Prevalence, risk factors, and antimicrobial resistance of endemic healthcare-associated infections in Africa: a systematic review and meta-analysis.
Africa
Bloodstream
Healthcare-associated infection
Pneumonia
Surgical site infection
Urinary tract infection
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
02 Feb 2024
02 Feb 2024
Historique:
received:
22
07
2023
accepted:
20
01
2024
medline:
2
2
2024
pubmed:
2
2
2024
entrez:
2
2
2024
Statut:
epublish
Résumé
Healthcare-associated infections (HCAI) place a significant burden on healthcare systems globally. This systematic review and meta-analysis aimed to investigate the prevalence, risk factors, and aetiologic agents of endemic HCAI in Africa. MEDLINE/PubMed, CINAHL, and Global Health databases (EBSCOhost interface) were searched for studies published in English and French describing HCAI in Africa from 2010 to 2022. We extracted data on prevalence of HCAI, risk factors, aetiologic agents, and associated antimicrobial resistance patterns. We used random-effects models to estimate parameter values with 95% confidence intervals for risk factors associated with HCAI. This study was registered in PROSPERO (CRD42022374559) and followed PRISMA 2020 guidelines. Of 2541 records screened, 92 were included, comprising data from 81,968 patients. Prevalence of HCAI varied between 1.6 and 90.2% with a median of 15% across studies. Heterogeneity (I HCAI is a greater problem in Africa than other regions, however, there remains a paucity of data to guide local action. There is a clear need to develop and validate sustainable HCAI definitions in Africa to support the implementation of routine HCAI surveillance and inform implementation of context appropriate infection prevention and control strategies.
Sections du résumé
BACKGROUND
BACKGROUND
Healthcare-associated infections (HCAI) place a significant burden on healthcare systems globally. This systematic review and meta-analysis aimed to investigate the prevalence, risk factors, and aetiologic agents of endemic HCAI in Africa.
METHODS
METHODS
MEDLINE/PubMed, CINAHL, and Global Health databases (EBSCOhost interface) were searched for studies published in English and French describing HCAI in Africa from 2010 to 2022. We extracted data on prevalence of HCAI, risk factors, aetiologic agents, and associated antimicrobial resistance patterns. We used random-effects models to estimate parameter values with 95% confidence intervals for risk factors associated with HCAI. This study was registered in PROSPERO (CRD42022374559) and followed PRISMA 2020 guidelines.
RESULTS
RESULTS
Of 2541 records screened, 92 were included, comprising data from 81,968 patients. Prevalence of HCAI varied between 1.6 and 90.2% with a median of 15% across studies. Heterogeneity (I
CONCLUSIONS
CONCLUSIONS
HCAI is a greater problem in Africa than other regions, however, there remains a paucity of data to guide local action. There is a clear need to develop and validate sustainable HCAI definitions in Africa to support the implementation of routine HCAI surveillance and inform implementation of context appropriate infection prevention and control strategies.
Identifiants
pubmed: 38302895
doi: 10.1186/s12879-024-09038-0
pii: 10.1186/s12879-024-09038-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
158Subventions
Organisme : NIHR Global Health Professorship
ID : NIHR301627
Organisme : NIHR Global Health Professorship
ID : NIHR301627
Organisme : Wellcome
ID : 223012/Z/21/Z
Informations de copyright
© 2024. The Author(s).
Références
Irek EOEO, Amupitan AA, Obadare TO, Aboderin AO. A systematic review of healthcare-associated infections in Africa: an antimicrobial resistance perspective. Afr J Lab Med. 2018;7(2):a796.
doi: 10.4102/ajlm.v7i2.796
Stewart S, Robertson C, Pan J, Kennedy S, Haahr L, Manoukian S, et al. Impact of healthcare-associated infection on length of stay. J Hosp Infect. 2021;114:23–31.
pubmed: 34301393
doi: 10.1016/j.jhin.2021.02.026
WHO. WHO guidelines on hand hygiene in health care. First global patient safety challenge clean care is safer care. 2009.
Cassini A, Plachouras D, Eckmanns T, Abu Sin M, Blank HP, Ducomble T, et al. Burden of six Healthcare-Associated infections on European population health: estimating incidence-based disability-adjusted life years through a Population prevalence-based modelling study. PLoS Med. 2016;13(10):e1002150.
pubmed: 27755545
pmcid: 5068791
doi: 10.1371/journal.pmed.1002150
Guest JF, Keating T, Gould D, Wigglesworth N. Modelling the annual NHS costs and outcomes attributable to healthcare-associated infections in England. BMJ Open. 2020;10:e033367.
pubmed: 31974088
pmcid: 7045184
doi: 10.1136/bmjopen-2019-033367
Suetens C, Latour K, Kärki T, Ricchizzi E, Kinross P, Moro ML, et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Eurosurveillance. 2018;23(46):pii.
doi: 10.2807/1560-7917.ES.2018.23.46.1800516
Allegranzi B, Nejad SB, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet. 2011;377(9761):228–41.
pubmed: 21146207
doi: 10.1016/S0140-6736(10)61458-4
Nejad SB, Allegranzi B, Syed SB, Ellis B, Pittet D. Health-care-associated infection in Africa: a systematic review. Bull World Health Organ. 2011;89(10):757–65.
doi: 10.2471/BLT.11.088179
Pittet D. Burden of endemic healthcare-associated infection in Africa. 16th ICID abstracts. Int J Infect Dis. 2014;21S:1–460.
