The association of puerperal sepsis with HIV infection at two tertiary hospitals in Zimbabwe
Open accessAbstract
Objective: To evaluate the association between HIV infection and puerperal sepsis among women in Zimbabwe. Methods: A subanalysis was performed using data from a prospective cohort study conducted between September 2, 2014, and July 1, 2015, at two tertiary hospitals in Zimbabwe. Eligible participants were consecutive women who met the WHO criteria for puerperal sepsis. Variables assessed included HIV‐infection status and the use of antiretroviral therapy. Severity of immunosuppression was defined by the number of T cells that expressed cluster of differentiation 4 (CD 4). Endocervical swabs and blood samples were collected for microbial culture and susceptibility testing. Results: In all, 33 (21.9%) of the 151 women included in the present analysis had HIV. Among women with HIV, severe immunosuppression (CD 4‐positive T cell count <200/mm 3) was associated with a mean hospital stay of 19.0 days versus 10.2 days for mild‐advanced immunosuppression (CD 4‐positive T cell count 200–500/mm 3) and insignificant immunosuppression (CD 4‐positive T cell count >500/mm 3; P=0.030). Use of antiretroviral therapy did not independently influence clinical outcomes. Furthermore, infection with HIV did not influence the microorganisms isolated from blood or endocervical samples. Conclusion: Severe immunosuppression was associated with increased length of hospitalization among women with HIV who had puerperal sepsis.
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Majangara et al. [27] reported increased length of hospitalization stay for HIV positive women with puerperal sepsis.
“Majangara et al. [27] was the only study reviewed here that stratified data according to HIV status and reported increased length of hospitalization stay for HIV positive women with puerperal sepsis but they did not find a specific microbial agent that significantly associated with HIV status.”
From The aetiology and antimicrobial resistance of bacterial maternal infections in Sub-Saharan Africa—a systematic review and meta-analysis (2024) · cites this paper as [27]
The Abstract Results report a longer hospital stay for women with HIV who had severe immunosuppression (19.0 versus 10.2 days for other women with HIV). The Results report no statistically significant differences by HIV status overall, so the claim omits the qualification that the increase was associated with severe immunosuppression, not HIV-positive status alone. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMajangara et al. [27] did not find a specific microbial agent that significantly associated with HIV status.
“Majangara et al. [27] was the only study reviewed here that stratified data according to HIV status and reported increased length of hospitalization stay for HIV positive women with puerperal sepsis but they did not find a specific microbial agent that significantly associated with HIV status.”
From The aetiology and antimicrobial resistance of bacterial maternal infections in Sub-Saharan Africa—a systematic review and meta-analysis (2024) · cites this paper as [27]
Majangara et al. [27] was the only study reviewed here that stratified data according to HIV status.
“Majangara et al. [27] was the only study reviewed here that stratified data according to HIV status and reported increased length of hospitalization stay for HIV positive women with puerperal sepsis but they did not find a specific microbial agent that significantly associated with HIV status.”
From The aetiology and antimicrobial resistance of bacterial maternal infections in Sub-Saharan Africa—a systematic review and meta-analysis (2024) · cites this paper as [27]
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Chapuma, C., Twabi, H. H., Monk, E. J. M., Jafali, J., Weeks, A., Beales, E., Kulapani, D., Selemani, A., Nliwasa, M., Gadama, L., et al. (2024) · BMC Infectious Diseases · doi:10.1186/s12879-024-09855-3 · Cited by 12 · see citing works
- Authors
- Majangara, R., Chirenje, Z. M., & Gidiri, M. F.
- Affiliations
- University of Zimbabwe (ZW)
- Corresponding author
- Majangara, Rumbidzai
- Venue
- International Journal of Gynecology & Obstetrics
- Publisher
- Wiley
- Published
- 2018-11-08
- Volume
- 144
- Issue
- 1
- Pages
- 67-72
- ISSN
- 0020-6695 (ISSN-L)
- 0020-7292
- 1879-3479
- PMC
- PMC6283678
- OpenAlex
- W2896556512
- Cited by
- 4
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Gynecology & Obstetrics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- Fogarty International Center
- National Institutes of Health
- U.S. Department of Health and Human Services
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- puerperal fever, HIV infection, immunosuppression, CD4 count, antiretroviral therapy, length of hospital stay, postpartum infection, endocervical swabs, blood culture, antimicrobial susceptibility, Zimbabwe
- MeSH terms
- Adult, Female, Humans, Length of Stay, Pregnancy, Prospective Studies, Puerperal Infection, Zimbabwe, HIV Infections, CD4 Lymphocyte Count, Sepsis, Antiretroviral Therapy, Highly Active, Tertiary Care Centers
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