RESUMO
Background: Hospital-acquired infections (HAI) are a leading cause of morbidity and mortality globally. These infections are diverse, but the majority are lower respiratory tract infection (LRTI), surgical site infection (SSI), bloodstream infection (BSI), and urinary tract infection (UTI). For most sub-Saharan African countries, studies revealing the burden and impact of HAI are scarce, and few systematic reviews and meta-analysis have been attempted. We sought to fill this gap by reporting recent trends in HAI in sub-Saharan Africa (SSA) with attention to key patient populations, geographic variation, and associated mortality. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a literature search of six electronic databases (Web of Science, Pubmed, APA PsycInfo, CINAHL, Embase, and the Cochrane Library) to identify studies assessing the prevalence of HAI in SSA countries. Studies published between 01 January 2014 and 31 December 2023 were included. We applied no language or publication restrictions. Record screening and data extractions were independently conducted by teams of two or more reviewers. Using the R software (version 4.3.1) meta and metafor packages, we calculated the pooled prevalence estimates from random-effect meta-analysis, and further explored sources of heterogeneity through subgroup analyses and meta-regression. This study is registered with PROSPERO, CRD42023433271. Findings: Forty-one relevant studies were identified for analysis, consisting of 15 from West Africa (n = 2107), 12 from Southern Africa (n = 2963), 11 from East Africa (n = 2142), and 3 from Central Africa (n = 124). A total of 59.4% of the patient population were associated with paediatric admissions. The pooled prevalence of HAI was estimated at 12.9% (95% CI: 8.9-17.4; n = 7336; number of included estimates [k] = 41, p < 0.001). By subregions, the pooled current prevalence of HAI in the West Africa, Southern Africa, East Africa and Central Africa were estimated at 15.5% (95% CI: 8.3-24.4; n = 2107; k = 15), 6.5% (95% CI: 3.3-10.7; n = 2963; k = 12), 19.7% (95% CI: 10.8-30.5; n = 2142; k = 11) and 10.3% (95% CI: 1.1-27.0; n = 124; k = 3) of the patient populations respectively. We estimated mortality resulting from HAI in SSA at 22.2% (95% CI: 14.2-31.4; n = 1118; k = 9). Interpretation: Our estimates reveal a high burden of HAI in SSA with significant heterogeneity between regions. Variations in HAI distribution highlight the need for infection prevention and surveillance strategies specifically tailored to enhance prevention and management with special focus on West and East Africa, as part of the broader global control effort. Funding: No funding was received for this study.
RESUMO
AIM: The aim of this study is to establish a valid and reliable culturally adapted instrument which can be used in the Arabian context to measure emotional well-being. DESIGN: The Mental Health Inventory tool was used to investigate the emotional well-being of Saudi nursing students. The instrument was originally developed in English and in a western cultural setting. As such, there was a need to translate and validate the instrument in Arabic for use in the Arabian setting. METHODS: The Arabic version MHI 38 (AV-MHI-38) was translated, reviewed and revised, then evaluated with a sample of Arabic-speaking nursing students from Saudi Arabia using cross-sectional multicentre survey approach. An iterative forward-backward-forward sequence of item translation and review by a bilingual and bicultural expert panel was then completed. The psychometric properties of the AV-MHI-38 were examined through an exploratory factor analysis, confirmatory factor analysis, correlation among factors and reliability assessment. RESULTS: The sample consisted of 252 nursing students from two different universities located in different geographic regions in Saudi Arabia. The mean age was 20.93 years, made up of 230 female and 22 male participants. An a priori two-factor model showed satisfactory fit with modifications. Results indicated two component AV-MHI-38 with 46.09% of the total variance and excellent internal consistency. The AV-MHI-38 had good psychometric properties and the two subscales had good internal consistency with Cronbach's and acceptable reliability measures. The AV-MHI can be used to assess emotional well-being among Arabic-speaking populations of nursing students, nurses and other healthcare providers. The instrument can be used to identify the emotional well-being of students and initiating strategies to support them to decrease their study and work-related stress, anxiety and depression.