Russo PL, Shaban RZ, Macbeth D, Carter A, Mitchell BG. Impact of electronic healthcare-associated infection surveillance software on infection prevention resources: a systematic review of the literature. J Hosp Infect. 2018;99(1):1–7.
pubmed: 28893614
doi: 10.1016/j.jhin.2017.09.002
Richet HM, Mohammed J, McDonald LC, Jarvis WR. Building communication networks: international network for the study and prevention of emerging antimicrobial resistance. Emerg Infect Dis. 2001;7(2):319–22.
pubmed: 11294732
pmcid: 2631723
doi: 10.3201/eid0702.010235
Burnham CAD, Leeds J, Nordmann P, O’Grady J, Patel J. Diagnosing antimicrobial resistance. Nat Rev Microbiol. 2017;15(11):697–703.
pubmed: 29021600
doi: 10.1038/nrmicro.2017.103
Bunduki GK, Feasey N, Henrion MYR, Noah P, Musaya J. Healthcare-associated infections and antimicrobial use in surgical wards of a large urban central hospital in Blantyre, Malawi: a point prevalence survey. Infect Prev Pract. 2021;3(3):100163.
pubmed: 34430842
pmcid: 8367802
doi: 10.1016/j.infpip.2021.100163
Kanyangarara M, Allen S, Jiwani SS, Fuente D. Access to water, sanitation and hygiene services in health facilities in sub-Saharan Africa 2013–2018: results of health facility surveys and implications for COVID-19 transmission. BMC Health Serv Res. 2021;21:601.
pubmed: 34172045
pmcid: 8231746
doi: 10.1186/s12913-021-06515-z
Storr J, Twyman A, Zingg W, Damani N, Kilpatrick C, Reilly J, et al. Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations. Antimicrob Resist Infect Control. 2017;6:6.
pubmed: 28078082
pmcid: 5223492
doi: 10.1186/s13756-016-0149-9
Tomczyk S, Twyman A, de Kraker MEA, Coutinho Rehse AP, Tartari E, Toledo JP, et al. The first WHO global survey on infection prevention and control in health-care facilities. Lancet Infect Dis. 2022;22(6):845–56.
pubmed: 35202599
pmcid: 9132775
doi: 10.1016/S1473-3099(21)00809-4
Allegranzi B, Kilpatrick C, Storr J, Kelley E, Park BJ, Donaldson L. Global infection prevention and control priorities 2018–22: a call for action. Lancet Glob Heal. 2017;5(12):e1178-1180.
doi: 10.1016/S2214-109X(17)30427-8
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
pubmed: 33782057
pmcid: 8005924
doi: 10.1136/bmj.n71
Stockdale AJ, Chaponda M, Beloukas A, Phillips RO, Matthews PC, Papadimitropoulos A, et al. Prevalence of hepatitis D virus infection in sub-saharan Africa: a systematic review and meta-analysis. Lancet Glob Heal. 2017;5(10):e992-1003.
doi: 10.1016/S2214-109X(17)30298-X
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ WV, editors. Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane, 2022. Available from: www.training.cochrane.org/handbook .
Munn Z, MClinSc SM, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc. 2015;13(3):147–53.
pubmed: 26317388
doi: 10.1097/XEB.0000000000000054
Abosse S, Genet C, Derbie A. Antimicrobial resistance profile of bacterial isolates identified from surgical site infections at a referral hospital, Northwest Ethiopia. Ethiop J Health Sci. 2021;31(3):635–44.
pubmed: 34483621
pmcid: 8365483
Alemye T, Oljira L, Fekadu G, Mengesha MM. Post cesarean section surgical site infection and associated factors among women who delivered in public hospitals in Harar city, Eastern Ethiopia: a hospital-based analytic cross-sectional study. PLoS One. 2021;16(6):e0253194.
pubmed: 34161361
pmcid: 8221476
doi: 10.1371/journal.pone.0253194
Endalafer N, Gebre-Selassie S, Kotiso B. Nosocomial bacterial infections in a tertiary hospital in Ethiopia. J Infect Prev. 2011;12(1):38–43.
doi: 10.1177/1757177410376680
Fisha K, Azage M, Mulat G, Tamirat KS. The prevalence and root causes of surgical site infections in public versus private hospitals in Ethiopia: a retrospective observational cohort study. Patient Saf Surg. 2019;13:26.
pubmed: 31333761
pmcid: 6617908
doi: 10.1186/s13037-019-0206-4
Gelaw KA, Aweke AM, Astawesegn FH, Demissie BW, Zeleke LB. Surgical site infection and its associated factors following cesarean section: a cross sectional study from a public hospital in Ethiopia. Patient Saf Surg. 2017;11(1):18.
pubmed: 28616079
pmcid: 5469177
doi: 10.1186/s13037-017-0131-3
Halawi E, Assefa T, Hussen S. Pattern of antibiotics use, incidence and predictors of surgical site infections in a Tertiary Care Teaching Hospital. BMC Res Notes. 2018;11:538.
