Healthcare-Associated Infections in Ghana

Project summary

Healthcare-associated infections (HCAIs) comprise one of the most common, significant and preventable patient safety issue worldwide. The challenge of HCAIs in Ghana and other developing countries is estimated to be high but scarcely addressed. We postulate that a high prevalence of HCAIs in Ghanaian healthcare settings leads to high patient morbidity and mortality, prolonged hospital stay, reduced quality of life as well as increased economic costs to patients and the health sector. This project aims to improve patient safety by reducing and preventing HCAIs through surveillance and effective infection control. This requires an interdisciplinary approach and the project involves collaboration and research capacity building within the fields of surveillance, clinical research, microbiology, ethnographic health facility research and cost-analysis. We will conduct a point prevalence survey among 6 selected hospitals from the Northern, Middle and Southern sectors of Ghana to assess the burden of HCAIs. A prospective survey focusing on surgical site infections, healthcare associated neonatal sepsis and puerperal infections will be conducted in 2 hospitals to generate data on the epidemiology, socioeconomic impact of HCAIs and socio-cultural barriers to infection control. We will pilot a surveillance system for surgical site infections in partnership with Ghana Health Service and evaluate cost-effectiveness of selected infection control interventions in reducing health care related puerperal and neonatal sepsis. There is a great need to intervene against HCAIs in Ghana to avoid jeopardizing the benefits of the increased uptake of facility-based healthcare services experienced in the country over the past decade. Prevention of HCAIs among mothers and neonates could further accelerate progress towards the attainment of the United Nations Millennium Development Goals 4 & 5. Finally, reductions in HCAI are likely to result in cost savings, thereby allowing resources to be used for provision of other healthcare services.

Outputs

Extra Midterm Report:

Within the HAI-Ghana project framework, the first national multi-center point prevalence survey was published in 2018 and found an overall rate of hospital acquired infections at 8.2%. The survey further documented broad use of antibiotics and low utilization of microbiological services that in combination may represent a key driver of AMR in Ghana. The most common HAI identified was surgical site infections (SSIs) representing more than one third of all HAIs identified. Some of our studies have document the epidemiology of SSIs and established a surveillance system for SSI. We are implementing the WHO multi modal hand hygiene interventional study at the neonatal intensive care unit at Korle-bu Teaching Hospital and hypothesize that it may have effect on hand hygiene compliance and effect on transmission of Gram negative bacteria and neonatal sepsis. Ethnographic studies are undertaken to inform the intervention and assess uptake as well as assess the overarching perception and cultural priority of AMR and IPC.