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. 2017 May 8:6:43.
doi: 10.1186/s13756-017-0205-0. eCollection 2017.

Reliability and validity of using telephone calls for post-discharge surveillance of surgical site infection following caesarean section at a tertiary hospital in Tanzania

Boniface Nguhuni #  1   2 , Pasquale De Nardo #  1   2 , Elisa Gentilotti  1   3 , Zainab Chaula  1 , Caroline Damian  4 , Paola Mencarini  1   2 , Emanuele Nicastri  2 , Arnold Fulment  5 , Alessandro Piscini  1   2 , Francesco Vairo  2 , Alexander M Aiken  6 , Giuseppe Ippolito  2
Affiliations

Reliability and validity of using telephone calls for post-discharge surveillance of surgical site infection following caesarean section at a tertiary hospital in Tanzania

Boniface Nguhuni et al. Antimicrob Resist Infect Control. .

Abstract

Background: Surgical site infection (SSI) is a common post-operative complication causing significant morbidity and mortality. Many SSI occur after discharge from hospital. Post-discharge SSI surveillance in low and middle income countries needs to be improved.

Methodology: We conducted an observational cohort study in Dodoma, Tanzania to examine the sensitivity and specificity of telephone calls to detect SSI after discharge from hospital in comparison to a gold standard of clinician review. Women undergoing caesarean section were enrolled and followed up for 30 days. Women providing a telephone number were interviewed using a structured questionnaire at approximately days 5, 12 and 28 post-surgery. Women were then invited for out-patient review by a clinician blinded to the findings of telephone interview.

Results: A total of 374 women were enrolled and an overall SSI rate of 12% (n = 45) was observed. Three hundred and sixteen (84%) women provided a telephone number, of which 202 had at least one telephone interview followed by a clinical review within 48 h, generating a total of 484 paired observations. From the clinical reviews, 25 SSI were diagnosed, of which telephone interview had correctly identified 18 infections; telephone calls did not incorrectly identify SSI in any patients. The overall sensitivity and specificity of telephone interviews as compared to clinician evaluation was 72 and 100%, respectively.

Conclusion: The use of telephone interview as a diagnostic tool for post-discharge surveillance of SSI had moderate sensitivity and high specificity in Tanzania. Telephone-based detection may be a useful method for SSI surveillance in low-income settings with high penetration of mobile telephones.

Keywords: Caesarean section; Phone call interview; Post-discharge surveillance; Resource limited settings; Surgical site infection.

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