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Puerperal sepsis, the leading cause of maternal deaths at a Tertiary University Teaching Hospital in Uganda
Open accessAbstract
BACKGROUND: Maternal mortality is highest in sub-Saharan Africa. In Uganda, the WHO- MDG 5 (aimed at reducing maternal mortality by 75 % between 1990 and 2015) has not been attained. The current maternal mortality ratio (MMR) in Uganda is 438 per 100,000 live births coming from 550 per 100,000 in 1990. This study sets out to find causes and predictors of maternal deaths in a tertiary University teaching Hospital in Uganda. METHODS: The study was a retrospective unmatched case control study which was carried out at the maternity unit of Mbarara Regional Referral Hospital (MRRH). The sample included pregnant women aged 15-49 years admitted to the Maternity unit between January 2011 and November 2014. Data from patient charts of 139 maternal deaths (cases) and 417 controls was collected using a standard audit/data extraction form. Multivariable logistic regression analysis was used to assess for the factors associated with maternal mortality. RESULTS: Direct causes of mortality accounted for 77.7 % while indirect causes contributed 22.3 %. The most frequent cause of maternal mortality was puerperal sepsis (30.9 %), followed by obstetric hemorrhage (21.6 %), hypertensive disorders in pregnancy (14.4 %), abortion complications (10.8 %). Malaria was the commonest indirect cause of mortality accounting for 8.92 %. On multivariable logistic regression analysis, the factors associated with maternal mortality were: primary or no education (OR 1.9; 95 % CI, 1.0-3.3); HIV positive sero-status (OR, 3.6; 95 % CI, 1.9-7.0); no antenatal care attendance (OR 3.6; 95 % CI, 1.8-7.0); rural dwellers (OR, 4.5; 95 % CI, 2.5-8.3); having been referred from another health facility (OR 5.0; 95 % CI, 2.9-10.0); delay to seek health care (delay-1) (OR 36.9; 95 % CI, 16.2-84.4). CONCLUSIONS: Most maternal deaths occur among mothers from rural areas, uneducated, HIV positive, unbooked mothers (lack of antenatal care), referred mothers in critical conditions and mothers delaying to seek health care. Puerperal sepsis is the leading cause of maternal deaths at Mbarara Regional Referral Hospital. Therefore more research into puerperal sepsis to describe the microbiology and epidemiology of sepsis is recommended.
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“prospective studies on incidence, microbiology and antimicrobial resistance are lacking.”
From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [6]
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“By comparison, Ngonzi et al. (2016) found that puerperal sepsis accounted for 31% of maternal deaths in a major Ugandan hospital during the period 2011 – 14.”
Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital
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Self-citation
Metadata
- Authors
- Ngonzi, J., Tornes, Y. F., Mukasa, P. K., Salongo, W., Kabakyenga, J., Sezalio, M., Wouters, K., Jacqueym, Y., & Van Geertruyden, J.-P.
- Affiliations
- Mbarara University of Science and Technology (UG)
- University of Antwerp (BE)
- Corresponding author
- Ngonzi, Joseph
- Venue
- BMC Pregnancy and Childbirth
- Published
- 2016-08-05
- Volume
- 16
- Issue
- 1
- Pages
- 207-207
- ISSN
- 1471-2393 (ISSN-L)
- PMC
- PMC4974713
- OpenAlex
- W2477516493
- Cited by
- 114
- References
- 28
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 13 · 2023: 14 · 2022: 24 · 2021: 13 · 2020: 16 · 2019: 10 · 2018: 5 · 2017: 4
- FWCI
- 7.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Pregnancy and Childbirth (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- VLIR-UOS via the HEFS Platform Harvest Call (ZIUS2013VOA0902)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- puerperal fever, maternal mortality, causes of maternal death, obstetric hemorrhage, hypertensive disorders of pregnancy, abortion complications, malaria, risk factors for maternal death, HIV, prenatal care, rural residence, Uganda, sub-Saharan Africa, Mbarara Regional Referral Hospital
- MeSH terms
- Adolescent, Adult, Cause of Death, Educational Status, Female, Postpartum Hemorrhage, HIV Seropositivity, Hospitals, Teaching, Humans, Malaria, Maternal Mortality, Prenatal Care, Puerperal Infection, Retrospective Studies, Risk Factors, Rural Population, Uganda, Case-Control Studies, Sepsis, Hypertension, Pregnancy-Induced, Young Adult, Time-to-Treatment
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