Healthcare-associated infections in sub-Saharan Africa

Rothe, Camilla; Schlaich, Clara; Thompson, Sharon E

doi:10.1016/j.jhin.2013.09.008

Cited by 107 publications

(103 citation statements)

References 86 publications

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“…Ironically, in resourcelimited settings, where the infection burden is highest, few or no patient isolation facilities exist. [19] The IP indications for patient isolation are also likely to differ across SA.…”

Section: Provisions and Infrastructure For Ip In Paediatric/neonatal mentioning

confidence: 99%

A framework for preventing healthcare-associated infection in neonates and children in South Africa

2017

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Healthcare-associated infection (HAI) is a frequent and serious complication affecting 4 -8% of hospitalised children and neonates in high-income countries. The burden of HAI in South African (SA) paediatric and neonatal wards is substantial but underappreciated, owing to a lack of HAI surveillance and reporting. Maternal and child health and infection prevention are priority areas for healthcare quality improvement in the National Core Standards programme. Despite increasing recognition in SA, infection prevention efforts targeting hospitalised children and neonates are hampered by health system, institutional and individual patient factors. To ensure safe healthcare delivery to children, a co-ordinated HAI prevention strategy should promote development of infection prevention norms and policies, education, patient safety advocacy, healthcare infrastructure, surveillance and research. We present a framework for SA to develop and expand HAI prevention in hospitalised neonates and children.

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Section: Provisions and Infrastructure For Ip In Paediatric/neonatal mentioning

confidence: 99%

A framework for preventing healthcare-associated infection in neonates and children in South Africa

2017

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“…[2][3][4][5] In sub-Saharan Africa, most healthcare facilities are unable to perform HAI surveillance because they lack trained infection prevention (IP) staff, data analysts and information technology (IT) infrastructure. [6] The situation in South Africa (SA), a country with greater resources than many of its neighbours, is similar, with no national HAI surveillance programme and extremely limited data on the paediatric and adult HAI burden. [7,8] A single study in 2005 estimated a prevalence of 9.7% for four major HAI types, with higher prevalence among children (16.5%) and patients in intensive care units (ICUs) (28.5%).…”

Section: Researchmentioning

confidence: 99%

Surveillance of healthcare-associated infection in hospitalised South African children: Which method performs best?

2016

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Background. In 2012, the South African (SA) National Department of Health mandated surveillance of healthcare-associated infection (HAI), but made no recommendations of appropriate surveillance methods. Methods. Prospective clinical HAI surveillance (the reference method) was conducted at Tygerberg Children's Hospital, Cape Town, from 1 May to 31 October 2015. Performance of three surveillance methods (point prevalence surveys (PPSs), laboratory surveillance and tracking of antimicrobial prescriptions) was compared with the reference method using surveillance evaluation guidelines. Factors associated with failure to detect HAI were identified by logistic regression analysis. Results. The reference method detected 417 HAIs among 1 347 paediatric hospitalisations (HAI incidence of 31/1000 patient days; 95% confidence interval (CI) 28.2 -34.2). Surveillance methods had variable sensitivity (S) and positive predictive value (PPV): PPS S = 24.9% (95% CI 21 -29.3), PPV = 100%; laboratory surveillance S = 48.4% (95% CI 43.7 -53.2), PPV = 55.2% (95% CI 50.1 -60.2); and antimicrobial prescriptions S = 66.4% (95% CI 61.8 -70.8%), PPV = 88.5% (95% CI 84.5 -91.6). Combined laboratory-antimicrobial surveillance achieved superior HAI detection (S = 84.7% (95% CI 80.9 -87.8%), PPV = 97% (95% CI 94.6 -98.4%)). Factors associated with failure to detect HAI included patient transfer (odds ratio (OR) 2.0), single HAI event (OR 2.8), age category 1 -5 years (OR 2.1) and hospitalisation in a general ward (OR 2.3). Conclusions. Repeated PPSs, laboratory surveillance and/or antimicrobial prescription tracking are feasible HAI surveillance methods for low-resource settings. Combined laboratory-antimicrobial surveillance achieved the best sensitivity and PPV. SA paediatric healthcare facilities should individualise HAI surveillance, selecting a method suited to available resources and practice context.

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“…[1][2][3] However; surgical site infection (SSI) after cesarean section is one of the major infections that can affect patients with a cesarean section (C-section) procedure. [4] Caesarean section (CS) is among the most frequent surgical interventions in women all over the world.…”

Section: Introductionmentioning

confidence: 99%

Post Cesarean Section Surgical Site Infection; Incidence and Risk Factors

2017

IJSR

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Abstract:The rate of births delivered by cesarean section (CS) has gone up substantially all over the world. Post-cesarean surgical site infection (SSI) is a common cause of maternal morbidity and mortality that results in prolonged period of hospitalization with increased cost and direct health implications, especially in low socioeconomic population, resource-restricted settings, and war-related conditions with internal forced movement. This study was aimed to find incidence of post cesarean section surgical site infection withthe accompanying risk factors.Pregnant ladies admitted to department of obstetrics and gynecology at Medical City Hospital in Baghdad who had undergone CSs were followed up prospectively from first of January 2017 till end of June 2017. Full medical evaluation was done to assess all clinical, laboratory, and sociodemographic characteristics ofboth; patients and controls. Statistical comparison was measured to appraise the important risk factors.A total of 3036 pregnant ladies were recruited, 191 patients had SSI with and an incidence rate of 6.3%. The above-mentioned 191 patients constituted of 93 (48.7%) internally moved patients due to the war, while they were 97 patients (25.4%) out of 382 control-group. Obesity, diabetes mellitus, emergency CS, vertical incision, interrupted suturing, and rupture of membranes before CS, were significant risk factors of post CS SSI. Rate and several risk factors of post CS SSI were studied to increase the public attention, and to take full steps to decrease it prophylactically.

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Healthcare-associated infections in sub-Saharan Africa

Cited by 107 publications

References 86 publications

A framework for preventing healthcare-associated infection in neonates and children in South Africa

A framework for preventing healthcare-associated infection in neonates and children in South Africa

Surveillance of healthcare-associated infection in hospitalised South African children: Which method performs best?

Post Cesarean Section Surgical Site Infection; Incidence and Risk Factors

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