Healthcare-Associated Infection in Burkina Faso: an Assessment in a District Hospital

In developing countries; few data are available on healthcare-associated infections. In Burkina Faso; there has been a failure to take into account risk management and patient safety in the quality assurance program. The main objective of our study was to carry out an assessment of healthcare-associated infection in a first level hospital. We conducted a crosssectional study in June 2011 in the care units of Ziniare District Hospital (Ziniare; Burkina Faso). The hospital has been divided in three components: i) hospital population (care providers; in-patients and patients' guardians); ii) healthcare and services organization; iii) hospital environment. We included: care providers of the clinical services; hospital inpatients and patients' guardians; hospitalization infrastructure and nursing units; and all the documents relating to standards and protocols. Data collection has been done by direct observation; interviews and biological samples taken at different settings. In hospital population; care providers and patients' guardians represented a high source of infection: adherence to hygiene practice on the part of care providers was low (12/19); and no patients' guardian experienced good conditions of staying in the hospital. In healthcare and services organization; healthcare waste management represented a high-risk source of infection. In hospital environment; hygiene level of the infrastructure in the hospital rooms was low (6.67). Prevalence of isolated bacteria was 71.8. Urinary-tract catheters infections were the most significant in our sample; followed by surgical-site infections. In total; 56.26(9/19) of germs were -Lactamase producers (ESBL). They were represented by Escherichia coli and Klebsiella pneumoniae. Our analysis identified clearly healthcare-associated infection as a problem in Ziniare district hospital. Hence; a national program of quality assurance in the hospitals should now integrate the risk infectious management of healthcare-associated infections

Assessment of the Health System to Support Tuberculosis and AIDS Care. A Study of Three Rural Health Districts of Burkina Faso

There is increasing evidence demonstrating the importance of healthcare systems for improvement of chronic illness care. The aims of this study were to develop a comprehensive assessment of the health services capacity to provide tuberculosis (TB) and human immunodeficiency virus (HIV) care but also to enhance patient empowerment; social network and community support. A cross-sectional study was conducted from 1 to 31 of August 2007 in 3 districts of Burkina Faso. We used a step-by-step model and the assessment of chronic illness care (ACIC) scale to assess capacities of 24 first line health centres (FLHC) and 3 district hospitals (DH) for providing TB and HIV/AIDS care. Data for the step-by-step model were extracted from medical records of 75 TB and 66 HIV patients. The ACIC scale was completed by health professionals; 6 medical doctors and 18 nurses; working at the DH level and at the FLHC level; respectively. The biological test for confirmation was free of charge for all the TB patients but only for 10.6(7/66) HIV cases. Up to the time of the survey; 5 TB (6.6) and 18 HIV+ patients (27.3) have been hospitalised for care at least once; 64 TB (85.3) had been declared cured and 38 HIV (54.5) were under antiretroviral treatment. Health care process organisation for TB and HIV care had distinct areas of weaknesses. From a maximum ACIC score of 11; the overall score for TB care ranged between 1.9 and 4.9 with a median of 3.7 and for HIV care between 2.1 and 6.7 with a median of 4.1. This study provides an illustration of assessing the HIV and TB care combining data from the routine information system and from the chronic illness care assessment tool; to encompass both disease control and patient health perspective. It provides to health managers arguments for clear conclusions and sufficient data for action