Documented Surgical Site Infection After Cesarean Delivery at Kiziguro District Hospital, Rwanda: A Retrospective Record Review.
- 1Department of Midwifery, Ruli Higher Institute of Health, Kigali, Rwanda.
- 2Center for Nursing and Midwifery, University of Global Health Equity, Kigali, Rwanda.
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.
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BibTeX
@article{tuyishime2026documented,
title = {{Documented Surgical Site Infection After Cesarean Delivery at Kiziguro District Hospital, Rwanda: A Retrospective Record Review.}},
author = {Valens Tuyishime and Emmanuel Ndahiro Manirafasha},
journal = {International journal of women's health},
year = {2026},
month = oct,
doi = {10.2147/ijwh.s649177},
url = {https://europepmc.org/article/MED/42968836},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Documented Surgical Site Infection After Cesarean Delivery at Kiziguro District Hospital, Rwanda: A Retrospective Record Review.
AU - Valens Tuyishime
AU - Emmanuel Ndahiro Manirafasha
PY - 2026
DA - 2026/10/28
JO - International journal of women's health
DO - 10.2147/ijwh.s649177
UR - https://europepmc.org/article/MED/42968836
AB - 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.
SN - 1179-1411
ER -