PREVALENCE OF SPONTANEOUS BACTERIAL PERITONITIS AND ASSOCIATED FACTORS AMONG CIRRHOTIC ASCITES PATIENTS ADMITTED TO PUBLIC HOSPITALS OF HARAR TOWN, EASTERN ETHIOPIA: A HOSPITAL BASED CROSS-SECTIONAL

Abstract

Spontaneous Bacterial Peritonitis is potentially lethal complication and serious sequel of ascites caused by cirrhosis. Although the burden of ascites caused by cirrhosis is high in public hospitals of Harar town, eastern Ethiopia, data regarding the prevalence and associated factors of spontaneous bacterial peritonitis is lacking. Objective: To determine the prevalence of spontaneous bacterial peritonitis and associated factors among cirrhotic ascites patients admitted to Hiwot Fana comprehensive Specialized University Hospital and Jugal general hospital, Harar town, eastern Ethiopia from December 15-31, 2022. Methods: A retrospective hospital based cross-sectional study was conducted from December 15-31,2022 on randomly selected 319 patients with cirrhotic ascites admitted to Hiwot Fana comprehensive Specialized University Hospital and Jugal general hospital from January 1, 2021 to December 15, 2022. Data about socio-demographic, clinical and laboratory characteristics were collected by reviewing medical record of patients. The data was tabulated, cleaned and entered into Epidata version 3.1 and exported to SPSS version 22 for analysis. Discrete variables were summarized by percentages and frequencies whereas continuous variables were summarized by medians and 25th and 75th quartile. Binary logistic regression analyses was used to identify significantly associated factors with SBP and Adjusted Odds Ratio with 95% CI was used to measure strength of association and statistical significance was declared at p ≤ 0.05. Result: A total of 319 admitted patients with cirrhotic ascites were included with mean age ±SD was 40.3 (±11.5) years and male accounts for 56.1%. The prevalence of spontaneous bacterial peritonitis was 34.8% [95% CI: 29.8%, 40.1%)]. Age between 31 and 40 years [AOR= 2.632 (1.065, 6.504)], age above 41 years [AOR= 2.596 (1.076, 6.262)], Abdominal pain and/ or tenderness[AOR= 2.084 (1.019, 4.263)], bloody vomiting and/or tarry stool [AOR= 2.084 (1.019, 4.263)], tachycardia [AOR= 2.906 (1.401, 6.027)], jaundice [AOR= 2.745 (1.304, 5.774)], low GCS [AOR= 4.513 (1.926, 10.576)], electrolyte disturbances (hypokalemia [AOR= 11.018 (5.008, 24.242)], hypernatremia [AOR= 4.561 (1.082, 19.234)] and hyperkalemia [AOR=10.464 (1.580, 69.302)]), low peritoneal fluid protein [AOR= 3.186 (1.498, 6.6773)] and glucose [AOR=2.461 (1.126, 5.379)] were significantly associated with SBP. Conclusion: The prevalence of SBP is 34.8% among patients with cirrhotic ascites admitted. Age between 31 and 40 years, age above 41 years, Abdominal pain and/ or tenderness, bloody vomiting and/or tarry stool, tachycardia, jaundice, low GCS, electrolyte disturbances (hypokalemia, hypernatremia and hyperkalemia), low peritoneal fluid protein and glucose were independent predictors of SBP