ABSTRACT Topic: Assessment of factors contributing to the prevalence of puerperal sepsis among mothers attending the obstetrics Ward at FortPortal regional referral hospital, western Uganda. Background: Puerperal sepsis is one of the leading causes of preventable maternal morbidity and mortality. It is still ranked as 3rd major cause of maternal death in our country. Aim: The objective of this study was to assess the factors that predispose a mother to the development of puerperal sepsis, to determine the age group associated with the highest prevalence of puerperal sepsis and to find out the proportion of mothers that have ever contracted puerperal sepsis among those attending the obstetrics Ward at FortPortal regional referral hospital. Method: This was a prospective study carried out at FortPortal regional referral Hospital over a period 1 year. Mothers attending the obstetrics Ward including, delivery, admission and treatment for puerperal infections were assessed. Mothers attending other clinical services were excluded. The risk factors for puerperal sepsis were analyzed and the findings of the research were presented using tables, graphs and pie charts. Results: 18% of the respondents reported never to have suffered from any puerperal infection and only 82% reported to have ever had a fever and other signs of infection during the first 42 Days after delivery (puerperal infection).The 8.5%, of the mothers that reported that they had ever been diagnosed and treated for puerperal sepsis were analyzed, and the following results were got. Puerperal sepsis was seen commonest in young mothers of 26-55 years 60%(30) , peasant farmers 30% (15), low education level (primary level) 20% (10), married 90%, prolonged rupture of membranes >2 hours 40% (20), duration of labour >18 hours 34%(17)delivered from hospital 90% (, resumption of sexual intercourse within 0-3 weeks 46.7% (7),use of herbs as a means of hygiene during puerperium 53.3%(8). Conclusion: Puerperal sepsis is an important public health problem contributing to maternal morbidity and mortality. Majority of the predisposing factors are preventable. Optimal antiseptic measures and careful monitoring are needed throughout the process of labor.
TABLE OF CONTENTS
DECLARATION ......................................................................................................................................................... I
APPROVAL................................................................................................................................................................II
ACKNOWLEDGEMENT ........................................................................................................................................IV
TABLE OF CONTENTS ...........................................................................................................................................V
LIST OF TABLES....................................................................................................................................................VII
LIST OF FIGURES.................................................................................................................................................VIII
ABBREVIATIONS....................................................................................................................................................IX
OPERATIONAL DEFINITIONS .............................................................................................................................X
ABSTRACT ...............................................................................................................................................................XI
CHAPTER ONE......................................................................................................................................................... 1
INTRODUCTION AND BACKGROUND .............................................................................................................. 1
1.0 GENERAL INTRODUCTION ................................................................................................................................... 1
1.1 BACKGROUND..................................................................................................................................................... 1
1.2 PROBLEM STATEMENT ................................................................................................................................ 5
1.3 STUDY OBJECTIVES...................................................................................................................................... 6
1.3.1 BROAD OBJECTIVE ................................................................................................................................ 6
1.3.2 SPECIFIC OBJECTIVES........................................................................................................................... 6
1.4.1 RESEARCH QUESTIONS......................................................................................................................... 6
1.4.2 HYPOTHESIS............................................................................................................................................ 6
1.5 JUSTIFICATION OF THE STUDY.................................................................................................................. 6
1.6 CONCEPTUAL FRAME WORK...................................................................................................................... 7
1.7.0 SCOPE OF THE STUDY ............................................................................................................................... 8
1.7.1 GEOGRAPHICAL SCOPE........................................................................................................................ 8
1.7.2 CONTENT SCOPE .................................................................................................................................... 8
1.7.3 TIME SCOPE ............................................................................................................................................. 8
CHAPTER TWO........................................................................................................................................................ 9
LITERATURE REVIEW.......................................................................................................................................... 9
2.0. INTRODUCTION .................................................................................................................................................. 9
2.1. LITERATURE REVIEW ......................................................................................................................................... 9
CHAPTER THREE: METHODOLOGY .............................................................................................................. 13
3.0 INTRODUCTION............................................................................................................................................ 13
3.1 STUDY DESIGN............................................................................................................................................. 13
3.2 STUDY AREA................................................................................................................................................. 13
3.3 STUDY POPULATION .................................................................................................................................. 14
3.4 SAMPLE SIZE DETERMINATION............................................................................................................... 14
3.5 SAMPLING METHOD ................................................................................................................................... 14
3.6 STUDY VARIABLES ..................................................................................................................................... 14
3.7 TOOLS AND METHODS OF DATA COLLECTION ................................................................................... 15
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3.8 DATA PROCESSING AND ANALYSIS ....................................................................................................... 15
3.9.1 PROBLEMS ENCOUNTERED............................................................................................................... 15
3.9.2 INCLUSION AND EXCLUSION CRITERIA......................................................................................... 15
3.9.2.1 INCLUSION CRITERIA....................................................................................................................... 15
3.9.2.2 EXCLUSION CRITERIA...................................................................................................................... 15
3.9.3 ETHICAL CONSIDERATION ................................................................................................................ 15
CHAPTER FOUR .................................................................................................................................................... 16
RESULTS.................................................................................................................................................................. 16
4.0 INTRODUCTION ................................................................................................................................................. 16
4.1 RESEARCH RESULTS................................................................................................................................... 16
CHAPTER FIVE...................................................................................................................................................... 26
DISCUSSION AND INTERPRETATION OF RESULTS ................................................................................... 26
5.0. INTRODUCTION ................................................................................................................................................ 26
5.1. DEMOGRAPHIC INFORMATION.......................................................................................................................... 26
5.2. THE PROPORTION OF MOTHERS THAT HAVE EVER HAD A PUERPERAL INFECTION AMONG THOSE ATTENDING THE
OBSTETRICS WARD AT FPRRH......................................................................................................................................................................27
5.3. FACTORS CONTRIBUTING TO PUERPERAL SEPSIS AMONG MOTHERS.................................................................. 27
5.4. CONCLUSION.................................................................................................................................................... 31
5.5. RECOMMENDATIONS........................................................................................................................................ 31
6.0 REFERENCES ................................................................................................................................................... 33
APPENDIX 1: WORK PLAN ................................................................................................................................. 35
APPENDIX 2: BUDGET ......................................................................................................................................... 36
APPENDIX: 3 DATA COLLECTION FORM...................................................................................................... 37
APPENDIX 4: MAP OF UGANDA ........................................................................................................................ 41
APPENDIX 5: MAP OF BUSHENYI DISTRICT................................................................................................. 42
APPENDIX 6: ISHAKA LOCATION.................................................................................................................... 43