Effectiveness of a multimodal hand hygiene campaign and obstacles to success in Addis Ababa, Ethiopia

Schmitz, Karen; Kempker, Russell R.; Tenna, Admasu; Stenehjem, Edward; Abebe, Engida; Tadesse, Lia; Jirru, Ermias Kacha; Blumberg, Henry M.

doi:10.1186/2047-2994-3-8

Cited by 41 publications

(68 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compliance at baseline was similar to two studies that had been undertaken in Ethiopia [19, 20] but was lower compared to a study from Bamako, Mali [21]. The main reason for the low baseline compliance appears obvious: hand hygiene products and facilities were not available on the wards.…”

Section: Discussionsupporting

confidence: 71%

Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

Pfäfflin

Tufa

Getachew

et al. 2017

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

BackgroundThe burden of health-care associated infections in low-income countries is high. Adequate hand hygiene is considered the most effective measure to reduce the transmission of nosocomial pathogens. We aimed to assess compliance with hand hygiene and perception and knowledge about hand hygiene before and after the implementation of a multimodal hand hygiene campaign designed by the World Health Organization.MethodsThe study was carried out at Asella Teaching Hospital, a university hospital and referral centre for a population of about 3.5 million in Arsi Zone, Central Ethiopia. Compliance with hand hygiene during routine patient care was measured by direct observation before and starting from six weeks after the intervention, which consisted of a four day workshop accompanied by training sessions and the provision of locally produced alcohol-based handrub and posters emphasizing the importance of hand hygiene. A second follow up was conducted three months after handing over project responsibility to the Ethiopian partners. Health-care workers’ perception and knowledge about hand hygiene were assessed before and after the intervention.ResultsAt baseline, first, and second follow up we observed a total of 2888, 2865, and 2244 hand hygiene opportunities, respectively. Compliance with hand hygiene was 1.4% at baseline and increased to 11.7% and 13.1% in the first and second follow up, respectively (p < 0.001). The increase in compliance with hand hygiene was consistent across professional categories and all participating wards and was independently associated with the intervention (adjusted odds ratio, 9.18; 95% confidence interval 6.61-12.76; p < 0.001). After the training, locally produced alcohol-based handrub was used in 98.4% of all hand hygiene actions. The median hand hygiene knowledge score overall was 13 (interquartile range 11–15) at baseline and increased to 17 (15–18) after training (p < 0.001). Health-care workers’ perception surveys revealed high appreciation of the different strategy components.ConclusionPromotion of hand hygiene is feasible and sustainable in a resource-constrained setting using a multimodal improvement strategy. However, absolute compliance remained low. Strong and long-term commitment by hospital management and health-care workers may be needed for further improvement.Electronic supplementary materialThe online version of this article (doi:10.1186/s13756-016-0165-9) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 71%

Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

Pfäfflin

Tufa

Getachew

et al. 2017

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

show abstract

“…28 These strategies have yielded short-term success, 29,30 but the longer-term impact has been negligible with rapid returns to baseline often displayed. 31 As multi-modal HH campaigns can sustain improvements most effectively, 12,14,32 involving patients in such endeavours could yield longer-term benefits. 14,33 Additionally, involving patients would enable continuous monitoring of HCPs' HH practices without the need for additional staff or resources.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of the effectiveness of strategies to encourage patients to remind healthcare professionals about their hand hygiene

Davis

Parand

Pinto

et al. 2015

Journal of Hospital Infection

View full text Add to dashboard Cite

“…Another study demonstrated poor tolerability of the WHO-recommended formulation of hand sanitizer and identi ed it as a barrier of hand hygiene (11). However, in this study we demonstrated a high demand for locally produced ABHS to combat the pandemic which is a key sign of acceptability during outbreaks.…”

Section: Discussion: Impact and Lessons Learntmentioning

confidence: 68%

Impacts and lessons learned from the local production of WHO-Recommended Alcohol-Based Hand Rub during Covid-19 Pandemic in Uganda.

Tusabe

Otita

Kesande

et al. 2020

Preprint

View full text Add to dashboard Cite

In January 2020, the World Health Organization (WHO) declared the outbreak of a new coronavirus disease, COVID-19. The WHO and the Centers for Disease Control and Prevention (CDC) recommend using an alcohol-based hand rub (ABHR) as one of the measures to combat the spread of COVID-19. Objective To assess the impacts and lessons learned from the local production of WHO-recommended alcohol-based hand rub during the COVID-19 Pandemic in Uganda. Method Space for local production was identified at a health facility in Central Uganda that was air-conditioned and well ventilated. Volunteers were trained on the local production of ABHR. The volunteers were trained theoretically and practically for Four days; and each was able to produce at least a batch of ABHR. Logistical support for supplying the raw materials needed for production was from the Infectious Diseases Institute. There were also already established ABHR production units and trained staff on local production of ABHR in 2019 in the Kabarole and Kasese districts, respectively in Western Uganda. These districts were threatened by several outbreaks, including Ebola virus disease, and were monitored for ABHR production during the COVID-19 Pandemic. Result Two production units were set up during the Ebola outbreak, in awake of COVID-19, a production unit in Kasese, was able to produce 3020 litres, and the Kabarole unit produced 2020 litres respectively. A new production unit was set up at Kasangati HCIV in central Uganda and eight laboratory technologists trained on Local Production of ABHR, and within Eleven days they were able to produce 2300ltrs. Conclusion The initiative to produce WHO-recommended hand rub locally during an outbreak is feasible, especially in a resource-limited country like Uganda. There is a need to rapidly scale-up the production capacity of ABHR and to ensure and maintain quality assurance at each production unit.

show abstract

Effectiveness of a multimodal hand hygiene campaign and obstacles to success in Addis Ababa, Ethiopia

Cited by 41 publications

References 20 publications

Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

Systematic review of the effectiveness of strategies to encourage patients to remind healthcare professionals about their hand hygiene

Impacts and lessons learned from the local production of WHO-Recommended Alcohol-Based Hand Rub during Covid-19 Pandemic in Uganda.

Contact Info

Product

Resources

About