Abstract:
Background: Healthcare-associated illnesses, of which surgical site infection is the most common are significant
causes of morbidity and mortality. Therefore, this study aimed to determine the prevalence and root causes of
surgical site infections in public versus private hospitals in Ethiopia.
Methods: An institution based retrospective observational cohort study was conducted among patients who underwent
surgical procedures at public and private health facilities from March 15 to April 15, 2018. Samples were selected by the
simple random sampling technique, and data extracted from the patient’s medical chart, operation, and anesthesia notes.
Data were entered using Epi info version 7 and analyzed using STATA 14. Binary logistic regression was fitted to identify
factors associated with surgical site infections in private and public hospitals. Crude and adjusted odds ratios (OR) with a
95% confidence interval (CI) were computed to assess the strength of associations. Variables with a p-value less than 0.05
in the multivariable logistic regression model considered as significant predictors of surgical site infections.
Result: The overall prevalence of surgical site infections was 9.9% (95%CI: 7.8, 12.5). The prevalence of the infections
was higher in procedures performed in public hospitals (13.4%) compared to private hospitals (6.5%). Rural residence
(AOR = 0.13, 95%CI: 0.034 0.55), clean-contaminated and dirty wound (AOR = 12.81, 95%CI: 4.42 37.08) were significant
predictors of the infections in private hospitals. Similarly, clean-contaminated and dirty wounds (AOR = 4.37, 95%CI: 1.88
10.14), length of hospital stay≥6 days (AOR = 2.86, 95%CI: 1.11 7.33), and surgical operation time of over 1 h
(AOR = 15.24, 95%CI: 4.48 51.83) were such factors in public hospitals.
Conclusion: The prevalence of surgical site infections was high, and significant differences were also observed between
public and private hospitals. Clean-contaminated and dirty wounds, prolonged operation, and length of hospital stay
were predictors of surgical site infections among patients in public hospitals, whereas clean-contaminated wound and
rural dwellings were predicted the infections among patients operated in the private hospital
Description:
Healthcare-associated infections (HIAs) are a significant
source of preventable morbidity and mortality [1–3].
More than 30% of the HIA are surgical site infections
(SSI) defined as infections related to operative procedures
that occur at or near surgical incisions within 30 days of
the procedure or within 90 days if prosthetic materials are
implanted at surgery [4]. Surgical site infections may
extend from the skin and superficial subcutaneous tissues
of incision sites to deep subcutaneous tissues and organ
spaces [5]. Due to poor infection prevention practices
among health care facilities in low and middle-income
countries, the incidence of SSI is substantially higher than
in high-income countries [6, 7]