pubmed: 30064487
pmcid: 6069967
doi: 10.1186/s13104-018-3643-8
Kefale B, Tegegne GT, Degu A, Molla M, Kefale Y. Surgical site infections and prophylaxis antibiotic use in the surgical ward of public hospital in western Ethiopia: a hospital-based retrospective cross-sectional study. Infect Drug Resist. 2020;13:3627–35.
pubmed: 33116682
pmcid: 7573320
doi: 10.2147/IDR.S281097
Ketema DB, Wagnew F, Assemie MA, Ferede A, Alamneh AA, Leshargie CT, et al. Incidence and predictors of surgical site infection following cesarean section in North-West Ethiopia: a prospective cohort study. BMC Infect Dis. 2020;20(1):902.
pubmed: 33256630
pmcid: 7708170
doi: 10.1186/s12879-020-05640-0
Laloto TL, Hiko Gemeda D, Abdella SH. Incidence and predictors of surgical site infection in Ethiopia: prospective cohort. BMC Infect Dis. 2017;17:119.
doi: 10.1186/s12879-016-2167-x
Lijaemiro H, Berhe Lemlem S, Tesfaye Deressa J. Incidence of surgical site infection and factors associated among cesarean deliveries in selected government hospitals in Addis Ababa, Ethiopia, 2019. Obstet Gynecol Int. 2020;2020:9714640.
pubmed: 32148511
pmcid: 7057000
doi: 10.1155/2020/9714640
Mamo T, Abebe TW, Chichiabellu TY, Anjulo AA. Risk factors for surgical site infections in obstetrics: a retrospective study in an Ethiopian referral hospital. Patient Saf Surg. 2017;11(1):24.
pubmed: 28932266
pmcid: 5605994
doi: 10.1186/s13037-017-0138-9
Melaku S, Kibret M, Abera B, Gebre-Sellassie S. Antibiogram of nosocomial urinary tract infections in Felege Hiwot referral hospital, Ethiopia. Afr Health Sci. 2012;12(2):134–9.
pubmed: 23056018
pmcid: 3462551
doi: 10.4314/ahs.v12i2.9
Awoke N, Arba A, Girma A. Magnitude of surgical site infection and its associated factors among patients who underwent a surgical procedure at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia. PLoS One. 2019;14(12):e0226140. Kamolz L-P, editor.
pubmed: 31805161
pmcid: 6894841
doi: 10.1371/journal.pone.0226140
Mezemir R, Seid A, Gishu T, Demas T, Gize A. Prevalence and root causes of surgical site infections at an academic trauma and burn center in Ethiopia: a cross-sectional study. Patient Saf Surg. 2020;14(1):3.
pubmed: 31921353
pmcid: 6945788
doi: 10.1186/s13037-019-0229-x
Misha G, Chelkeba L, Melaku T. Bacterial profile and antimicrobial susceptibility patterns of isolates among patients diagnosed with surgical site infection at a tertiary teaching hospital in Ethiopia: a prospective cohort study. Ann Clin Microbiol Antimicrob. 2021;20:33.
pubmed: 33971896
pmcid: 8112062
doi: 10.1186/s12941-021-00440-z
Misha G, Chelkeba L, Melaku T. Incidence, risk factors and outcomes of surgical site infections among patients admitted to Jimma Medical Center, South West Ethiopia: prospective cohort study. Ann Med Surg. 2021;65:102247.
doi: 10.1016/j.amsu.2021.102247
Mohamed AA, Haftu H, Hadgu A, Seyoum D, Gebrekidan G, Ebrahim MM, et al. Prevalence, clinical profile and risk factors of nosocomial infection in Ayder Pediatric Intensive Care Unit, Tigray, Ethiopia. Int J Gen Med. 2022;15:7145–53.
pubmed: 36110918
pmcid: 9470080
doi: 10.2147/IJGM.S384233
Molla M, Temesgen K, Seyoum T, Melkamu M. Surgical site infection and associated factors among women underwent cesarean delivery in Debretabor General Hospital, Northwest Ethiopia: hospital based cross sectional study. BMC Pregnancy Childbirth. 2019;19:317.
pubmed: 31464598
pmcid: 6716814
doi: 10.1186/s12884-019-2442-0
Oumer Y, Dadi BR, Seid M, Biresaw G, Manilal A. Catheter-associated urinary tract infection: incidence, associated factors and drug resistance patterns of bacterial isolates in southern Ethiopia. Infect Drug Resist. 2021;14:2883–94.
pubmed: 34335034
pmcid: 8318706
doi: 10.2147/IDR.S311229
Sahiledengle B, Seyoum F, Abebe D, Geleta EN, Negash G, Kalu A, et al. Incidence and risk factors for hospital-acquired infection among paediatric patients in a teaching hospital: a prospective study in southeast Ethiopia. BMJ Open. 2020;10(12):1–10.
doi: 10.1136/bmjopen-2020-037997
Shakir A, Abate D, Tebeje F, Weledegebreal F. Magnitude of surgical site infections, bacterial etiologies, associated factors and antimicrobial susceptibility patterns of isolates among post-operative patients in Harari region public hospitals, harar, eastern Ethiopia. Infect Drug Resist. 2021;14:4629–39.
