Prevalence and Determinants of Post - Operative Surgical Site Infections at Amana Regional Referral Hospital, Tanzania: A Prospective Observational Study

Background: Surgical site infection (SSI) remains a significant concern in hospital settings, contributing to prolonged hospitalization, increased morbidity rates, and heightened healthcare expenses. This prospective observational study, conducted at the surgical ward of Amana Regional Referral Hospital (ARRH) in Tanzania from March to July 2023, aimed to investigate factors associated with SSI during the initial week following surgery. Materials and Methods: A cohort of 258 patients undergoing surgery was enrolled, with a 7 -day follow -up period. Data, including socio -demographic and clinical information, were collected through questionnaires, and surgical sites were examined for signs of SSI. Univariate and multivariate analyses were performed using SPSS version 25, with a significance level of 5%. Results: Out of the initial cohort, 8 patients were lost to follow -up, 6 experienced fatalities, and 2 were referred from the study site. The remaining 242 participants included 167 males (67%) and 33% females, with the predominant age group of 30 -44 years. Co -morbidities, such as diabetes mellitus (DM) and hypertension, were observed in 16.4% of patients. Statistical analysis revealed that wound class and duration of surgery were significantly associated with the development of SSI at ARRH, with p -values of 0.003 and 0.037, respectively. Conclusion: This study highlights the significant impact of wound class and duration of surgery on the development of surgical site infections at ARRH. The findings emphasize the importance of meticulous attention to these factors in preoperative planning and postoperative care to minimize the risk of SSI. Further research and interventions focused on addressing these specific factors may contribute to the reduction of SSI rates, ultimately improving patient outcomes and reducing healthcare costs. This research has implications for surgical practice and underscores the need for tailored strategies to mitigate the identified risk factors in the local context. In this study 22.8% of patients developed SSI. Among the several factors studied (smoking; operator skill level;prophylactic antibiotics taken before surgery; shaving in the operating room or ward; length of surgery; and wound type) the strongest predictors of SSI were the length of the procedure and wound classification.The use of prophylactic antibiotics before surgery was found to be an important factor in preventing SSI.Since many of these factors are modifiable then these results will help reduce SSI rates after general surgery.