ABSTRACT
BACKGROUND: Healthcare associated infections (HAIs) are a major threat to patient safety and quality care. However, they are avoidable by implementing evidence-based infection prevention and control measures. This review evaluated the evidence of the effectiveness of Infection Prevention and Control (IPC) interventions in reducing rates of HAIs in healthcare settings in Africa. METHOD: We searched several databases: CENTRAL, EMBASE, PUBMED, CINAHL, WHO IRIS and AJOL for primary studies reporting rates of the four most frequent HAIs: surgical site infections, central line-associated blood stream infections, catheter-associated urinary tract infections, ventilator-associated pneumoniae and increase in hand hygiene compliance. Two reviewers appraised the studies and PRISMA guidelines were followed. RESULTS: Out of 4,624 studies identified from databases and additional sources, 15 studies were finally included in the review. Majority of studies were of pre and post-test study design. All the studies implemented a combination of interventions and not as stand-alone components. Across all included studies, an improvement was reported in at least one primary outcome. CONCLUSION: Our review highlights the potential of IPC interventions in reducing HAIs and improving compliance with hand hygiene in healthcare facilities in Africa. However, the certainty of evidence was low for majority of the outcomes. For future research, we recommend more pragmatic study designs with improved methodological rigor.
ABSTRACT
AIMS: Surveillance is a useful tool for tracking antimicrobial resistance (AMR) trends, patterns, therapeutic and policy interventions. Proper correlation of surveillance data gives meaningful insight into the underlying epidemiology and facilitates development of rational interventions. This comprehensive review aims to identify, classify and assess gaps in Global Antimicrobial Resistance and Use Surveillance System (GLASS) reporting and national action plan (NAP) implementation in Africa. METHODS: Articles published in English were searched across five electronic databases (PubMed, Scopus, Embase, AJOL and Cochrane) and grey literature. Articles were screened against inclusion/exclusion criteria and data from eligible studies were retrieved and analysed. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 31 July 2020 under protocol CRD42020192165. RESULTS: Of the 4304 records found, only 32 met the initial inclusion criteria (4 peer reviews and 28 were grey literature). From these records, 41 surveillance systems were identified (30 national and 11 transnational). After final review of reported outcomes, only 23 national surveillance systems met the inclusion criteria. Indicators recorded from these systems shows lack of external quality assessment (EQA) in some systems and limited reporting of parameters such as infection origin, patient population and pathogen types. CONCLUSIONS: The outcome of the review shows that although AMR surveillance has been implemented in 23 out of the 47 countries in the region, a number of limitations exist in the surveillance methods and reporting protocols that can impair the usefulness, validity and trustworthiness of data generated from these surveillance systems.
Subject(s)
Anti-Infective Agents , Policy , Humans , Africa/epidemiologyABSTRACT
There has been little agreement on the role that socioeconomic factors play in the aetiology of cardiovascular diseases (CVDs), obesity, and diabetes among migrants in the United Kingdom (UK). We systematically reviewed the existing evidence on this association to contribute to filling this gap in the literature. Two reviewers were involved at each stage of the review process to ensure validity. We comprehensively searched through several electronic databases and grey literature sources to identify potentially eligible papers for our review. We extracted data from our finally included studies and appraised the methodological rigour of our studies. A narrative synthesis approach was used to synthesise and interpret the extracted data. We sieved through 2485 records identified from our search and finally obtained 10 studies that met our inclusion criteria. The findings of this review show that there is a trend towards an association between socioeconomic factors and CVDs, diabetes, and obesity among migrants in the UK. However, the picture was more complex when specific socioeconomic variables and migrant subgroups were analysed. The evidence for this association is inconclusive and its causal relationship remains speculative. There is, therefore, the need for further research to understand the exact association between socioeconomic factors and CVD, diabetes, and obesity among migrants in the UK.
