Prevalence and determinants of surgical site infection following cesarean section in africa: Umbrella review

Background Surgical site infection following cesarean section remains a major contributor to maternal morbidity, particularly in low- and middle-income countries. Although several systematic reviews and meta-analyses have evaluated its burden and determinants in Africa, findings remain heterogeneous and have not previously been synthesized through an umbrella review. Objective To synthesize evidence on the prevalence and determinants of surgical site infection following cesarean section in Africa. Design Umbrella review. Methods A comprehensive search of PubMed, HINARI/Research4Life, African Journals Online, ScienceDirect, Google Scholar, and Ethiopian scholarly repositories was conducted from March 1, 2026 to March 30, 2026. Systematic reviews and meta-analyses reporting the prevalence and/or determinants of surgical site infection following cesarean section in African populations were eligible. Methodological quality was assessed using AMSTAR 2, and overlap among primary studies was evaluated using the corrected covered area method. Results Seven systematic reviews and meta-analyses, comprising 71 primary studies and 61,485 participants, were included. Across the included reviews, reported pooled prevalence estimates consistently clustered around 10%. Maternal anemia, chorioamnionitis, prolonged labor, prolonged rupture of membranes, vertical skin incision, and general anesthesia were the determinants most consistently associated with increased surgical site infection risk following cesarean section. Methodological quality varied across reviews (five high quality and 2 moderate quality), and substantial heterogeneity with slight overlap among primary studies was identified. Conclusion The available evidence indicates that surgical site infection remains an important maternal health concern following cesarean section in Africa. However, the findings should be interpreted cautiously because of heterogeneity and methodological limitations within the existing evidence base. Strengthening evidence-based perioperative infection prevention, standardized surgical site infection surveillance, and high-quality multicounty prospective research are important priorities.