Health care-associated infections pose a major patient
safety problem in the developing world, reveals a World Health Organization
(WHO) lead research project. This serious issue is scarcely addressed in the
scientific literature. Though hundreds of millions of people are affected
globally, precise numbers remain unknown. This is because of the inability of
the vast majority of middle- and low-income countries to afford efficient
national surveillance systems. The
levels of health care-associated infection in developing nations are at least
twice as high when compared to the high income countries. Study results
were published in The Lancet, the leading medical journal. The report was based
on the analysis of 220 previous cases studies.
Infections lead to prolonged hospital stay, increased
resistance to life-saving medications and thus drives up costs for patients and
their family. They create long-term disability and even lead to death. Hospital
obtained pneumonia, surgical site infections, urinary tract and bloodstream
infections are among major health problems within poorer nation's hospitals
The contraction of malaria and tuberculosis lays additional burden.
The data covering 13 years worth of research found
healthcare-associated infection rates within developing countries was 15.5 per
100 patients. This value was 4.5 and 7.1 per 100 patients in USA and Europe
respectively. The rate of infections obtained during intensive care within
developing countries was alarmingly high. Critically ill patients admitted to
hospital in low-income countries had at least double the device-associated
health-care-associated infection rates of patients in industrialised countries.
Limited resources available in developing countries contribute to major safety
concerns for patients receiving treatment in hospitals.
The following are the risk factors listed by WHO:
• Poor hygiene and waste disposal
• Inadequate infrastructure and equipment
• Lack of basic infection control knowledge and implementation
• Unsafe procedures
• Lack of guidelines and policies.
Long-term development of healthcare facilities, processes
for measuring infection rates and pressure groups to minimize the impact of
illness from this source are the three major players that reduces the infection
burden of wealthy nations. Lack of these factors doesn't mean it is impossible
to save the developing world. Simple and low-cost interventions are available.
A change of health-care workers' behaviour in all settings
is a must. Suggested solutions are:
• Implementation of system-wide surveillance: Surveillance is key to the reduction of health care-associated infections.
• Training, education and good communication
• Apt usage of devices
• Following proper procedures
• Ensuring optimal hand hygiene practices
Establishment of effective simple and low-cost measures can
reduce the burden of middle- and low-income countries.
Allegranzi B, Nejad S Bagheri, et al. Burden of
endemic health-care-associated infection in developing countries: systematic
review and meta-analysis. The Lancet, 2010.
• The Lancet
• WHO Media Centre