pubmed: 34764659
pmcid: 8577515
doi: 10.2147/IDR.S329721
Weldu MG, Berhane H, Berhe N, Haile K, Sibhatu Y, Gidey T, et al. Magnitude and determinant factors of surgical site infection in Suhul Hospital Tigrai, Northern Ethiopia: a cross-sectional study. Surg Infect (Larchmt). 2018;19(7):684–90.
pubmed: 30124378
doi: 10.1089/sur.2017.312
Wendmagegn TA, Abera GB, Tsehaye WT, Gebresslasie KB, Tella BG. Magnitude and determinants of surgical site infecion among women underwent cesarean section in Ayder comprehensive specialized hospital Mekelle City, Tigray region, Northern Ethiopia, 2016. BMC Pregnancy Childbirth. 2018;18(1):489.
pubmed: 30541473
pmcid: 6291995
doi: 10.1186/s12884-018-2075-8
Ayala D, Tolossa T, Markos J, Yilma MT. Magnitude and factors associated with surgical site infection among mothers underwent cesarean delivery in Nekemte town public hospitals, western Ethiopia. PLoS One. 2021;16(4):e0250736.
pubmed: 33905428
pmcid: 8079023
doi: 10.1371/journal.pone.0250736
Wodajo S, Belayneh M, Gebremedhin S. Magnitude and factors associated with post-cesarean surgical site infection at Hawassa University teaching and referral hospital, Southern Ethiopia: a cross-sectional study. Ethiop J Health Sci. 2017;27(3):283–90.
pubmed: 29217927
pmcid: 5614999
doi: 10.4314/ejhs.v27i3.10
Yallew WW, Abera K, Feleke MY. Point prevalence of hospital-acquired infections in two teaching hospitals of Amhara region in. Drug Healthc Patient Saf. 2016;8:71–6.
pubmed: 27601932
pmcid: 5003516
doi: 10.2147/DHPS.S107344
Azeze GG, Bizuneh AD. Surgical site infection and its associated factors following cesarean section in Ethiopia: a cross-sectional study. BMC Res Notes. 2019;12(1):288.
pubmed: 31133045
pmcid: 6537424
doi: 10.1186/s13104-019-4325-x
Belay CM, Zewale TAb, Amlak BT, Abebe TG, Hailu G. Incidence and predictors of ventilator-associated pneumonia among adult intubated patients in Bahir Dar Specialized Hospitals, 2021: a retrospective follow-up study. Int J Gen Med. 2022;15:8173–82.
pubmed: 36389019
pmcid: 9664917
doi: 10.2147/IJGM.S380301
Birhanu A, Amare HH, G/Mariam M, Girma T, Tadesse M, Assefa DG. Magnitude of surgical site infection and determinant factors among postoperative patients, a cross sectional study. Ann Med Surg. 2022;83:104324.
doi: 10.1016/j.amsu.2022.104324
Bizuayehu H, Bitew A, Abdeta A, Ebrahim S. Catheter-associated urinary tract infections in adult intensive care units at a selected tertiary hospital, Addis Ababa, Ethiopia. PLoS One. 2022;17(3):1–15. Bhatta DR, editor.
doi: 10.1371/journal.pone.0265102
Bizuayew H, Abebe H, Mullu G, Bewuket L, Tsega D, Alemye T. Post-cesarean section surgical site infection and associated factors in East Gojjam Zone primary hospitals, Amhara region, North West Ethiopia, 2020. PLoS One. 2021;16(12):1–15.
doi: 10.1371/journal.pone.0261951
Dawit TC, Mengesha RE, Ebrahim MM, Tequare MH, Abraha HE. Nosocomial sepsis and drug susceptibility pattern among patients admitted to adult intensive care unit of Ayder Comprehensive Specialized Hospital, Northern Ethiopia. BMC Infect Dis. 2021;21:824.
pubmed: 34404343
pmcid: 8369143
doi: 10.1186/s12879-021-06527-4
Abdel-Wahab F, Ghoneim M, Khashaba M, El-Gilany AH, Abdel-Hady D. Nosocomial infection surveillance in an Egyptian neonatal intensive care unit. J Hosp Infect. 2013;83(3):196–9.
pubmed: 23374289
doi: 10.1016/j.jhin.2012.10.017
Chernet AZ, Dasta K, Belachew F, Zewdu B, Melese M, Ali MM. Burden of healthcare-associated infections and associated risk factors at Adama hospital medical college, Adama, Oromia, Ethiopia. Drug Healthc Patient Saf. 2020;12:177–85.
pubmed: 33116913
pmcid: 7569037
doi: 10.2147/DHPS.S251827
Gadallah MAH, Fotouh AMA, Habil IS, Imam SS, Wassef G. Surveillance of health care-associated infections in a tertiary hospital neonatal intensive care unit in Egypt: 1-year follow-up. Am J Infect Control. 2014;42(11):1207–11.
pubmed: 25238664
doi: 10.1016/j.ajic.2014.07.020
Galal YS, Youssef MRL, Ibrahiem SK. Ventilator-associated pneumonia: incidence, risk factors and outcome in paediatric intensive care units at Cairo university hospital. J Clin Diagnostic Res. 2016;10(6):SC06-08.
