Factors associated with the Development of Breast Abscesses in Women Presenting to University Teaching Hospital, Lusaka

Abstract

A case controlled study to determine factors associated with the development of breast abscesses it women presenting to the UTH was designed and conducted over seven months. 110 cases and controls were serially recruited for the study. Blood for HIV and CD4 counts as well as pus aspirates were collected for analysis from each patient. Epidemiological, socio-demographic, and medical history data of patients was also collected.Over 70% of cases were below 25yrs and had either one or two children. Age range of infants involved was between 0-6months. 85.5% of clients were married though only 31% were housewives. 76.4% cases came from high-density suburbs with all patients attaining some form of education (primary or secondary). Cigarette smoking and alcohol drinking was not a common habit amongst respondents (3.6% smoking and 30% drinking) with no statistical significance. Most patients’ breastfed adlib (79.5%) and all claimed to have visited the antenatal clinic during their pregnancies. Despite the good antenatal attendance, 39.1% did not know cause, 35.5% thought it was due to child belching and 14.5% thought it was poor breast hygiene.HIV infection rates were higher amongst cases 49.1%, against 22.9% in controls and statistically significant (p=0.001) with an ODDS ratio of 3.3, 83% (45) of HIV+ cases had their CD4 counts between 201 – 499cells/cmm. Thirteen percent (7) cases had CD4 counts below 200cells/cmm, whilst only 4% (2) had their CD4 counts above 500cells/cmm. Staphylococcus aureas remains the primary infective organism (91.8%) and is responsive to Ciprofloxacin (99%), Erythromycin (97.1%), Chloramphenicol (93.3%) and Cefotaxime (88.2%).Factors identified associated with breast abscess formation include young age, low parity, living in high-density suburbs, feeding patterns and being HIV+. Cigarette smoking and alcohol drinking were not associated with the disease. Breast-Abscesses may define low CD4 counts as observed though further studies are required to substantiate the finding. Erythromycin is the recommended drug of choice followed by Cefotaxime.