Asian Journal of Research in Nursing and Health

Factors Influencing and the Effect of Puerperal Sepsis among Postnatal Women in Vom Christian Hospital, Plateau State, Nigeria

Mangdik E. Christiana

School of Basic Midwifery Vom, College of Nursing Sciences Vom, Plateau State, Nigeria.

Ari S. Eunice

Nursing Department, University of Jos, Plateau State, Nigeria.

Kure Laraba

School of Basic Midwifery Vom, College of Nursing Sciences Vom, Plateau State, Nigeria.

Adams Lishikah

School of Basic Midwifery Jos, College of Nursing Sciences Vom, Plateau State, Nigeria.

Luka J. Tongdima

School of Nursing Jos, College of Nursing Sciences Vom, Plateau State, Nigeria.

Izzah G. Nanko

School of Basic Midwifery Vom, College of Nursing Sciences Vom, Plateau State, Nigeria.

Ramyil S. Mary *

Department of Nursing and Midwifery Services, Plateau Specialist Hospital, Jos, Nigeria.

Zwalnan Nanmi

Department of Nursing Services, Jos University Teaching Hospital, Plateau State, Nigeria.

*Author to whom correspondence should be addressed.

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Abstract

Despite all efforts made by WHO to reduce the incidence of Puerperal sepsis globally, it remains the third most common cause of death following childbirth or miscarriage accounting for 15% of 50,000 maternal lives lost annually. It usually occurs within 10 days – 6 weeks postpartum following delivery. The most common infection is that of the uterus and surrounding tissues. The purpose of this study was to assess the factors influencing and effects of puerperal sepsis among postnatal women in Vom Christian Hospital. Non-probability sampling technique using convenient methods of sampling and sample size was determined through the Taro Yamani formula where 80 women were recruited into the study and questionnaires administered for data collection with 100% retrieval rate and analyzed using descriptive statistical analysis. This study revealed high rates of respondents agreeing that anaemia (75%) followed by early cesarean section (62.5%) and delay in seeking healthcare (62.5%) with (56.3%) multiply vaginal examination as factors swaying puerperal sepsis infections in women. 75% respondents agreed that puerperal sepsis causes both painful inflammation of breast and pain while urinating, with 81.3% cause by vaginal discharge as the common effect of puerperal sepsis in most women while majority (81.3%) of the respondents revealed that poor vagina hygiene causes infection where endogenous infectious agents are mostly harboured. Puerperal sepsis is a deadly disease among women, our finding showed that most of the postnatal women had knowledge about puerperal sepsis and its factors, hence, preventive measures and women personal hygiene during antenatal visits be emphasized. Thus, healthcare givers should follow aseptic technique to prevent puerperal sepsis infections among women during delivery.

Keywords: Puerperal sepsis, haemorrhage, postpartum women, chorioamnionitis and pyelonephritis

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References

Olutoye AS, Agboola AD, Bello OO. Puerperal Sepsis at University College Hospital, Ibadan: A 10-Year Review. Annals of Ibadan postgraduate medicine. 2022;20(1):32–39.

Demisse GA, Sifer SD, Kedir B, Fekene DB, Bulto GA. Determinants of puerperal sepsis among post partum women at public hospitals in west SHOA zone Oromia regional STATE, Ethiopia (institution BASEDCASE control study). BMC Pregnancy Childbirth. 2019;19:95 Available:https://doi.org/10.1186/s12884-019-2230-x

Knight M. what is a life threating complication in pregnancy and childbirth; 2015.

Khaskheli MN, Baloch S, Sheeba A. Risk factors and complications of puerperal sepsis at a tertiary healthcare centre. Pakistan Journal of Medical Sciences. 2013;29(4):972–976. Available:https://doi.org/10.12669/pjms.294.3389

Nail R. puerperal sepsis infection; 2014. Available:https://www.healthline.com/health /puerperal infection

Kajeguka DC, Mrema NR, Mawazo A, Malya R, Mgabo MR. Factors and causes of puerperal sepsis in kilimanjaro, Tanzania: A Descriptive Study among Postnatal Women who Attended Kilimanjaro Christian Medical Centre. The East African Health Research Journal. 2020;4(2), 158–163. Available:https://doi.org/10.24248/eahrj.v4i2.639

