The critical role of infection prevention overlooked in Ethiopia, only one-half of health-care workers had safe practice: A systematic review and meta-analysis

Sahiledengle, Biniyam; Tekalegn, Yohannes; Woldeyohannes, Demelash

doi:10.1371/journal.pone.0245469

Cited by 16 publications

(13 citation statements)

References 30 publications

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“…Surgical site, urinary tract and blood stream infections were found to be commonest forms. The type of surgery, patients' underlying medical conditions and the type of the ward were found to be important factors associated with increased risk of HAI in Ethiopia (13,14). Similar results were reported in West Africa and Tanzania where the infection reached over 50% particularly with a high resistant Gram positive and gram negative bacteria (15,16).…”

supporting

confidence: 63%

Epidemiological manifestations and burden of healthcare-associated infections in Libyan national hospitals

2023

Preprint

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Background Healthcare-associated infection is a serious global problem, particularly within developing countries. In Northern African countries comprehensive research on the prevalence and effects of such infections was rarely carried out. The objectives of this study were aimed to evaluate the epidemiology and determine the burden of healthcare-associated infections in Libyan national teaching hospitals. Methods A prospective longitudinal study was carried out in the four largest teaching and referral hospitals in Libya including Tripoli Medical Centre, Tripoli-Central Hospital, Benghazi Medical Centre, and Sebha Medical Centre within a year from November 1, 2021, to October 31, 2022. The epidemiological events and the parameters incorporated in this study were based on the data published by the Centre for disease control. The surveillance analysis was carried out on all patients admitted to medical wards, surgical, ICU, gynecology & obstetrics, and pediatrics in all four hospitals. Trained staff reviewed medical records and the percentages of patients with health care–associated infections were compared. Bio-statistical and multivariable logistic regression analyses were carried out to test variables associated with HAI events and the resulting deaths. Results A total of 22170 hospitalized patients in four hospitals were included in the study. Hospital-acquired infection was reported among 3037 patients with an overall prevalence of 13.7% (95% CI:12.9%- 14.4%). Interestingly the prevalence varied among the hospitals studied. The highest was reported in Benghazi Medical Centre reported (17.9 % (95% CI:16.9%- 18.71%), followed by Sebha Medical Centre (14.8% (95% CI:14.5.9%- 16.51%). Surgical site infection was the highest (31.28 %), followed by Ventilator-associated pneumonia (29.34 %), urinary tract infections (26.84 %), and Bloodstream infection (12.55 %). Patients with HAIs experienced severe morbidity that required intervention. New antimicrobial regimens were needed for 1836(93 %) patients and 752(34 %) required ICU admission. In addition to surgical intervention, respiratory support, and inotropes were needed as a consequence of HAI events. Conclusions The prevalence of Healthcare-associated infection in Libyan hospitals was found to be high and it should be considered a major problem with a serious burden. Hospital management should be alerted, indicating an urgent need to intervene at the national and hospital levels to implement preventive and control strategies to combat HAI.

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confidence: 63%

Epidemiological manifestations and burden of healthcare-associated infections in Libyan national hospitals

2023

Preprint

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“…6 Even though HAI is suggested to be reduced by applying standard precautions, the practice among HCWs in clinical settings is low, thus exposing them to risk of infections. 7,8 In Ethiopia, only about half of the HCWs practiced appropriate standard precautions. [9][10][11] The studies identified the associated factors for the poor compliance of the HCWs to the SPs, including lack of infection control programs, lack of training, lack of knowledge and negative attitude towards SPs, inadequate management support, lack of supplies, crowded hospitals and excessive workloads.…”

Section: Introductionmentioning

confidence: 99%

Compliance with Standard Precautions and Associated Factors Among Health Professionals in Public Hospitals of East Wallaga Zone, Oromia Regional State, Ethiopia

