Resources to support infection prevention and control in African neonatal units
Keywords:
Infant, Newborn; Infant, Premature; Sepsis / prevention & control; Infection Control / organization & administration; Cross Infection / prevention & control; Infection Control / standards; Health Facility Environment; Africa South of the Sahara; Global HealthAbstract
Background: Sub-
Saharan African experiences the
highest burden of neonatal sepsis
and antimicrobial resistance attributable
deaths globally due to inadequate
infrastructure, resources,
and staffing for infection prevention
and control (IPC), suboptimal
cleaning, equipment sharing,
and re-use of single-use items.
Methods: Fourteen hospitals in the
African Neonatal Network responded
to an annual facility survey
and a health facility survey co
-developed by faculty in the African
Neonatal Network and Vermont
Oxford Network. All analyses
use descriptive statistics.
Results: Most hospitals (86%)
had guidelines for IPC and policies
for environmental cleaning
(79%). Running water was routinely
available at 9 hospitals
(64%). Alcohol hand rub was
regularly available at the patient
bedside in 8 neonatal units (57%).
Almost all neonatal units (93%) re
-used single-use consumables and
reported using non-standardised
decontamination methods such as
soaking in sodium hypochlorite.
Oral and intravenous antibiotics
were shared between neonates at
four hospitals (29%), while parenteral
fluids were shared at six
neonatal units (43%), with several
units reporting prolonged use after
opening and/or reconstituting
medication and fluids.
Conclusion: Although most units
had IPC and hospital cleaning
guidelines, many lacked adequate
infrastructure and consumables to
support optimal IPC practices.
Clinical care practices such as
reprocessing of single-use items
and sharing of parenteral fluids
and medications, further highlight
the major contribution of resource
limitations to the burden of healthcare
associated infections in
African neonatal units.
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