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Infection Prevention and Control at Lira University Hospital, Uganda: More Needs to Be Done.

ABSTRACT: Globally, 5-15% of hospitalized patients acquire infections (often caused by antimicrobial-resistant microbes) due to inadequate infection prevention and control (IPC) measures. We used the World Health Organization's (WHO) 'Infection Prevention and Control Assessment Framework' (IPCAF) tool to assess the IPC compliance at Lira University hospital (LUH), a teaching hospital in Uganda. We also characterized challenges in completing the tool. This was a hospital-based, cross-sectional study conducted in November 2020. The IPC focal person at LUH completed the WHO IPCAF tool. Responses were validated, scored, and interpreted per WHO guidelines. The overall IPC compliance score at LUH was 225/800 (28.5%), implying a basic IPC compliance level. There was no IPC committee, no IPC team, and no budgets. Training was rarely or never conducted. There was no surveillance system and no monitoring/audit of IPC activities. Bed capacity, water, electricity, and disposal of hospital waste were adequate. Disposables and personal protective equipment were not available in appropriate quantities. Major challenges in completing the IPCAF tool were related to the detailed questions requiring repeated consultation with other hospital stakeholders and the long time it took to complete the tool. IPC compliance at LUH was not optimal. The gaps identified need to be addressed urgently.

SUBMITTER: Opollo MS

PROVIDER: S-EPMC8167580 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundSevere anaemia is a common clinical problem among young children in sub-Saharan Africa. However, the effect of severe anaemia on neurodevelopment of these children is not well described. Therefore, we assessed the neurodevelopmental performance of preschool children diagnosed with severe anaemia in Northern Uganda.MethodsWe conducted a prospective cohort study among children < 5 years of age 14 days post discharge after an episode of severe anaemia (Hb < 5.0 g/dl; n = 171; mean Hb = 3.9g/dl) at Lira Regional Referral Hospital, Uganda. Neurodevelopmental outcomes (cognitive, language and motor) were assessed using Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III). Age-adjusted z-scores for each domain were calculated using scores from healthy community control children (n = 88) recruited from the same environment for each age category. Multiple linear regression was used to compare z-scores in the cognitive, language and motor scales between the two groups after adjusting for weight-for-age z-score, socioeconomic status, mother's education, and father's employment on all the scales.ResultsThe prevalence of neurodevelopmental impairment was 2.3% (95% CI: 0.8-6.1) for cognition, 1.7% (95%: 0.6-5.3) for language and 3.5% (95% CI: 1.6-7.6) for motor scales and 4.6% (95% CI: 2.3-9.1) for deficits in ≥1 area of neurodevelopment. Significant differences were observed between the two groups with the SA group performing worse on cognition [adjusted mean score, (Standard error, SE), P-value] [-0.20, (0.01) vs. 0.00, (0.01), P = 0.02]; language [-0.25, (0.01) vs. 0.00, (0.01), P< 0.001]; and motor [-0.17, (0.01) vs. 0.00, (0.01), P = 0.05] scales.ConclusionIn children < 5 years of age, severe anaemia was associated with neurocognitive (cognition, language and motor) deficits in the immediate period post treatment. Further research is needed to identify risk factors and determine the long-term effects of poor neurodevelopment in young children with severe anaemia.

Project description:BackgroundYoung people (15-24 years) bear the highest burden of new infections and are particularly vulnerable because of their highly risky behavior such as early sexual activity. There is paucity of information on the role of religious leaders in the multi-sectoral fight against HIV/AIDS. We examined the role of religious leaders in the use of HIV prevention strategies among young people.MethodsA cross sectional study was conducted between March and April 2021 among 422 randomly selected young people in Lira district, Uganda. An interviewer administered a questionnaire to the young people in order to collect quantitative data. A total 20 key informants were purposively sampled and interviews were conducted with religious leaders using a key informant's interview guide. Data was collected on social demographics, HIV prevention messages, and awareness about HIV prevention strategies. Data was analyzed using Stata version 15 using proportions, means, percentages, frequencies, and logistic regression analysis at a 95% level of significance. Qualitative data was analyzed using thematic content analysis and the major themes were generated from the participants' responses.ResultsAbout 57.1% (241/422) of the respondents were females. The prevalence of use of HIV prevention strategies among young people was 69.4%. Factors significantly associated with the use of HIV prevention included completing the primary level (aOR 4.95, p< 0.05), completing at least A level (aOR 8.85, p < <0.05), Awareness of HIV prevention strategies advocated for by religious leaders (aOR 0.02, p<0.001), religious leaders provided targeted HIV prevention messages (aOR 2.53, p<0.01), Advocacy for abstinence outside marriage and fidelity in marriage (aOR 35.6, p<0.01), Religious leaders preaching about HIV prevention (aOR 4.88, p<0.001). Qualitative data indicated that a section of religious leaders recommended abstinence/faithfulness. Condom use was the most discouraged HIV prevention strategy. However, most religious leaders agree with the fact that they have a role to play in HIV prevention, which includes sensitization, teaching and organizing sermons about HIV prevention.ConclusionThe use of HIV prevention strategies advocated for by religious leaders among young people was nearly 70%. This finding indicates that religious leaders have a role to play in HIV/AIDS prevention among young people in the Lira district. This calls for the involvement of religious leaders in HIV prevention programs tailored to prevent new infections of HIV among young people.

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Infection Prevention and Control at Lira University Hospital, Uganda: More Needs to Be Done.

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