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Rationale and guidance for strengthening infection prevention and control measures and antimicrobial stewardship programs in Bangladesh: a study protocol.
Harun, Md Golam Dostogir; Anwar, Md Mahabub Ul; Sumon, Shariful Amin; Hassan, Md Zakiul; Mohona, Tahrima Mohsin; Rahman, Aninda; Abdullah, Syed Abul Hassan Md; Islam, Md Saiful; Kaydos-Daniels, S Cornelia; Styczynski, Ashley R.
Affiliation
  • Harun MGD; Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh. dostogirharun@icddrb.org.
  • Anwar MMU; Centers for Disease Control and Prevention (CDC), Bangladesh Country Office, Dhaka, Bangladesh.
  • Sumon SA; Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
  • Hassan MZ; Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
  • Mohona TM; Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
  • Rahman A; Communicable Disease Control, Directorate General of Health Services, Dhaka, Bangladesh.
  • Abdullah SAHM; SafetyNet, Dhaka, Bangladesh.
  • Islam MS; University of New South Wales, Sydney, Australia.
  • Kaydos-Daniels SC; Centers for Disease Control and Prevention (CDC), Bangladesh Country Office, Dhaka, Bangladesh.
  • Styczynski AR; Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, USA.
BMC Health Serv Res ; 22(1): 1239, 2022 Oct 07.
Article in En | MEDLINE | ID: mdl-36207710
ABSTRACT

BACKGROUND:

Hospital-acquired infections (HAIs) and antimicrobial resistance (AMR) are major global health challenges. Drug-resistant infectious diseases continue to rise in developing countries, driven by shortfalls in infection control measures, antibiotic misuse, and scarcity of reliable diagnostics. These escalating global challenges have highlighted the importance of strengthening fundamental infection prevention and control (IPC) measures and implementing effective antimicrobial stewardship programs (ASP). This study aims to present a framework for enhancing IPC measures and ASP efforts to reduce the HAI and AMR burden in Bangladesh.

METHODS:

This implementation approach will employ a mixed-methods strategy, combining both quantitative and qualitative data from 12 tertiary hospitals in Bangladesh. A baseline assessment will be conducted using the Infection Prevention and Control Assessment Framework (IPCAF) developed by the WHO. We will record IPC practices through direct observations of hand hygiene, personal protective equipment (PPE) utilization, and hospital ward IPC infrastructure. Additionally, data on healthcare providers' knowledge, attitudes, and practices regarding IPC and antibiotic prescribing will be collected using both structured questionnaires and qualitative interviews. We will also assist the hospital leadership with establishing and/or strengthening IPC and ASP committees. Based on baseline assessments of each healthcare facility, tailored interventions and quality improvement projects will be designed and implemented. An end-line assessment will also be conducted after 12 months of intervention using the same assessment tools. The findings will be compared with the baseline to determine changes in IPC and antibiotic stewardship practices.

DISCUSSION:

Comprehensive assessments of healthcare facilities in low-resource settings are crucial for strengthening IPC measures and ASP activities,. This approach to assessing existing IPC and ASP activities will provide policy-relevant data for addressing current shortfalls. Moreover, this framework proposes identifying institutionally-tailored solutions, which will ensure that response activities are appropriately contextualized, aligned with stakeholder priorities, and offer sustainable solutions.

CONCLUSION:

Findings from this study can guide the design and implementation of feasible and sustainable interventions in resource-constrained healthcare settings to address gaps in existing IPC and ASP activities. Therefore, this protocol will be applicable across a broad range of settings to improve IPC and ASP and reduce the burden of hospital-acquired infections and AMR.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cross Infection / Antimicrobial Stewardship Type of study: Guideline / Prognostic_studies / Qualitative_research Limits: Humans Country/Region as subject: Asia Language: En Journal: BMC Health Serv Res Journal subject: PESQUISA EM SERVICOS DE SAUDE Year: 2022 Document type: Article Affiliation country:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cross Infection / Antimicrobial Stewardship Type of study: Guideline / Prognostic_studies / Qualitative_research Limits: Humans Country/Region as subject: Asia Language: En Journal: BMC Health Serv Res Journal subject: PESQUISA EM SERVICOS DE SAUDE Year: 2022 Document type: Article Affiliation country: