Prevalence of healthcare-associated infection at a tertiary hospital in the Northern Cape Province, South Africa

Nair, Arun; Steinberg, Wilhelm Johannes; Habib, Talat; Saeed, Hamid; Raubenheimer, Jacques

doi:10.4102/safp.v60i5.4922

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…Fifteen studies were included in the qualitative summary of the prevalence of HAIs among hospitalized patients in Africa. Overall, the prevalence of HAIs ranged between 7.24% and 28% [4,[19][20][21][22][23][24][25][26][27][28][29][30][31][32], and the prevalence varied between the regions in Africa. (2.0-10.8%) [22,26,28,30,31].…”

Section: Prevalence and Distribution Of Hais Among Hospitalized Patie...mentioning

confidence: 99%

Healthcare-associated infections in Africa: a systematic review and meta-analysis of point prevalence studies

Abubakar

Amir

Rodríguez‐Baño

2022

J of Pharm Policy and Pract

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Background There is limited data to describe the point-prevalence of healthcare-associated infections (HAIs) among patients at a regional level in Africa. This study estimated the pooled prevalence of HAIs and described the distribution of HAIs as well as the pathogens identified from African studies. Methods PubMed, Scopus and Google Scholar databases were searched to find point-prevalence studies of HAIs in Africa. Studies conducted in Humans that reported the prevalence of HAIs among hospitalized patients and published in English language from January 2010 to March 2022 were selected. Longitudinal studies of HAIs and unpublished studies were excluded. The reference list of the selected studies was checked to find additional studies. A meta-analysis was conducted using RevMan 5.4 and the pooled prevalence of HAIs was determined using a random effect model. Results Of the 6094 articles identified from the databases, fifteen eligible articles were selected. The studies were conducted in the North, South, East and West African regions with Tunisia (n = 4) and South Africa (n = 2) having the highest number of studies. Most of the studies (n = 12, 80.0%) had good quality. The pooled prevalence of HAIs was 12.76% (95% confidence interval [CI] 10.30–15.23) with a high degree of heterogeneity (I2 = 90.0%). The prevalence of HAIs varied between wards with the highest rate found in the ICU (25.2%–100%), followed by neonatal ICU/ward (7.0%–53.6%) and paediatric medical ward (2.7%–33.0%). Surgical site infection was the most common HAIs and accounted for 41.6% of all HAIs (95% CI 23.55–59.80), followed by bloodstream infection (17.07%, 95% CI 11.80–22.33) and respiratory tract infections/pneumonia (17.04%, 95% CI 13.21–20.87). Recent hospitalization (adjusted odds ratio [AOR]: 4.17, 95% CI 1.85–9.41), presence of peripheral vascular catheter (AOR: 2.87, 95% CI 1.54–5.36) and having diabetes mellitus (AOR: 2.46, 95% CI 1.45–4.17) were the strongest predictors of HAIs in Africa. Only 37.9% of HAIs had documented positive microbiological culture result with gram negative bacteria including Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii and Citrobacter been the most common microorganisms and accounted for 40%–100% of the pathogens. Conclusions The pooled point-prevalence of HAIs in Africa is more than two times higher than the rate reported in developed countries. The prevalence varied between the countries and was highest in the ICU and neonatal ICU/ward. Surgical site infection and bloodstream infection were the most common HAIs reported in African studies. Recent hospitalization, presence of peripheral vascular catheter and having diabetes mellitus were the strongest predictors of HAIs in African studies. Most of the HAIs are preventable with appropriate infection control measures and antimicrobial stewardship. Additional studies are needed especially in the Central African region. Future studies should be designed using standardized protocol and standardized definition to reduce heterogeneity among the studies.

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Section: Prevalence and Distribution Of Hais Among Hospitalized Patie...mentioning

confidence: 99%

Healthcare-associated infections in Africa: a systematic review and meta-analysis of point prevalence studies

Abubakar

Amir

Rodríguez‐Baño

2022

J of Pharm Policy and Pract

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“…Of 4338 citations identified, 41 prevalence studies, 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 which included 6821 patients, met our eligibility criteria ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…1 ). The included studies were selected from all four subregions of SSA: fifteen studies from West Africa, 17 , 21 , 22 , 25 , 27 , 28 , 32 , 36 , 37 , 43 , 46 , 47 , 49 , 50 , 55 twelve from Southern Africa, 16 , 19 , 23 , 29 , 30 , 33 , 38 , 40 , 45 , 52 , 53 , 54 eleven from East Africa, 20 , 24 , 26 , 31 , 34 , 35 , 41 , 42 , 44 , 48 , 51 and three from Central Africa 18 , 39 , 56 ( Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…38 , 53 Use of antibiotics, 38 , 48 blood transfusion 48 and age less than 12 years 48 were also reported. Associated risk factors for HAI in adults were indwelling device, 18 , 20 , 24 , 26 , 29 , 42 , 44 , 55 , 56 prolonged hospital stay, 22 , 24 , 26 , 34 , 42 , 47 surgery, 29 , 38 , 42 , 46 , 47 , 55 , 56 antibiotic use, 47 , 55 , 56 pre-existing medical conditions, 22 , 26 , 27 , 29 , 43 blood transfusion 34 , 46 and male sex. 21 …”

Section: Resultsmentioning

confidence: 99%

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The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis

Melariri,

Freercks,

van der Merwe

et al. 2024

eClinicalMedicine

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“…[13,14] Such circumstances lengthen hospital stay, which puts patients at risk of acquiring serious nosocomial infections. [15] The only 'solution' in place is that of backup generators, which also provide a challenge, as these are poorly maintained and prone to failure. [16] Moreover, the cost of diesel is proving difficult to maintain, since hospitals spend millions of rands to function when cuts occur.…”

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confidence: 99%

Loadshedding and Healthcare: Salt in The Wound?

Malange

2023

S Afr Med J

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Loadshedding and healthcare: Salt in the wound?To the Editor: South Africa (SA)'s energy crisis is a longstanding problem. With no permanent solution in sight, the worsening power cuts continue to detrimentally impact the quality of public healthcare across the nation. [1,2] At present, the country is experiencing the highest numbers of loadshedding hours since its inceptionaveraging over 1 500 hours in 2022. [3] As the effects of the COVID-19 pandemic remain apparent, it is questionable whether we can handle another crisis.Currently, only 72 hospitals are exempt from loadshedding nationwide! [4] This is frightening, as state-run hospitals nationwide care for >80% of the population. [5] Of most concern is the impact on intensive care units, which utilise electronic machinery to keep patients alive. [5][6][7] Multiple technologies involved in critical care are unable to function without power, which leaves numerous healthcare workers forced to do these tasks manually. [6] In an already shortstaffed system, where there is only 1 doctor per 3 198 citizens, [8] this proves deadly. The pandemic saw the lives of over 1 300 SA healthcare professionals lost -replacements for whom have proven difficult to come by. [9] Loss of massive aid from technology, even for minutes, leaves opportunity for worker exhaustion and patient mismanagement.Another major blow affects surgical departments, where doctors have had to resort to torches during surgery. [10] Poor lighting in procedures is associated with a higher error rate and increased postoperative complications. [11] More importantly, the inability to carry out emergency procedures and scans causes untimely deaths and emotional trauma for all involved. [12] In less urgent instances, multiple procedures must be delayed or cancelled, resulting in an increase in the backlog -which was already an issue post-COVID. [13,14] Such circumstances lengthen hospital stay, which puts patients at risk of acquiring serious nosocomial infections. [15] The only 'solution' in place is that of backup generators, which also provide a challenge, as these are poorly maintained and prone to failure. [16] Moreover, the cost of diesel is proving difficult to maintain, since hospitals spend millions of rands to function when cuts occur. [17] It has been stated that other power sources are being investigated, as generators are not meant to be utilised for long periods. [18] The Health Professionals Council of SA has voiced a plea that all healthcare facilities be exempt from loadshedding, [19] but this has not yet occurred. [4] With no effective solution in sight, the morale of healthcare workers is on the decline. Aside from the lingering 'side-effects' of the COVID-19 pandemic, the exacerbation of power cuts brings an already dilapidated system to its knees. If not addressed, this problem is one that will further place patients' lives at risk, and doctors and nurses may not be able to work under such challenging conditions much longer.

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Prevalence of healthcare-associated infection at a tertiary hospital in the Northern Cape Province, South Africa

Cited by 4 publications

References 7 publications

Healthcare-associated infections in Africa: a systematic review and meta-analysis of point prevalence studies

Healthcare-associated infections in Africa: a systematic review and meta-analysis of point prevalence studies

The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis

Loadshedding and Healthcare: Salt in The Wound?

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