The prevalence and determinants of puerperal sepsis among post-natal mothers attending at Hoima regional referral hospital, Uganda

It is estimated that 30 million patients worldwide are affected by puerperal sepsis, with nearly 6 million deaths among them. The Annual Health Sector Performance Report (AHSPR) 2021–2022 of Uganda reported that pregnancy-related sepsis contributed to 9% of maternal deaths, following hemorrhage (41%) and hypertensive disorders (14%) as the leading causes (MOH, 2022). This study assessed the prevalence and determinants of puerperal sepsis among postnatal mothers attending Hoima Regional Referral Hospital. A cross-sectional descriptive study design was used, recruiting 156 mothers, with a questionnaire as the primary data collection tool. The prevalence of puerperal sepsis was estimated at 10.9%. The most affected women were grand multiparous, with parity >4, accounting for 13 (76.4%) cases, while multiparous women constituted 2 (11.8%) cases. The condition was more frequent among unbooked mothers, representing 11 (64.7%) cases, compared to booked women: 4 (23.5%) with 1–2 ANC visits, 1 (5.9%) with 3–4 ANC visits, and 1 (5.9%) with >5 ANC visits. Mothers who delivered via cesarean section were at the highest risk, with 9 (52.9%) cases, followed by those who underwent instrumental delivery, 6 (35.3%), while only 2 (11.8%) cases occurred among vaginal deliveries. Referral status was also a significant risk factor, as 12 (70.6%) women who were referred to the hospital for delivery later developed sepsis, compared to only 5 (29.4%) non-referred cases. Considering these findings, increasing community awareness of the importance of frequent ANC visits, postpartum care, and educational interventions, as well as supporting women from low socioeconomic backgrounds, are recommended strategies for reducing puerperal sepsis. Keywords: Puerperal sepsis, Prevalence, Determinants, Postnatal mothers, Antenatal care (ANC)