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Variability of water, sanitation, and hygiene conditions and the potential infection risk following cesarean delivery in rural Rwanda
Journal of Water & Health ( IF 2.3 ) Pub Date : 2020-10-01 , DOI: 10.2166/wh.2020.220
Katharine Ann Robb 1 , Caste Habiyakare 2 , Fredrick Kateera 3 , Theoneste Nkurunziza 3 , Leila Dusabe 3 , Marthe Kubwimana 3 , Brittany Powell 4 , Rachel Koch 5 , Magdalena Gruendl 6 , Patient Ngamije 2 , Robert Riviello 7 , Bethany Hedt-Gauthier 8
Affiliation  

Safe water, sanitation, and hygiene (WASH) is critical for the prevention of postpartum infections. The aim of this study was to characterize the WASH conditions women are exposed to following cesarean section in rural Rwanda. We assessed the variability of WASH conditions in the postpartum ward of a district hospital over two months, the WASH conditions at the women's homes, and the association between WASH conditions and suspected surgical site infection (SSI). Piped water flowed more consistently during the rainy month, which increased availability of water for drinking and handwashing (p < 0.05 for all). Latex gloves and hand-sanitizer were more likely to be available on weekends versus weekdays (p < 0.05 for both). Evaluation for suspected SSI after cesarean section was completed for 173 women. Women exposed to a day or more without running water in the hospital were 2.6 times more likely to develop a suspected SSI (p = 0.027). 92% of women returned home to unsafe WASH environments, with notable shortfalls in handwashing supplies and sanitation. The variability in hospital WASH conditions and the poor home WASH conditions may be contributing to SSIs after cesarean section. These relationships must be further explored to develop appropriate interventions to improve mothers’ outcomes.



中文翻译:

卢旺达农村地区剖宫产后水、环境卫生和个人卫生条件的变化以及潜在的感染风险

安全的水、环境卫生和个人卫生 (WASH) 对于预防产后感染至关重要。本研究的目的是描述卢旺达农村妇女剖宫产后面临的 WASH 条件。我们评估了地区医院产后病房两个月内 WASH 条件的变异性、妇女之家的 WASH 条件以及 WASH 条件与疑似手术部位感染 (SSI) 之间的关联。在下雨月份,管道水的流动更加一致,这增加了饮用水和洗手用水的可用性(所有p < 0.05)。与工作日相比,周末更有可能提供乳胶手套和洗手液(p< 0.05 两者)。对 173 名妇女进行了剖宫产后疑似 SSI 的评估。在医院接触一天或更长时间没有自来水的女性患疑似 SSI 的可能性是其他女性的 2.6 倍 ( p = 0.027)。92% 的妇女回到不安全的 WASH 环境,洗手用品和卫生设施明显短缺。医院 WASH 条件的可变性和家庭 WASH 条件差可能导致剖宫产后出现 SSI。必须进一步探索这些关系,以制定适当的干预措施来改善母亲的结局。

更新日期:2020-10-30
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