Posted on Dec 13, 2010 by Sergio Ulloa
A World Health Organization (WHO) lead research project has highlighted the struggle developing nations are facing in the fight against healthcare-associated infections.
A report on the subject is based on the analysis of 220 previous cases studies, which compared the position in poorer nations to the USA and found that infection rates were three times higher in developing nations.
The Lancet released the findings of the study into infections rates while patients were receiving healthcare and highlighted the fact that the problem has been largely overlooked in the less developed nations.
Research found that healthcare associated infections such as hospital obtained pneumonia, surgical site infections, urinary tract and bloodstream infections where among major health problems within poorer nation's hospitals; the contraction of malaria and tuberculosis were also being obscured.
Information for the report was obtained from relevant data collected between 1995 and 2008. The data pooled details contained in electronic databases, relevant medical articles and full or partial information supplied by developing countries.
The data covering 13 years worth of research found healthcare-associated infection rates within developing countries was 15.5 per 100 patients, while in the USA it was 4.5 and Europe 7.1 per 100 patients.
There was also an alarming difference in the rate of infections obtained during intensive care within developing countries, which was reported at 47.9 infections per 1000 patient-days compared to the USA where there are 13.6 infections per 1000 patient days.
The problem primarily stems from the limited resources available in developing countries, which contribute to major safety concerns for patients receiving treatment in hospitals. The report calls for improved surveillance and a better understanding of the severity of the health issues; the report highlights the urgent need for the problem to be addressed often by adopting simple low cost measures.
Contracting a hospital-associated infection can lead to an extensive stay in a hospital, increase the risk of an individual becoming resistant to vital medication, long-term disability and, in extreme circumstances, death. In addition to the direct health concerns, a prolonged stay in hospitals will drive-up healthcare bills leading to higher financial obligations for national economies in a state funded facilities or to the patients who are required to pay for healthcare services out of pocket.
The overall number of people affected by healthcare-associated infections is difficult to identify precisely due to insufficient data being available in developing nations. While developed nations are able to install critical surveillance systems, middle and low income nations have been unable to establish sophisticated tools to monitor this healthcare problem.
Health factors surrounding risks of healthcare-associated infections include inadequate medical equipment, poor infrastructure, lack of medical professionals, overcrowding in hospitals, unsafe methods, poor guidelines and unhygienic procedures. All these elements can contribute to a patient contracting an infection while receiving treatment in a hospital, while many infections are capable of being remedied through the adoption of simple, affordable measures.
Dr Benedetta Allegranzi, Technical Lead for the Clean Care is Safer Care programme at the WHO and author of the study said: "Healthcare-associated infections have long been established as the biggest cause of avoidable harm and unnecessary death in the health systems of high income countries. We now know that the situation in developing countries is even worse. There, levels of health care-associated infection are at least twice as high."
Commenting on resources Dr Benedetta Allegranzi said: "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."
Wealthy countries have a much lower level of healthcare-associated infection rates due to the long-term development of healthcare facilities, processes for measuring infection rates and pressure groups to minimize the impact of illness from this source. On the other hand, developing countries face more of a challenge in handling this issue, but medical
professionals cite it is not impossible to minimize risks from healthcare-associated infections in future with simple and low-cost measures.
Author of The Lancet study, and Head of the Collaborating Centre on Patient Safety at the University of Geneva Hospitals, Professor Didier Pitted said: "The number of healthcare-associated infections should be much lower in high-income countries, because we know what works and we have the means to act. 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."
The current burden of healthcare-associated infections on developing nation's healthcare systems is a major problem which can be eradicated, but has proven to be a challenge for the low and middle income nations - partially through a lack of expertise and partly through lack of suitable guidelines being present in these countries. Experts believe the issues of healthcare-associated infections can be rectified by developing countries following low-cost and simple measures to prevent pathogen transmissions occurring in hospitals; this would include establishing effective steps covering basic hygiene, surveillance procedures, education and infection control processes.