Work

Documented Surgical Site Infection After Cesarean Delivery at Kiziguro District Hospital, Rwanda: A Retrospective Record Review

Year: 2026

Type: article

Abstract: Background: Surgical site infection (SSI) following cesarean delivery contributes to maternal morbidity, yet facility-specific evidence from Rwandan district hospitals remains limited. Objective: To estimate the prevalence of documented post-cesarean SSI and explore associated maternal, obstetric, intrapartum and procedure-related factors at Kiziguro District Hospital. Methods: A retrospective analytical record review was conducted using 399 systematically selected medical records of women who underwent cesarean delivery between 1 July 2022 and 30 June 2025. Data were extracted using a structured checklist; no active post-discharge surveillance was performed. Documented SSI prevalence was estimated with an exact 95% confidence interval (CI). Fisher’s exact tests and Firth penalized logistic regression were used to explore associated factors. Because the sample size was calculated to estimate prevalence and few SSI events occurred, the associated-factor analysis was exploratory and substantially underpowered. Results: Eight of 399 women had documented SSI, yielding a prevalence of 2.01% (95% CI: 0.87%– 3.91%). The exploratory multivariable model included only six SSI events among 312 complete records and estimated eight parameters. More than three vaginal examinations were associated with higher adjusted odds of documented SSI (adjusted odds ratio [AOR] = 7.60; 95% CI: 1.17– 49.53; p = 0.034), but this estimate was highly imprecise, and the overall model was not statistically significant (Wald χ 2 (8) = 10.18; p = 0.252). Conclusion: Documented post-cesarean SSI prevalence was low, but infections occurring after discharge may have been missed; this figure therefore reflects documented hospital-record SSI rather than true incidence. The association with repeated vaginal examinations is hypothesis-generating, does not establish an independent risk factor, and requires confirmation in larger prospective studies with active post-discharge surveillance. Keywords: surgical site infection, cesarean delivery, Rwanda

Source: International Journal of Women s Health

DOI: 10.2147/ijwh.s649177

Authors: Valens Tuyishime, Emmanuel Ndahiro Manirafasha

Institutions: University of Rwanda, University of Global Health Equity

Language: English

Topic: Surgical site infection prevention

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836