Feyisa¹,

Demisie²,

Geta³

2022

RMHP

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Health care workers are potentially exposed to infections through contact with blood and bodily fluids while performing their duties. Compliance with the standard precautions reduces the risks of health care workers' exposure to blood and bodily fluids. However, the compliance level among health care workers is not well studied in the study area. Therefore, this study aimed to assess the level of compliance with standard precautions and its associated factors among health care workers in all public hospitals of East Wallaga Zone, Western Ethiopia. Materials and Methods: Multi-facility-based cross-sectional study was conducted among 392 health care workers, from January to February, 2022. Simple random sampling technique was used to select study participants. Logistic regression model was fitted to determine presence of statistically significant associations. A p-value of less than or equal to 0.05 along with the adjusted odds ratio of 95% confidence interval was used to declare statistical significance. Results: The proportion of health care workers who comply with standard precautions was found to be 51.6% [95% CI; 46.9-56.7%]. Having positive attitude towards standard precautions (AOR=2.71; 95% C.I: 1.68-4.39), having training on standard precautions (AOR=3.27; 95% C.I: 2.019-5.29), and working in referral hospitals (AOR=1.83; 95% C.I: 1.13-2.96) were the associated factors of good compliance with standard precautions. Conclusion:In this study, half of the health care workers comply with standard precautions. Positive attitude, training, and level of hospitals were factors for compliance with the standard precautions. As a result, to sustain and improve compliance of health care workers on standard precautions, periodic in-service training is needed to bring about behavioral changes among health care workers, particularly for those working in other settings than referral hospitals.

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“…Intravenous therapy furthermore carries an important risk of fatal healthcare-associated infections [56,57,59,60], as observed in this study. The fact that more than half of the children received intramuscular antipyretics further illustrate the widespread problem of unnecessary and unsafe injection practices in sub-Saharan Africa [61][62][63].…”

Section: Delayed Appropriate Treatment Due To Prehospital Antibiotics...mentioning

confidence: 99%

Health itinerary-related survival of children under-five with severe malaria or bloodstream infection, DR Congo

Tack

Vita²,

Nketo³

et al. 2023

PLoS Negl Trop Dis

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Background Prompt appropriate treatment reduces mortality of severe febrile illness in sub-Saharan Africa. We studied the health itinerary of children under-five admitted to the hospital with severe febrile illness in a setting endemic for Plasmodium falciparum (Pf) malaria and invasive non-typhoidal Salmonella infections, identified delaying factors and assessed their associations with in-hospital death. Methodology Health itinerary data of this cohort study were collected during 6 months by interviewing caretakers of children (>28 days − <5 years) admitted with suspected bloodstream infection to Kisantu district hospital, DR Congo. The cohort was followed until discharge to assess in-hospital death. Principal findings From 784 enrolled children, 36.1% were admitted >3 days after fever onset. This long health itinerary was more frequent in children with bacterial bloodstream infection (52.9% (63/119)) than in children with severe Pf malaria (31.0% (97/313)). Long health itinerary was associated with in-hospital death (OR = 2.1, p = 0.007) and two thirds of deaths occurred during the first 3 days of admission. Case fatality was higher in bloodstream infection (22.8% (26/114)) compared to severe Pf malaria (2.6%, 8/309). Bloodstream infections were mainly (74.8% (89/119)) caused by non-typhoidal Salmonella. Bloodstream infections occurred in 20/43 children who died in-hospital before possible enrolment and non-typhoidal Salmonella caused 16 out of these 20 bloodstream infections. Delaying factors associated with in-hospital death were consulting traditional, private and/or multiple providers, rural residence, prehospital intravenous therapy, and prehospital overnight stays. Use of antibiotics reserved for hospital use, intravenous therapy and prehospital overnight stays were most frequent in the private sector. Conclusions Long health itineraries delayed appropriate treatment of bloodstream infections in children under-five and were associated with increased in-hospital mortality. Non-typhoidal Salmonella were the main cause of bloodstream infection and had high case fatality. Trial registration NCT04289688

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The critical role of infection prevention overlooked in Ethiopia, only one-half of health-care workers had safe practice: A systematic review and meta-analysis

Cited by 16 publications

References 30 publications

Epidemiological manifestations and burden of healthcare-associated infections in Libyan national hospitals

Epidemiological manifestations and burden of healthcare-associated infections in Libyan national hospitals

Compliance with Standard Precautions and Associated Factors Among Health Professionals in Public Hospitals of East Wallaga Zone, Oromia Regional State, Ethiopia

Health itinerary-related survival of children under-five with severe malaria or bloodstream infection, DR Congo

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