Infection Prevention and Control at Lira University Hospital, Uganda: More Needs to Be Done.

Marc Sam Opollo,Maria Zolfo,Freddy Eric Kitutu,Pruthu Thekkur,Tom Charles Otim,Walter Kizito,Rogers Kisame,Ajay M V Kumar

doi:10.3390/tropicalmed6020069

Abstract

Globally, 5–15% of hospitalized patients acquire infections (often caused by antimicrobial-resistant microbes) due to inadequate infection prevention and control (IPC) measures. We used the World Health Organization’s (WHO) ‘Infection Prevention and Control Assessment Framework’ (IPCAF) tool to assess the IPC compliance at Lira University hospital (LUH), a teaching hospital in Uganda. We also characterized challenges in completing the tool. This was a hospital-based, cross-sectional study conducted in November 2020. The IPC focal person at LUH completed the WHO IPCAF tool. Responses were validated, scored, and interpreted per WHO guidelines. The overall IPC compliance score at LUH was 225/800 (28.5%), implying a basic IPC compliance level. There was no IPC committee, no IPC team, and no budgets. Training was rarely or never conducted. There was no surveillance system and no monitoring/audit of IPC activities. Bed capacity, water, electricity, and disposal of hospital waste were adequate. Disposables and personal protective equipment were not available in appropriate quantities. Major challenges in completing the IPCAF tool were related to the detailed questions requiring repeated consultation with other hospital stakeholders and the long time it took to complete the tool. IPC compliance at LUH was not optimal. The gaps identified need to be addressed urgently.

Highlights

Healthcare-associated infections (HCAIs) are those infections occurring in a patient during the process of care in a hospital or other healthcare facility, which was not present or incubating at the time of admission
5–15% of hospitalized patients suffer from HCAIs and this is primarily due to poor infection prevention and control (IPC) practices in the hospitals
For the individual components of Infection Prevention and Control Assessment Framework’ (IPCAF), scores ranged from 0% to 77.5%

Summary

Introduction

Healthcare-associated infections (HCAIs) are those infections occurring in a patient during the process of care in a hospital or other healthcare facility, which was not present or incubating at the time of admission. This includes infections acquired in the hospital, but appearing after discharge [1]. HCAIs include occupational infections that occur among the healthcare workers. 5–15% of hospitalized patients suffer from HCAIs and this is primarily due to poor infection prevention and control (IPC) practices in the hospitals. In low-income and middle-income countries (LMICs), the frequency of HCAIs is estimated to be more than double compared to high-income countries.

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