Gomaa K, Abdelraheim AR, El Gelany S, Khalifa EM, Yousef AM, Hassan H, et al. Incidence, risk factors and management of post cesarean section surgical site infection (SSI) in a tertiary hospital in Egypt: a five year retrospective study. BMC Pregnancy Childbirth. 2021;21(1):634.
pubmed: 34537018
pmcid: 8449867
doi: 10.1186/s12884-021-04054-3
Hafez S, Saied T, Hasan E, Elnawasany M, Ahmad E, Lloyd L, et al. Incidence and modifiable risk factors of surveillance of surgical site infections in Egypt: a prospective study. Am J Infect Control. 2012;40(5):426–30.
pubmed: 21943830
doi: 10.1016/j.ajic.2011.07.001
Hassan R, El-Gilany AH, Abd elaal AM, El-Mashad N, Azim DA. An overview of healthcare-associated infections in a tertiary care hospital in Egypt. Infect Prev Pract. 2020;2(3):100059.
pubmed: 34368710
pmcid: 8335937
doi: 10.1016/j.infpip.2020.100059
Raouf M, Ghazal T, Kassem M, Agamya A, Amer A. Surveillance of surgical-site infections and antimicrobial resistance patterns in a tertiary hospital in Alexandria, Egypt. J Infect Dev Ctries. 2020;14(3):277–83.
pubmed: 32235088
doi: 10.3855/jidc.12124
Saied T, Elkholy A, Hafez SF, Basim H, Wasfy MO, El-Shoubary W, et al. Antimicrobial resistance in pathogens causing nosocomial bloodstream infections in university hospitals in Egypt. Am J Infect Control. 2011;39(9):e61-65.
pubmed: 21835504
doi: 10.1016/j.ajic.2011.04.009
See I, Lessa FC, ElAta OA, Hafez S, Samy K, El-Kholy A, et al. Incidence and pathogen distribution of healthcare-associated infections in pilot hospitals in Egypt. Infect Control Hosp Epidemiol. 2013;34(12):1281–8.
pubmed: 24225613
pmcid: 4697449
doi: 10.1086/673985
Ayed H, Ben, Yaich S, Trigui M, Jemaa M, Ben HM, Ben, Karray R, et al. Prevalence and risk factors of health care–associated infections in a limited resources country: a cross-sectional study. Am J Infect Control. 2019;47(8):945–50.
pubmed: 30777390
doi: 10.1016/j.ajic.2019.01.008
Ghali H, Ben Rejeb M, Chahed C, Harrabi F, Ben Rejeb O, Ben Fredj S, et al. Incidence and risk factors of surgical site infection in general surgery department of a Tunisian tertiary teaching hospital: a prospective observational study. Can J Infect Control. 2018;33(1):25–32.
Hajjej Z, Nasri M, Sellami W, Gharsallah H, Labben I, Ferjani M. Incidence, risk factors and microbiology of central vascular catheterrelated bloodstream infection in an intensive care unit. J Infect Chemother. 2014;20(3):163–8.
pubmed: 24508422
doi: 10.1016/j.jiac.2013.08.001
Jamoussi A, Ayed S, Ben Ismail K, Chtara K, Bouaziz M, Mokline A, et al. The prevalence of healthcare-associated infection in medical intensive care units in Tunisia. Results of the multi-centre nosorea1 study. Tunisie Medicale. 2018;96(10–11):731–6.
pubmed: 30746666
Kallel H, Dammak H, Bahloul M, Ksibi H, Chelly H, Ben Hamida C, et al. Risk factors and outcomes of intensive care unit-acquired infections in a Tunisian ICU. Med Sci Monit. 2010;16(8):69–75.
Ketata N, Ben Ayed H, Ben Hmida M, Trigui M, Ben Jemaa M, Yaich S, et al. Point prevalence survey of health-care associated infections and their risk factors in the tertiary-care referral hospitals of Southern Tunisia. Infect Dis Heal. 2021;26(4):284–91.
doi: 10.1016/j.idh.2021.06.004
Salem K, Ben MS, El, Letaief M, Bchir M, Soltani MS. Epidemiological profile of health-care-associated infections in the central-east area of Tunisia. East Mediterr Heal J. 2011;17(6):486.
Akoko LO, Mwanga AH, Fredrick F, Mbembati NM, Health C. Risk factors of surgical site infection at Muhimbili National Hospital, Dar Es Salaam, Tanzania. East Cent African J Surg. 2012;17(3):12–7.
