{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:06:00Z","timestamp":1791839160664,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,10,31]],"date-time":"2014-10-31T00:00:00Z","timestamp":1414713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2014,10,31]],"date-time":"2014-10-31T00:00:00Z","timestamp":1414713600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2014,10,31]],"date-time":"2014-10-31T00:00:00Z","timestamp":1414713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Surgical site infections (SSI) are a significant cause of post\u2010surgical morbidity and mortality and can be an indicator of surgical quality. The objectives of this study were to measure post\u2010operative SSI after cesarean section (CS) at four sites in three sub\u2010Saharan African countries and to describe the associated risk factors in order to improved quality of care in low and middle income surgical programs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included data from four emergency obstetric programs supported by Medecins sans Frontieres, from Burundi, the Democratic Republic of Congo (DRC), and Sierra Leone. Women undergoing from August 1 2010 to January 31 2011 were included. CS post\u2010operative SSI data were prospectively collected. Logistic regression was used to model SSI risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>In total, 1,276 women underwent CS. The incidence of SSI was 7.3 % (range 1.7\u201310.4 %). 93 % of SSI were superficial. The median length of stay of women without SSI was 7\u00a0days (range 3\u201363\u00a0days) compared to 21\u00a0days (range 5\u201351\u00a0days) in those with SSI (<jats:italic>p<\/jats:italic> &lt; 0.001). In multivariate analysis, younger age, premature rupture of the membranes, and neonatal death were associated with an increased risk of SSI, while antenatal hemorrhage and the Lubutu, DRC project site were associated with a lower risk of developing an SSI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrates that surgery can be performed with a low incidence of SSI, a proxy for surgical safety, in sub\u2010Saharan Africa. Protocols such as perioperative antibiotics and basic infrastructure such as clean water and sterilization can be achieved. Simple data collection tools will assist policymakers with monitoring and evaluation as well as quality control assurance of surgical programs in low and middle income countries.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-014-2840-4","type":"journal-article","created":{"date-parts":[[2014,10,30]],"date-time":"2014-10-30T14:03:34Z","timestamp":1414677814000},"page":"350-355","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Cesarean Section Surgical Site Infections in Sub\u2010Saharan Africa: A Multi\u2010Country Study from Medecins Sans Frontieres"],"prefix":"10.1002","volume":"39","author":[{"given":"Kathryn","family":"Chu","sequence":"first","affiliation":[{"name":"M\u00e9decins sans Fronti\u00e8res 49 Jorrisen St, Braamfontein 2017 Johannesburg South Africa"},{"name":"PO Box 154 7180 Elgin Republic of South 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