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Gap Analysis of Infection Control Practices in Low- and Middle-Income Countries

Published online by Cambridge University Press:  22 July 2015

Kristy Weinshel ,
Angela Dramowski ,
Ágnes Hajdu ,
Saul Jacob ,
Basudha Khanal ,
Maszárovics Zoltán ,
Katerina Mougkou ,
Chimanjita Phukan ,
Maria Inés Staneloni  and
Nalini Singh
Kristy Weinshel
Affiliation:
Society for Healthcare Epidemiology of America, Arlington, Virginia
Angela Dramowski
Affiliation:
Stellenbosch University, Cape Town, South Africa
Ágnes Hajdu
Affiliation:
National Center for Epidemiology, Budapest, Hungary
Saul Jacob
Affiliation:
George Washington University, Washington, DC
Basudha Khanal
Affiliation:
B. P. Koirala Institute of Health Sciences, Nepal
Maszárovics Zoltán
Affiliation:
Markhot Ferenc Teaching Hospital and Outpatient Clinic, Eger, Hungary
Katerina Mougkou
Affiliation:
National Kapodistrian University, Athens School of Medicine, Athens, Greece
Chimanjita Phukan
Affiliation:
Gauhati Medical College and Hospital, Guwahati, India
Maria Inés Staneloni
Affiliation:
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Nalini Singh*
Affiliation:
Children’s National Medical Center, George Washington University, Washington, DC
*
Address correspondence to Nalini Singh, MD, MPH, George Washington University Schools of Medicine and Public Health, Children’s National Medical Center, 111 Michigan Ave, NW, NW, Washington, DC (nsingh@childrensnational.org).
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Abstract

BACKGROUND

Healthcare-associated infection rates are higher in low- and middle-income countries compared with high-income countries, resulting in relatively larger incidence of patient mortality and disability and additional healthcare costs.

OBJECTIVE

To use the Infection Control Assessment Tool to assess gaps in infection control (IC) practices in the participating countries.

METHODS

Six international sites located in Argentina, Greece, Hungary, India, Nepal, and South Africa provided information on the health facility and the surgical modules relating to IC programs, surgical antibiotic use and surgical equipment procedures, surgical area practices, sterilization and disinfection of equipment and intravenous fluid, and hand hygiene. Modules were scored for each country.

RESULTS

The 6 international sites completed 5 modules. Of 121 completed sections, scores of less than 50% of the recommended IC practices were received in 23 (19%) and scores from 50% to 75% were received in 43 (36%). IC programs had various limitations in many sites and surveillance of healthcare-associated infections was not consistently performed. Lack of administration of perioperative antibiotics, inadequate sterilization and disinfection of equipment, and paucity of hand hygiene were found even in a high-income country. There was also a lack of clearly written defined policies and procedures across many facilities.

CONCLUSIONS

Our results indicate that adherence to recommended IC practices is suboptimal. Opportunities for improvement of IC practices exist in several areas, including hospital-wide IC programs and surveillance, antibiotic stewardship, written and posted guidelines and policies across a range of topics, surgical instrument sterilization procedures, and improved hand hygiene.

Infect. Control Hosp. Epidemiol. 2015;36(10):1208–1214

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 10 , October 2015 , pp. 1208 - 1214
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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