Maharaj D. Puerperal pyrexia: A review. Part I. Obstetrical & Gynecological Survey. 2007;62(6):393–399. Available:https://doi.org/10.1097/01.ogx.0000265998.40912.5e

Nchimbi DB, Joho AA. Puerperal sepsis-related knowledge and reported self- care practices among postpartum women in Dar es salaam, Tanzania. Women's health (London, England). 2022;18, 17455057221082954. Available:https://doi.org/10.1177/17455057221082954

Schrey-Petersen S, Tauscher A, Dathan-Stumpf A, Stepan H. Diseases and complications of the puerperium. Deutsches Arzteblatt international, 118(Forthcoming). 2021;436–446. Available:https://doi.org/10.3238/arztebl.m2021.0168

WHO. Recommendations for prevention and treatment of maternal peripartum infections: evidence base; 2015. Available:https://apps.who.int/iris/bitstream/10665/186171/1/9789241549363_eng.pdf www.who.int/reproductivehealth/publications/maternal_perinatal_health/peripartum-infections-guidelines

Koo YJ. Puerperal septic shock and necrotizing fasciitis caused by staphylococcus caprae and Escherichia coli. Yeungnam University Journal of Medicine. 2018;35(2):248–252. Available:https://doi.org/10.12701/yujm.2018.35.2.248

Michael Miller J. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: Update by the Infectious Diseases Society of America and the American Society for Microbiology, Clinical Infectious Diseases. 2018;67(6):e1–e94. Available:https://doi.org/10.1093/cid/ciy381

Dharmarag D, Patrigiun G. Puerperal sepsis infection; 2012 Available:https://www.sharinginhealth.ca/condition-and-diseases/puerperal-infection

Royal College of Obstetrician and Gynaecologist sepsis following pregnancy, bacterial. Green-top Guideline No. 64b; 2012. Available:https://www.rcog.org.uk/en/guidelines-research-service/guidelines.gtg64gb/

Fowler JR, Simon LV. Chorioamnionitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Available:https://www.ncbi.nlm.nih.gov/books/NBK532251/

McClure EM, Goldenberg RL. Infection and stillbirth. Seminars in Fetal & Neonatal Medicine. 2009;14(4):182–189. Available:https://doi.org/10.1016/j.siny.2009.02.003

Ngonzi J, Tornes YF, Mukasa PK, Salongo Kabakyenga J, Sezalio K et al. Puerperal sepsis, the leading cause of maternal deaths at a Tertiary University Teaching Hospital in Uganda. BMC Pregnancy Childbirth. 2016;16:207

Available:https://doi.org/10.1186/s12884-016-0986-9

Karsnitz DB. Puerperal Infections of the Genital Tract: A Clinical Review. Journal of Midwifery & Women’s Health. 2014;58(6): 632-642.

Song H, Hu K, Du X, Zhang J, Zhao S. Risk factors, changes in serum inflammatory factors, and clinical prevention and control measures for puerperal infection. Journal of Clinical Laboratory Analysis. 2019;34(3):e23047.

Bhattacharyya O, Khor S, McGahan A, Dunne D. Daar AS, Singer PA. Innovative health service delivery models in low and middle income countries - what can we learn from the private sector? Health research policy and systems. 2010;8:24. Available:https://doi.org/10.1186/1478-4505-8-24

Abah OV. Poor Health Care Access in Nigeria: A Function of Fundamental Misconceptions and Misconstruction of the Health System. Intech Open; 2022. DOI: 10.5772/intechopen.108530

Hussein J, Ramani KV, Kanguru L, Patel K, Bell J, Patel P, Walker L, Mehta R, Mavalankar D. The effect of surveillance and appreciative inquiry on puerperal infections: A longitudinal cohort study in India. PloS one. 2014;9(1):e87378. Available:https://doi.org/10.1371/journal.pone.0087378

Latunji OO, Akinyemi OO. Factors influencing health-seeking behaviour among civil servants in ibadan, Nigeria. Annals of Ibadan postgraduate medicine. 2018;16(1):52–60.