De Nardo P, Gentilotti E, Nguhuni B, Vairo F, Chaula Z, Nicastri E, et al. Post-caesarean section surgical site infections at a Tanzanian tertiary hospital: a prospective observational study. J Hosp Infect. 2016;93(4):355–9.
pubmed: 27125664
doi: 10.1016/j.jhin.2016.02.021
Kibwana UO, Manyahi J, Sensa V, Yongolo SC, Lyamuya E. Predictors of surgical site infections among patients undergoing open urological surgery at a Tertiary Hospital, Tanzania: a cross sectional study. East Afr Heal Res J. 2022;6(1):113–8.
doi: 10.24248/eahrj.v6i1.686
Kisibo A, Ndume VA, Semiono A, Mika E, Sariah A, Protas J, et al. Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar Es Salaam, Tanzania. East Cent African J Surg. 2017;22(1):49.
doi: 10.4314/ecajs.v22i1.7
Mawalla B, Mshana SE, Chalya PL, Imirzalioglu C, Mahalu W. Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania. BMC Surg. 2011;11(1):21.
pubmed: 21880145
pmcid: 3175437
doi: 10.1186/1471-2482-11-21
Mpogoro FJ, Mshana SE, Mirambo MM, Kidenya BR, Gumodoka B, Imirzalioglu C. Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania. Antimicrob Resist Infect Control. 2014;3: 25.
pubmed: 25126415
pmcid: 4131772
doi: 10.1186/2047-2994-3-25
Abubakar U. Point-prevalence survey of hospital acquired infections in three acute care hospitals in Northern Nigeria. Antimicrob Resist Infect Control. 2020;9:63.
pubmed: 32393348
pmcid: 7216694
doi: 10.1186/s13756-020-00722-9
Iwuafor AA, Ogunsola FT, Oladele RO, Oduyebo OO, Desalu I, Egwuatu CC, et al. Incidence, clinical outcome and risk factors of intensive care unit infections in the Lagos university teaching hospital (LUTH), Lagos, Nigeria. Lazzeri C, editor. PLoS One. 2016;11(10):e0165242.
pubmed: 27776162
pmcid: 5077115
doi: 10.1371/journal.pone.0165242
Nwankwo E, Edino S. Seasonal variation and risk factors associated with surgical site infection rate in Kano, Nigeria. Turkish J Med Sci. 2014;44(4):674–80.
doi: 10.3906/sag-1305-47
Olowo-okere A, Ibrahim Y, Sani A, Olayinka B. Occurrence of surgical site infections at a tertiary healthcare facility in Abuja, Nigeria: a prospective observational study. Med Sci. 2018;6(3):60.
Dayyab FM, Iliyasu G, Aminu A, Habib ZG, Tiamiyu AB, Tambuwal SH, et al. A prospective study of hospital-acquired infections among adults in a tertiary hospital in north-western Nigeria. Trans R Soc Trop Med Hyg. 2018;112(1):36–42.
pubmed: 29538772
doi: 10.1093/trstmh/try020
Behari AA, Kalafatis N. Incidence and outcome of ventilator-associated pneumonia in Inkosi Albert Luthuli and King Edward VIII hospital surgical intensive care units. South Afr J Crit Care. 2015;31(1):16–8.
doi: 10.7196/SAJCC.227
Dramowki A, Whitelaw A, Cotton MF. Burden, spectrum, and impact of healthcare-associated infection at a South African children’s hospital. Ann Thorac Surg. 2016;94:364–72.
Dramowski A, Madide A, Bekker A. Neonatal nosocomial bloodstream infections at a referral hospital in a middle-income country: burden, pathogens, antimicrobial resistance and mortality. Paediatr Int Child Health. 2015;35(3):265–72.
pubmed: 25940506
doi: 10.1179/2046905515Y.0000000029
Nair A, Steinberg WJ, Habib T, Saeed H, Raubenheimer JE. Prevalence of healthcare-associated infection at a tertiary hospital in the Northern Cape Province, South Africa. South Afr Fam Pract. 2018;60(5):162–7.
doi: 10.1080/20786190.2018.1487211
Mukagendaneza MJ, Munyaneza E, Muhawenayo E, Nyirasebura D, Abahuje E, Nyirigira J, et al. Incidence, root causes, and outcomes of surgical site infections in a tertiary care hospital in Rwanda: a prospective observational cohort study. Patient Saf Surg. 2019;13:10.
pubmed: 30820247
pmcid: 6378727
doi: 10.1186/s13037-019-0190-8
Nkurunziza T, Kateera F, Sonderman K, Gruendl M, Nihiwacu E, Ramadhan B, et al. Prevalence and predictors of surgical-site infection after caesarean section at a rural district hospital in Rwanda. Br J Surg. 2019;106(2):e121-128.
pubmed: 30620071
doi: 10.1002/bjs.11060
Velin L, Umutesi G, Riviello R, Muwanguzi M, Bebell LM, Yankurije M, et al. Surgical site infections and antimicrobial resistance after cesarean section delivery in rural Rwanda. Ann Glob Heal. 2021;87(1):77.
doi: 10.5334/aogh.3413
Bediako-Bowan AAA, Mølbak K, Kurtzhals JAL, Owusu E, Debrah S, Newman MJ. Risk factors for surgical site infections in abdominal surgeries in Ghana: emphasis on the impact of operating rooms door openings. Epidemiol Infect. 2020;148:e147.
pubmed: 32605670
pmcid: 7398855
doi: 10.1017/S0950268820001454
Bediako-Bowan A, Owusu E, Debrah S, Kjerulf A, Newman MJ, Kurtzhals JALL, et al. Surveillance of surgical site infection in a teaching hospital in Ghana: a prospective cohort study. J Hosp Infect. 2020;104(3):321–7.
