DETERMINANTS OF PUERPERAL SEPSIS AMONG POSTPARTUM WOMEN AT PUBLIC HOSPITALS, IN GEDEO ZONE, SOUTHERN ETHIOPIA: A CASE CONTROL STUDY 2020

Abstract Introduction: Puerperal sepsis is bacterial infection of genital tract that occurs at any time between the onset of rupture of membranes or labour and the 42nd days postpartum. It ranks third leading cause of direct maternal mortality in developing nations. It is the fourth leading cause of maternal death and accounts about 14.68% in Ethiopia. Although multiple interventions were done to tackle this health problem, maternal morbidities and mortality were still high. Objective: To identify the determinants of puerperal sepsis among postpartum women at public hospitals, in Gedeo zone, Southern Ethiopia 2020. Methodology: This facility-based unmatched case-control study included 252 participants from February 20– May 20/2020. Cases recruited conveniently while controls enrolled by systematic sampling. Data was collected using interviewer administered questionnaire and the collected data was entered in to Epi data version 3.1 which was then exported to statistical package for social science version 22 for analysis. The association between variables was analyzed with bivariate and multi variable logistic regression. Multicollinearity was checked by variance inflation factor. Hosmar and Lemeshow test was used for model adequacy. A statistical significance was declared at p value < 0.05, with 95% confidence interval. Result: A total number of 252 (63 cases and 189 controls) study participants involved in the present study yielding a response rate of 96.9%. Participants" age ranges from 17 to 38 years. After adjusting for the possible confounders, age <25 years [AOR=2.37, 95%CI (1.08-5.21)], rural residence [AOR=4.83, 95% CI (2.04-11.40)], no antenatal care [AOR=6.10, 95%CI (2.54-14.67)], mode of delivery (caesarean section) [AOR=4.32 95% CI (1.39-13.43)] and having referral [AOR=2.39, 95% CI (1.02-5.62)] were found to be significant determinants for puerperal sepsis among postpartum women at public hospitals in Gedeo zone, Southern Ethiopia. Conclusion- Age, residence, antenatal care, mode of delivery and referral status were found to be significant determinants for puerperal sepsis. Scaling up antenatal care for women was warranted for health extension workers.