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Application of tools to monitor environmental conditions, identify exposures, and inform decision-making to improve infection prevention and control practices in Malawian maternity wards.
Oza, Hemali Harish; Fisher, Michael Benjamin; Abebe, Lydia; Cronk, Ryan; McCord, Ryan; Reuland, Frances; Behnke, Nikki; Kafanikhale, Holystone; Mofolo, Innocent; Hoffman, Irving; Bartram, Jamie.
Afiliação
  • Oza HH; The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA. hemali.harish.oza@emory.edu.
  • Fisher MB; Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA. hemali.harish.oza@emory.edu.
  • Abebe L; Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. hemali.harish.oza@emory.edu.
  • Cronk R; The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA. mischaf2@email.unc.edu.
  • McCord R; Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA. mischaf2@email.unc.edu.
  • Reuland F; The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
  • Behnke N; Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA.
  • Kafanikhale H; United States Agency for International Development (USAID), Washington, DC, USA.
  • Mofolo I; The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
  • Hoffman I; Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA.
  • Bartram J; The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
Environ Monit Assess ; 192(2): 134, 2020 Jan 22.
Article em En | MEDLINE | ID: mdl-31970501
Healthcare-acquired infections (HAIs) contribute to maternal and neonatal morbidity and mortality, especially in low- and middle-income countries (LMICs). Deficient environmental health (EH) conditions and infection prevention and control (IPC) practices in healthcare facilities (HCFs) contribute to the spread of HAIs, but microbial sampling of sources of contamination is rarely conducted nor reported in low-resource settings. The purpose of this study was to assess EH conditions and IPC practices in Malawian HCFs and evaluate how EH deficiencies contribute to pathogen exposures and HAIs, and to provide recommendations to inform improvements in EH conditions using a mixed-methods approach. Thirty-one maternity wards in government-run HCFs were surveyed in the three regions of Malawi. Questionnaires were administered in parallel with structured observations of EH conditions and IPC practices and microbial testing of water sources and facility surfaces. Results indicated significant associations between IPC practices and microbial contamination. Facilities where separate wards were not available for mothers and newborns with infections and where linens were not used for patients during healthcare services were more likely to have delivery tables with surface contamination (relative risk = 2.23; 1.49, 3.34). E. coli was detected in water samples from seven (23%) HCFs. Our results suggest that Malawian maternity wards could reduce microbial contamination, and potentially reduce the occurrence of HAIs, by improving EH conditions and IPC practices. HCF staff can use the simple, low-cost EH monitoring methods used in this study to incorporate microbial monitoring of EH conditions and IPC practices in HCFs in low-resource settings.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Controle de Infecções / Escherichia coli / Maternidades / Infecções Tipo de estudo: Etiology_studies / Guideline / Prognostic_studies / Qualitative_research Limite: Female / Humans / Newborn / Pregnancy País/Região como assunto: Africa Idioma: En Revista: Environ Monit Assess Assunto da revista: SAUDE AMBIENTAL Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Holanda

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Controle de Infecções / Escherichia coli / Maternidades / Infecções Tipo de estudo: Etiology_studies / Guideline / Prognostic_studies / Qualitative_research Limite: Female / Humans / Newborn / Pregnancy País/Região como assunto: Africa Idioma: En Revista: Environ Monit Assess Assunto da revista: SAUDE AMBIENTAL Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Holanda