Abstract
Cesarean section (CS) is the most common operative procedure performed in sub-Saharan Africa (SSA), accounting for as much as 80% of the surgical workload. In contrast to CSs performed in high-income countries, CSs performed in SSA are accompanied by high morbidity and mortality rates. This operation is the most important known variable associated with an increased probability of postpartum bacterial infection. The objective of this review was to assess surgical outcomes related to CS in SSA. PubMed (including Medline), CINAHL, Embase, and the World Health Organization’s Global Health Library were searched without date or language restrictions. A total of 26 studies reporting surgical site–infection rates after CS were identified, representing 14,063 women from 14 countries. The vast majority (76.7%) of CSs performed were emergency operations. The overall CS rate for women included in this review was 12.4% (range: 1.0%–41.9%). Only 17 of 26 total studies reported a significant proportion of women receiving antimicrobials of any kind. The surgical site–infection rate was 15.6% and the wound-infection rate 10.3%.
Acknowledgments
The authors would like to thank Benedetta Allegranzi, Stacey Gomes, and Katrina Kraft for their time, guidance, and contributions to this manuscript. An abstract of this paper was presented at the 27th European Congress of Clinical Microbiology and Infectious Diseases as a poster presentation with interim findings. The poster’s abstract has been published by the European Society of Clinical Microbiology and Infectious Diseases.Citation43
Disclosure
The authors report no conflicts of interest in this work.