Maternal Cesarian Section Infection (MACSI) in Sierra Leone

NCT ID: NCT03929991

Last Updated: 2019-04-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-05-01

Study Completion Date

2020-05-01

Brief Summary

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Up to 1 in 5 women in Africa who deliver their baby by cesarean section get a wound infection.

Surgical site infections (SSIs) are largely preventable, but they represent a considerable burden for health-care systems, particularly in low-income and middle-income countries. The prevention of these infections is complex and requires the integration of a range of preventive measures before, during, and after surgery.

The aim of the proposed project is to determine the risk factors of Surgical Site Infection post-Cesarean Section in women admitted to Princess Christian Maternity Hospital (PCMH) in Freetown, Sierra Leone. Secondary aims are to determine the incidence of SSI and the predictors of a negative outcome in women with post-CS SSI.

Detailed Description

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Rationale: More than 1 in 10 people who have surgery in low and middle-income countries (LMICs) get surgical site infection. People's risk of SSI in LMICs is 3 to 5 times higher than in high-income countries. Up to 1 in 5 women in Africa who deliver their baby by cesarean section get a wound infection.

Surgical site infections (SSIs) are largely preventable, but they represent a considerable burden for health-care systems, particularly in low-income and middle-income countries. The prevention of these infections is complex and requires the integration of a range of preventive measures before, during, and after surgery.

Objective: The aim of the proposed project is to determine the risk factors of Surgical Site Infection post-Cesarean Section in women admitted to Princess Christian Maternity Hospital (PCMH) in Freetown, Sierra Leone. Secondary aims are to determine the incidence of SSI and the predictors of a negative outcome in women with post-CS SSI.

Study design: This is a prospective case-control (1:3 ratio) study. Study population and Methods: All women admitted or already hospitalized with suspected or confirmed infection after C/S will be screened for inclusion in the study as a case. Case confirmation will be clinically established by an infectious disease expert. For each case, 3 patients undergoing the C/S on the same day and admitted to the same ward but not presenting SSI, will be selected as controls.

Sample size: No formal sample size calculation is performed.

Main study parameters/primary endpoints: SSI post C/S will be classified as:

Superficial incisional surgical site infection, Deep incisional surgical site infection; Organ/space surgical site infection Nature and extent of the burden and risks associated with participation, benefit, and group relatedness: Because all proceedings in the method of this study are based on common clinical practice, there are no serious adverse events (SAEs) expected.

Conditions

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Infection Cesarean Section Complications Site Infection Maternal Death

Keywords

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Site infection Sierra Leone Africa Cesarean Infection Maternal Mortality

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Case

All women admitted or already hospitalized with suspected or confirmed infection after C/S will be screened for inclusion in the study as a case. Case confirmation will be clinically established by an infectious disease expert.SSI post C/S will be classified as:

* Superficial incisional surgical site infection,
* Deep incisional surgical site infection,
* Organ/space surgical site infection.

Observational

Intervention Type OTHER

To record social and clinical characteristics

Control

For each case, 3 patients undergoing the C/S on the same day and admitted to the same ward but not presenting Surgical Site Infection

Observational

Intervention Type OTHER

To record social and clinical characteristics

Interventions

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Observational

To record social and clinical characteristics

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All pregnant women undergoing a C/S in on the hospitals during the study period will be eligible to participate in this study.

Exclusion Criteria

The following conditions will not be considered as outcome, unless they present with systemic repercussion due to infection. For example:

* Vaginosis, candidiasis
* Lower tract urinary infection
* Fungal infections of the skin (athlete's foot, jockitch, ringworm, and yeast infections)
* Otitis
* Pharyngitis
* Herpes simplex, Herpes Zoster (Shingles)
* Uncomplicated chronic infection
* Sexually transmitted infections (Gonorrhoea, Syphilis, Trichomonas, Chlamydia, Hepatitis, HIV)
* Tuberculosis
* Bacterial colonization (presence of microorganisms without clinical signs/symptoms)
* Known vaginal, urethral and/or rectal GBS colonization
* Asymptomatic bacteriuria
* Known oropharyngeal colonization
* Non-infectious hypothermia/hyperthermia (e.g. related to epidural, thyroid storm, prostaglandin administration) during hospital stay
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Bari

OTHER

Sponsor Role collaborator

University of Palermo

OTHER

Sponsor Role collaborator

Doctors with Africa - CUAMM

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Giovanni Putoto, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of operational research Doctors with Africa CUAMM Padova, Italy

Locations

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Princess Christian Maternity Hospital

Freetown, , Sierra Leone

Site Status RECRUITING

Countries

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Sierra Leone

Central Contacts

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Francesco Di Gennaro, MD

Role: CONTACT

Phone: 3924804707

Email: [email protected]

Giovanni Putoto, PhD

Role: CONTACT

Phone: 3475791347

Email: [email protected]

Facility Contacts

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Francesco Di Gennaro

Role: primary

Other Identifiers

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1902

Identifier Type: -

Identifier Source: org_study_id