Department of General Medicine and Surgery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
The Foundation to Prevent Antibiotic Resistance, Stockholm, Sweden.
Int Wound J. 2024 May;21(5):e14929. doi: 10.1111/iwj.14929.
Caesarean section (C-section) is the most performed major surgery worldwide. About 15% of births are delivered through C-section in Rwanda. The post-caesarean surgical section is one of the most frequent complications that follow a C-section. The purpose of this systematic review and meta-analysis is to estimate the pooled prevalence of surgical site infections following caesarean section deliveries in Rwanda. A comprehensive search was conducted across PubMed/MEDLINE, Google Scholar, DOAJ, AJOL and the Cochrane Library to identify primary studies on post-caesarean surgical site infections in Rwanda. Studies meeting predetermined criteria were included, and their quality was assessed using the JBI Critical Appraisal Tools. Heterogeneity was evaluated using I2 statistics, while publication bias was examined via funnel plots and statistical tests. Pooled prevalence was calculated using Jamovi 2.3.28 software, with subgroup analysis conducted to identify sources of heterogeneity. Statistical significance was set at p < 0.05. From 139 articles initially searched from the databases, only 17 studies with 8, 082 individuals were finally included in the systematic review and meta-analysis. Using the random-effects model, the pooled estimate of post C-section SSIs prevalence in Rwanda was 6.85% (95% CI 5.2, 8.5). Subgroup analysis based on publication year, sample size, hospital and study design showed no much difference in SSI prevalence. The current systematic review and meta-analysis indicates that post-caesarean surgical site infections are significant in Rwanda. A collaborative effort is required to lower post-C-section SSIs and provide the best surgical care in the country.
剖宫产术(C -section)是全球施行最多的主要手术之一。在卢旺达,约有 15%的分娩是通过剖宫产进行的。剖宫产术后切口部位感染是紧随剖宫产术后最常见的并发症之一。本系统评价和荟萃分析的目的是估计卢旺达剖宫产术后切口部位感染的综合患病率。通过 PubMed/MEDLINE、Google Scholar、DOAJ、AJOL 和 Cochrane 图书馆全面检索了关于卢旺达剖宫产术后切口部位感染的原始研究。纳入符合预定标准的研究,并使用 JBI 批判性评估工具评估其质量。使用 I2 统计量评估异质性,通过漏斗图和统计检验检查发表偏倚。使用 Jamovi 2.3.28 软件计算汇总患病率,并进行亚组分析以确定异质性的来源。统计显著性设为 p<0.05。从数据库中最初搜索到的 139 篇文章中,最终只有 17 项研究(8082 人)纳入系统评价和荟萃分析。使用随机效应模型,卢旺达剖宫产术后切口部位感染的汇总患病率为 6.85%(95%CI 5.2, 8.5)。基于发表年份、样本量、医院和研究设计的亚组分析显示,SSI 患病率没有太大差异。本系统评价和荟萃分析表明,卢旺达的剖宫产术后切口部位感染较为严重。需要共同努力来降低剖宫产术后切口部位感染率,并为该国提供最佳的手术护理。