Developing world needs surveillance system
Healthcare-associated infections, an avoidable scourge estimated to affect hundreds of millions of people globally, are at least twice as high in the developing world as in high-income countries, according to the first review of its kind, co-authored by a United Nations health official.
Factors increasing the risk of such infections include poor hygiene and waste disposal, inadequate infrastructure and equipment, understaffing, overcrowding, lack of basic infection control knowledge and implementation, unsafe procedures, and a lack of guidelines and policies.
“Health-care associated infections have long been established as the biggest cause of avoidable harm and unnecessary death in the health systems of high-income countries,” said Benedetta Allegranzi, Technical Lead for the Clean Care is Safer Care programme at the UN World Health Organisation (WHO), co-author of the study.
“We now know that the situation in developing countries is even worse. There, levels of healthcare-associated infection are at least twice as high. One in three patients having surgery in some settings with limited resources becomes infected. Solutions exist, and the time to act is now. The cost of delay is even more lives tragically lost.”
Implementing system-wide surveillance, training, education and good communication, using devices appropriately, following proper procedures, and ensuring optimal hand hygiene practices are some of the solutions to the problem, according to the study. To be successful, they ultimately require a change of healthcare workers’ behaviour.
While surveillance systems exist in high-income countries, they are non-existent in the vast majority of middle- and low-income nations, with the consequent inability to determine the likelihood and magnitude of the risk of infection associated with each of the susceptible factors mentioned above.
“The number of health care-associated infections should be much lower in high-income countries, because we know what works and we have the means to act,” said Didier Pittet, Head of the Collaborating Centre on Patient Safety at the University of Geneva Hospitals and co-author of the Lancet study.
“Low- and middle-income countries face many more challenges, but this does not mean the problem is insurmountable. Several interventions are simple and low-cost.”