Adherence to Infection Prevention and Control Measures Among Health-Care Workers Serving in COVID-19 Treatment Centers in Punjab, Pakistan

Mustafa, Zia Ul; Majeed, Hafiza Kiran; Latif, Shaiza; Salman, Muhammad; Hayat, Khezar; Mallhi, Tauqeer Hussain; Khan, Yusra Habib; Khan, Amer Hayat; Abubakar, Usman; Sultana, Kishwar; Godman, Brian

doi:10.1017/dmp.2022.252

Cited by 8 publications

(12 citation statements)

References 33 publications

(38 reference statements)

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“…The extensive prescription post-operatively until the day of discharge that was seen in our study in Pakistan may be due to a number of factors. These include a lack of awareness and non-compliance with current international guidelines among physicians, i.e., perceiving that such guidelines are not directly attributable to their hospital and setting, concerns with the cleanliness of their wards, a general lack of infection control practices due to resource issues as well as a lack of trust in the validity of antimicrobial susceptibility data in the hospital [ 17 , 53 , 54 , 55 ]. Our findings regarding the extensive prescription of antimicrobials post-operatively for SAP are similar to those of a study by Khan et al (2020), as well as one by Saleem et al (2023), in Pakistan alongside other LMICs ( Supplementary Table S1 ), and this issue urgently needs to be addressed going forward [ 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Utilization Patterns for Different Wound Types among Surgical Patients: Findings and Implications

et al. 2023

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Antimicrobial prophylaxis is effective in reducing the rate of surgical site infections (SSIs) post-operatively. However, there are concerns with the extent of prophylaxis post-operatively, especially in low- and middle-income countries (LMICs). This increases antimicrobial resistance (AMR), which is a key issue in Pakistan. Consequently, we conducted an observational cross-sectional study on 583 patients undergoing surgery at a leading teaching hospital in Pakistan with respect to the choice, time and duration of antimicrobials to prevent SSIs. The identified variables included post-operative prophylactic antimicrobials given to all patients for all surgical procedures. In addition, cephalosporins were frequently used for all surgical procedures, and among these, the use of third-generation cephalosporins was common. The duration of post-operative prophylaxis was 3–4 days, appreciably longer than the suggestions of the guidelines, with most patients prescribed antimicrobials until discharge. The inappropriate choice of antimicrobials combined with prolonged post-operative antibiotic administration need to be addressed. This includes appropriate interventions, such as antimicrobial stewardship programs, which have been successful in other LMICs to improve antibiotic utilization associated with SSIs and to reduce AMR.

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Section: Discussionmentioning

confidence: 99%

Antibiotic Utilization Patterns for Different Wound Types among Surgical Patients: Findings and Implications

et al. 2023

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“…Punjab was selected for this study because it is the most populus province in Pakistan, with a number of previous studies undertaken by the co-authors in the province, including patients with COVID-19, serving as comparators [ 23 , 39 , 86 , 87 , 88 , 89 , 90 ]. Moreover, these tertiary care/teaching hospitals were equipped with adequate medical personnel, laboratory facilities and personal protective equipment, as well as medicines for the effective management of children admitted with COVID-19.…”

Section: Methodsmentioning

confidence: 99%

Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications

et al. 2023

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There are concerns with excessive antibiotic prescribing among patients admitted to hospital with COVID-19, increasing antimicrobial resistance (AMR). Most studies have been conducted in adults with limited data on neonates and children, including in Pakistan. A retrospective study was conducted among four referral/tertiary care hospitals, including the clinical manifestations, laboratory findings, the prevalence of bacterial co-infections or secondary bacterial infections and antibiotics prescribed among neonates and children hospitalized due to COVID-19. Among 1237 neonates and children, 511 were admitted to the COVID-19 wards and 433 were finally included in the study. The majority of admitted children were COVID-19-positive (85.9%) with severe COVID-19 (38.2%), and 37.4% were admitted to the ICU. The prevalence of bacterial co-infections or secondary bacterial infections was 3.7%; however, 85.5% were prescribed antibiotics during their hospital stay (average 1.70 ± 0.98 antibiotics per patient). Further, 54.3% were prescribed two antibiotics via the parenteral route (75.5%) for ≤5 days (57.5), with most being ‘Watch’ antibiotics (80.4%). Increased antibiotic prescribing was reported among patients requiring mechanical ventilation and high WBCs, CRP, D-dimer and ferritin levels (p < 0.001). Increased COVID-19 severity, length of stay and hospital setting were significantly associated with antibiotic prescribing (p < 0.001). Excessive antibiotic prescribing among hospitalized neonates and children, despite very low bacterial co-infections or secondary bacterial infections, requires urgent attention to reduce AMR.

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“…Since the start of the COVID-19 vaccine drive, prisoners have also been provided with vaccines free of charge if they wish to be vaccinated against COVID-19. Punjab Province was selected for this initial study due to the fact that Punjab contained ≥65% of the country’s population [ 67 , 68 ].…”

Section: Methodsmentioning

confidence: 99%

COVID-19 Vaccination Status as Well as Factors Associated with COVID-19 Vaccine Acceptance and Hesitancy among Prisoners and the Implications

Shabir,

Alkubaisi,

Shafiq

et al. 2023

Vaccines

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Prisoners form a population who are highly vulnerable to COVID-19 due to overcrowding, limited movement, and a poor living environment. Consequently, there is a need to ascertain the status of COVID-19 vaccination and factors associated with hesitancy among prisoners. A cross-sectional questionnaire-based study was undertaken among prisoners at three district jails in Punjab Province, Pakistan. A total of 381 prisoners participated and none of the study participants had received an influenza vaccine this year. In total, 53% received at least one dose of a COVID-19 vaccine, with the majority having two doses. The top three reasons of vaccine acceptance were “fear of contracting SARS-CoV-2 infection” (56.9%), “desire to return to a pre-pandemic routine as soon as possible” (56.4%), and “having no doubts on the safety of COVID-19 vaccines” (39.6%). There was no statistically significant difference (p > 0.05) in any demographic variables between vaccinated and unvaccinated prisoners except for age, which was strongly association with COVID-19 vaccine uptake (χ2(3) = 76.645, p < 0.001, Cramer’s V = 0.457). Among the unvaccinated prisoners (N = 179), only 16 subsequently showed willingness to receive a COVID-19 vaccine. The top three reasons for hesitancy were: COVID-19 is not a real problem/disease (60.1%), safety concerns (51.1%), and COVID-19 vaccine is a conspiracy (50.3%). Efforts are needed to address their concerns given this population’s risks and high hesitancy rates, especially among younger prisoners.

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Adherence to Infection Prevention and Control Measures Among Health-Care Workers Serving in COVID-19 Treatment Centers in Punjab, Pakistan

Cited by 8 publications

References 33 publications

Antibiotic Utilization Patterns for Different Wound Types among Surgical Patients: Findings and Implications

Antibiotic Utilization Patterns for Different Wound Types among Surgical Patients: Findings and Implications

Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications

COVID-19 Vaccination Status as Well as Factors Associated with COVID-19 Vaccine Acceptance and Hesitancy among Prisoners and the Implications

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