pubmed: 31931045
doi: 10.1016/j.jhin.2020.01.004
Labi AK, Obeng-Nkrumah N, Owusu E, Bjerrum S, Bediako-Bowan A, Sunkwa-Mills G, et al. Multi-centre point-prevalence survey of hospital-acquired infections in Ghana. J Hosp Infect. 2019;101(1):60–8.
pubmed: 29730140
doi: 10.1016/j.jhin.2018.04.019
Nouetchognou JS, Ateudjieu J, Jemea B, Mesumbe EN, Mbanya D. Surveillance of nosocomial infections in the Yaounde University Teaching Hospital, Cameroon. BMC Res Notes. 2016;9(1):505.
pubmed: 27931241
pmcid: 5146876
doi: 10.1186/s13104-016-2310-1
Ebogo Titus N, Nzinga J, Nchufor N, Njuma T, Ntih L, Sena G, et al. Epidemiology of surgical site infection following abdominal surgeries at a reference hospital in North-West Cameroon. J West African Coll Surg. 2021;11(2):1.
doi: 10.4103/jwas.jwas_51_22
Yaouba D, Ngaroua, Ngah JE, Perpoint T, Mbo Amvene J, Vanhems P, et al. Incidence and risk factors for surgical site infections in N’Gaoundéré Regional Hospital, Cameroon. Am J Infect Control. 2016;44(10):1195–6.
pubmed: 27544794
doi: 10.1016/j.ajic.2016.04.250
Di Gennaro F, Marotta C, Pisani L, Veronese N, Pisani V, Lippolis V, et al. Maternal caesarean section infection (MACSI) in Sierra Leone: a case-control study. Epidemiol Infect. 2020;148(e40):1–6.
Lakoh S, Yi L, Russell JBW, Zhang J, Sevalie S, Zhao Y, et al. The burden of surgical site infections and related antibiotic resistance in two geographic regions of Sierra Leone: a prospective study. Ther Adv Infect Dis. 2022;9:20499361221135130.
Lakoh S, Yi L, Sevalie S, Guo X, Adekanmbi O, Smalle IO, et al. Incidence and risk factors of surgical site infections and related antibiotic resistance in Freetown, Sierra Leone: a prospective cohort study. Antimicrob Resist Infect Control. 2022;11(1):39.
pubmed: 35189952
pmcid: 8862228
doi: 10.1186/s13756-022-01078-y
Flouchi R, Far M, El, Hibatallah A, Elmniai A, Rhbibou I, Touzani I, et al. Incidence of surgical site infections and prediction of risk factors in a hospital center in Morocco. J Infect Dev Ctries. 2022;16(7):1191–8.
pubmed: 35905024
doi: 10.3855/jidc.15289
Maoulainine FMR, Elidrissi NS, Chkil G, Abba F, Soraa N, Chabaa L, et al. Épidémiologie De L’Infection Nosocomiale Bactérienne dans Un Service De Réanimation Néonatale Marocain. Arch Pediatr. 2014;21(9):938–43.
pubmed: 24993147
doi: 10.1016/j.arcped.2014.04.033
Shimi A, Touzani S, Elbakouri N, Bechri B, Derkaoui A, Khatouf M. Nosocomial pneumonia in ICU CHU Hassan II of Fez. Pan Afr Med J. 2015;22:285.
pubmed: 26966481
pmcid: 4769063
doi: 10.11604/pamj.2015.22.285.7630
Victor D, Gunturu R, Kariuki S, Hakeem A, Raja A, Kimang’a A. Pattern of pathogens and their sensitivity isolated from surgical site infections at the Aga Khan University Hospital, Nairobi, Kenya. Ethiop J Health Sci. 2013;23(2):141–9.
Sattar FAA, Quadros DRS, Olang P, Chokwe T. Incidence of ventilator-associated pneumonia in the critical care unit at Kenyatta National Hospital, a public tertiary care hospital. East Afr Med J. 2018;95(6):1613–23.
Nanyunja D, Chothia M-Y, Opio KC, Ocama P, Bwanga F, Kiggundu D, et al. Incidence, microbiological aspects and associated risk factors of catheter-related bloodstream infections in adults on chronic haemodialysis at a tertiary hospital in Uganda. IJID Reg. 2022;5(May):72–8.
pubmed: 36212918
pmcid: 9535435
doi: 10.1016/j.ijregi.2022.09.002
Lubega A, Joel B, Justina Lucy N. Incidence and etiology of surgical site infections among emergency postoperative patients in mbarara regional referral hospital, South Western Uganda. Surg Res Pract. 2017;2017:6365172.
pubmed: 28168215
pmcid: 5266862
Kakupa DK, Muenze PK, Byl B, Wilmet MD. Etude de la prévalence des infections nosocomiales et des facteurs associes dans les deux hopitaux universitaires de Lubumbashi, République Démocratique Du Congo: Cas Des Cliniques Universitaires De Lubumbashi et l’Hôpital Janson Sendwe. Pan Afr Med J. 2016;24:275.
