Factors Associated with Infection in Patients with Continuous Ambulatory Peritoneal Dialysis, Song District, Phrae Province, Thailand - ปัจจัยที่มีผลต่อการติดเชื้อในผู้ป่วยล้างไตทางช่องท้อง อำเภอสอง จังหวัดแพร่

Abstract

The increasing trends of hypertension and diabetes in Song hospital, Prae Province, had led to an
increasing number of patients with end state renal failure. Continuous ambulatory peritoneal dialysis
(CAPD) was the first policy choice for the patients under universal health care coverage due to the
lower cost compared to hemodialysis, the ability for care givers to manage at home, and the reduction
of the cost and time to travel to the hospital. However, such technique can lead to infection if septic
practice is not strictly followed. The objectives of this study were to assess infection rate and identify
factors associated with the infection in CAPD patients. The study samples were CAPD patients in Song
District; and the study was conducted during October 2011 to September 2012. Data were collected by
observation and interview using questionnaires. Data were analyzed with frequency distribution test and
context analysis. There were altogether 22 CAPD cases of whom infection was observed in 7 cases (8
episodes) or 0.4 infection 0.4 per case per year. Majority of the patients were men (64.0%) with mean
age of 57 years old. Hypertension and diabetes were found in 78.2% of cases. Duration of the dialysis
was 2 years on average. The locations where the patients underwent CAPD procedure at home were
separated from the place to sleep 59.0%. Majority of care givers were relatives (64.0%). All care
givers passed the CAPD training course. Through observation, 64.0% of them did not wash hands
correctly; and 64.0% did not properly cover the wound during bathing. The two factors were found to
be significantly associated with the infection (p<0.05). Therefore, emphasis should be placed on proper
hand washing and covering of the wound during taking bath in order to prevent infection. Such experiences
should be shared among patients and care givers to strengthen and sustain the care for CAPD
patients.
Key words: infection, continuous ambulatory peritoneal dialysis, chronic kidney diseases, dialysis patients,chronic diseases