Omer S, Zakar R, Zakar MZ, Fischer F. The influence of social and cultural practices on maternal mortality: a qualitative study from South Punjab, Pakistan. Reprod Health. 2021;18:97. Available:https://doi.org/10.1186/s12978-021-01151-6

Chisembele M, Rodriguez VJ, Brown MR, Jones DL, Alcaide ML. Intravaginal practices among young HIV-infected women in Lusaka, Zambia. International Journal of STD & AIDS. 2018;29(2):164-171. DOI: 10.1177/0956462417721438

DeNoble AE, Heine RP, Dotters-Katz SK. Chorioamnionitis and Infectious Complications after Vaginal Delivery. Am J Perinatol. 2019;36(14):1437-1441.

Boakes E, Woods A, Johnson N, Kadoglou N. Breast Infection: A Review of Diagnosis and Management Practices. European journal of breast health. 2018;14(3):136–143. Available:https://doi.org/10.5152/ejbh.2018.3871

Julie S. Moldenhauer Mastitis Revised and Modified; 2022. Available:https://www.msdmanuals.com/professional/gynecology-and-obstetrics/postpartum-care-and-associated-disorders/mastitis#

Dalton E, Castillo E. Post partum infections: A review for the non- OBGYN. Obstetric Medicine. 2014;7(3): 98–102. Available:https://doi.org/10.1177/1753495X14522784

Sykes JE, Westropp JL. Bacterial Infections of the Genitourinary Tract. Canine and Feline Infectious Diseases. 2014;871–885. Available:https://doi.org/10.1016/B978-1-4377-0795-3.00089-2

Belyayeva M, Jeong JM. Acute Pyelonephritis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Available:https://www.ncbi.nlm.nih.gov/books/NBK519537/

Bianco A, Roccia S, Nobile CG, et al. Postdischarge surveillance following delivery: the incidence of infections and associated factors. Am J Infect Control. 2013;41:549–553.

Johnson AN, Buchmann EJ. Puerperal infection after Caesarean section at Chris Hani Baragwanath Academic Hospital, Johannesburg, South African Journal of Obstetrics and Gynaecology. 2012;18(3): 90-91.

Bishaw KA, Sharew Y, Beka E, Aynalem BY, Zeleke LB, Desta M, Kassie B, Amha H, Eshete T, Tamir W, Bantigen K, Mulugeta H, Ferede AA and Bitewa YB. Incidence and predictors of puerperal sepsis among postpartum women at Debre Markos comprehensive specialized hospital, northwest Ethiopia: A prospective cohort study. Front. Glob. Womens Health. 2023;4:966942. DOI: 10.3389/fgwh.2023.966942

McKinley LP, Wen T, Gyamfi-Bannerman C, Wright JD, Goffman D, Sheen JJ, D'Alton ME, Friedman AM. Hospital Safety-Net Burden and Risk for Readmissions and Severe Maternal Morbidity. Am J Perinatol. 2021;38(S 01):e359-e366.

Atlaw D, seyoum K, Woldeyohannes D, et al. Puerperal sepsis and its associated factors among mothers in University of Gondar referral hospital, Ethiopia, 2017. Int J Pregn & Chi Birth. 2019;5(5):190-195.

DOI: 10.15406/ipcb.2019.05.00175

Kiponza, R., Balandya, B., Majigo, M.V. et al. Laboratory confirmed puerperal sepsis in a national referral hospital in Tanzania: etiological agents and their susceptibility to commonly prescribed antibiotics. BMC Infect Dis. 2019;19:690. Available:https://doi.org/10.1186/s12879-019-4324-5

Nouri L, Zakour B, Venturin C, Beatson SA, Walker MJ. Analysis of a streptococcus pyogenes puerperal Sepsis cluster by use of whole-genome sequencing. J Clin Microbiol. 2012;50: 2224–2228. DOI: 10.1128/JCM.00675-12.

WHO. Library Cataloguing-in-Publication Data: Standards for improving quality of maternal and newborn care in health facilities; 2016. Available:http://www.who.int ISBN 978 92 4 151121 6 NLM Classification: WA 310.