pubmed: 28154630
pmcid: 5267913
doi: 10.11604/pamj.2016.24.275.7626
Lukuke HM, Kasamba E, Mahuridi A, Ngatu NR, Narufumi S, Mukengeshayi AN, et al. L’incidence des infections nosocomiales urinaires et des sites opératoires dans la maternité de l’hôpital général de référence de katuba à lubumbashi en république Démocratique Du Congo. Pan Afr Med J. 2017;28:1–13.
doi: 10.11604/pamj.2017.28.57.9866
Ahoyo TA, Bankolé HS, Adéoti FM, Gbohoun AA, Assavèdo S, Amoussou-Guénou M, et al. Prevalence of nosocomial infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012. Antimicrob Resist Infect Control. 2014;3:17.
pubmed: 24883183
pmcid: 4039045
doi: 10.1186/2047-2994-3-17
Dégbey C, Kpozehouen A, Coulibaly D, Chigblo P, Avakoudjo J, Ouendo EM, et al. Prevalence and factors associated with surgical site infections in the university clinics of traumatology and urology of the National University Hospital Centre Hubert Koutoukou Maga in Cotonou. Front Public Heal. 2021;9:629351.
doi: 10.3389/fpubh.2021.629351
Scherbaum M, Kösters K, Mürbeth RE, Ngoa UA, Kremsner PG, Lell B, et al. Incidence, pathogens and resistance patterns of nosocomial infections at a rural hospital in Gabon. BMC Infect Dis. 2014;14(1):124.
pubmed: 24592922
pmcid: 3943987
doi: 10.1186/1471-2334-14-124
Ouedraogo S, Kambire JL, Ouedraogo S, Ouangre E, Diallo I, Zida M, et al. Surgical site infection after digestive surgery: diagnosis and treatment in a context of limited resources. Surg Infect (Larchmt). 2020;21(6):547–51.
pubmed: 32053063
doi: 10.1089/sur.2019.007
Togo A, Traoré A, Kante L, Coulibaly Y, Diango D, Keita M, et al. Fighting Nosocomial Infection Rates in the General Surgery Department of the Teaching Hospital Gabriel Toure in Bamako, Mali. Open Biol J. 2010;3(3):87–91.
Atif ML, Azouaou A, Bouadda N, Bezzaoucha A, Si-Ahmed M, Bellouni R. Incidence and predictors of surgical site infection in a general surgery department in Algeria. Rev Epidemiol Sante Publique. 2015;63(4):275–9.
pubmed: 26143961
doi: 10.1016/j.respe.2015.05.003
Ling ML, Apisarnthanarak A, Madriaga G. The burden of healthcare-associated infections in southeast Asia: a systematic literature review and meta-analysis. Clin Infect Dis. 2015;60(11):1690–9.
pubmed: 25676799
doi: 10.1093/cid/civ095
Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate point-prevalence survey of health care–associated infections. N Engl J Med. 2014;370(13):1198–208.
pubmed: 24670166
pmcid: 4648343
doi: 10.1056/NEJMoa1306801
Russo PL, Stewardson AJ, Cheng AC, Bucknall T, Mitchell BG. The prevalence of healthcare associated infections among adult inpatients at nineteen large Australian acute-care public hospitals: a point prevalence survey. Antimicrob Resist Infect Control. 2019;8:114.
pubmed: 31338161
pmcid: 6628491
doi: 10.1186/s13756-019-0570-y
Bunduki GK, Mukululi MP, Masumbuko CK, Uwonda SA. Compliance of antibiotics used for surgical site infection prophylaxis among patients undergoing surgery in a Congolese teaching hospital. Infect Prev Pract. 2020;2(3):100075.
pubmed: 34368716
pmcid: 8336289
doi: 10.1016/j.infpip.2020.100075
Kalata NL, Kamange L, Muula AS. Adherence to hand hygiene protocol by clinicians and medical students at Queen Elizabeth Central Hospital, Blantyre-Malawi. Malawi Med J. 2013;25(2):50–2.
pubmed: 24098831
pmcid: 3784937
Abubakar U, Amir O, Rodríguez-Baño J. Healthcare-associated infections in Africa: a systematic review and meta-analysis of point prevalence studies. J Pharm Policy Pract. 2022;15:99.
pubmed: 36494700
pmcid: 9733066
doi: 10.1186/s40545-022-00500-5
European Centre for Disease Prevention and Control. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals-protocol version 5.3. Stockolm: ECDC; 2016.
CDC NHSN, January. CDC / NHSN surveillance definitions for specific types of infections. 2021. Available at: https://www.cdc.gov/nhsn/pdfs/pscmanual/17pscnosinfdef_current.pdf .
Ferreira E, Pina E, Sousa-Uva M, Sousa-Uva A. Risk factors for health care–associated infections: from better knowledge to better prevention. Am J Infect Control. 2017;45(10):e103-107.
pubmed: 28549880
doi: 10.1016/j.ajic.2017.03.036
Rice S, Carr K, Sobiesuo P, Shabaninejad H, Orozco-Leal G, Kontogiannis V, et al. Economic evaluations of interventions to prevent and control health-care-associated infections: a systematic review. Lancet Infect Dis. 2023;3099(22). https://doi.org/10.1016/S1473-3099(22)00877-5 .