received a standard ward pre-operative preparation procedures. All participants were followed up for 30 days and assessed using an SSI screening tool.

Results

ninety-six women were randomized, and 48 were assigned to each arm. The overall incidence of SSI was 30.21%. The incidence of SSI was significantly lower in the intervention compared to the control arm (6.25% in the intervention arm versus 54.17% in the control arm) (p-value <0.001). Chloroxylenol bath was protective of SSI with a 90% risk reduction for SSI (95% confidence interval of 67%–97%).

Conclusion

a preoperative bath with chloroxylenol for pregnant mothers is associated with a significantly lower risk of post cesarean section surgical site infections. Health facilities with a high burden of post SSI should consider adding this simple and effective intervention to the existing infection prevention measures. Clinical Trials.gov registration (NCT03544710).

Reasons for delay in seeking medical care among women with Obstetric anal sphincter injuries

Aims: To determine the reasons for delay in seeking medical care for OASIS among attendees of the Fistula Camp. Methods: A cross sectional study done at Kisiizi hospital during the EngenderHealth Fistula Care Plus camp in July 2018 involving a total of 10women who had OASIS were enrolled into the study. Information was obtained using a questionnaire and analysis was done using Microsoft excel. Results: The average period of time a woman stays with OASIS before seeking medical care was 10 years. On average, women deliver two babies following OASIS before they seek medical care. OASIS was sustained mainly during 1st and 2nddeliveries (80%), and delivering in absence of a skilled birth attendant (70%). The lack of: support from the husband (60%); funds to seek medical care (60%);and knowledge about the condition (70%); painless tear after healing (50%) are reasons for the delays. Conclusions: Reasons for the delay in seeking medical care after OASIS were lack of funds, knowledge and the awareness required to seek medical care. Recommendation is to strengthen the OASIS awareness programs in Southwestern Uganda. Keywords: care, delay, OASIS