Prevalence, risk factors, and antimicrobial resistance of endemic healthcare-associated infections in Africa: a systematic review and meta-analysis

Bunduki, Gabriel Kambale; Masoamphambe, Effita; Fox, Tilly; Musaya, Janelisa; Musicha, Patrick; Feasey, Nicholas

doi:10.1186/s12879-024-09038-0

Table 1 Characteristics of included studies

From: Prevalence, risk factors, and antimicrobial resistance of endemic healthcare-associated infections in Africa: a systematic review and meta-analysis

1st Authors, publication year	Region	Country	Type of setting	Study design/type	Targeted ward	Age group	Surveillance definition used	Population	HCAI Prevalence
Abdel-Wahab et al. 2013 [54]	Northern	Egypt	University/Teaching hospital	Prospective	Neonatal ICU	Neonates	Adapted CDC	238	21.4
Abosse et al. 2021 [22]	Eastern	Ethiopia	Tertiary hospital	Cross-sectional	All	All	NR	165	69.7
Abubakar, 2020 [77]	Western	Nigeria	University/Teaching hospital	PPS	All	All	ECDC	321	15.6
Ahoyo et al. 2014 [107]	Western	Benin	Tertiary hospital	PPS	All	All	CDC	3130	19.1
Akoko et al. 2012 [71]	Eastern	Tanzania	Tertiary hospital	Cross-sectional	Surgical	All	NINSS	118	35.6
Alemye et al. 2021 [23]	Eastern	Ethiopia	Tertiary hospital	Cross-sectional	Obstetrics	Women	CDC	1069	12.3
Atif et al. 2015 [112]	Northern	Algeria	University/Teaching hospital	Prospective	Surgical	Adults	NNIS^a	593	5.4
Awoke et al. 2019 [34]	Eastern	Ethiopia	University/Teaching hospital	Cross-sectional	Surgical	All	NR	261	13.0
Ayala et al. 2021 [45]	Eastern	Ethiopia	University/Teaching hospital	Cross-sectional	Obstetrics	Women	NR	382	8.9
Ayed et al. 2019 [64]	Northern	Tunisia	University/Teaching hospital	PPS	All	All	CDC	752	10.9
Azeze et al. 2019 [48]	Eastern	Ethiopia	Tertiary hospital	Cross-sectional	Obstetrics	Women	NR	383	7.8
Bediako-Bowan et al. 2020 [89]	Western	Ghana	University/Teaching hospital	Cross-sectional	Surgical	Adults	CDC	3267	10.1
Bediako-Bowan et al. 2020 (2) [90]	Western	Ghana	University/Teaching hospital	Prospective	Surgical	All	CDC	358	16.2
Behari et al. 2015 [82]	Southern	South Africa	District hospital	Prospective	Surgical ICU	Adults	Own	32	25.0
Belay et al. 2022 [49]	Eastern	Ethiopia	Tertiary hospital	Retrospective	ICU	Adults	Own	312	27.9
Birhanu et al. 2022 [50]	Eastern	Ethiopia	University/Teaching hospital	Cross-sectional	Surgical	All	Own	373	19.3
Bizuayehu et al. 2022 [51]	Eastern	Ethiopia	Tertiary hospital	Cross-sectional	ICU	Adults	Own	220	51.4
Bizuayew et al. 2021 [52]	Eastern	Ethiopia	District hospital	Cross-sectional	Obstetrics	Women	CDC	622	12.4
Bunduki et al., 2021 [13]	Eastern	Malawi	University/Teaching hospital	PPS	Surgical	Adults	ECDC	105	11.4
Chernet et al. 2020 [55]	Northern	Egypt	University/Teaching hospital	Longitudinal	All	Adults	WHO	300	14.0
Dawit et al. 2021 [53]	Eastern	Ethiopia	Tertiary hospital	Longitudinal	ICU	Adults	NR	278	21.6
Dayyab et al. 2018 [81]	Western	Nigeria	Tertiary hospital	Prospective	Medical, Surgical, ICU, Dialysis unit	Adults	CDC	2334	6.2
De Nardo et al. 2016 [72]	Eastern	Tanzania	Tertiary hospital	Prospective cohort	Obstetrics	Women	CDC	467	48.2
Degbey et al. 2021 [108]	Western	Benin	University/Teaching hospital	Retrospective	Surgical	Adults	NR	384	7.8
Di Gennaro et al. 2020 [95]	Western	Sierra Leone	Tertiary hospital	Case–control	Obstetrics	Women	CDC	1016	25.0
Dramowski et al. 2015 [84]	Southern	South Africa	University/Teaching hospital	Retrospective	Neonatal ICU	Neonates	CDC	1145	62.6
Dramowski et al. 2016 [83]	Southern	South Africa	Tertiary hospital	Prospective	Paediatric ICU	Children	CDC/NHSN^a	1347	31.0
Endalafer et al. 2011 [24]	Eastern	Ethiopia	University/Teaching hospital	Prospective	Surgical, ICU	Adults	CDC	215	39.1
Fisha et al. 2019 [25]	Eastern	Ethiopia	District hospital	Retrospective	Surgical	All	Own	642	10.0
Flouchi et al. 2022 [98]	Northern	Morocco	Tertiary hospital	Prospective	Surgical	All	CDC	2521	6.3
Gadallah et al. 2014 [56]	Northern	Egypt	University/Teaching hospital	Prospective	Neonatal ICU	Neonates	CDC	434	34.3
Galal et al. 2016 [57]	Northern	Egypt	University/Teaching hospital	Prospective	Paediatric ICU	Children	Own	427	30.9
Gelaw et al. 2017 [26]	Eastern	Ethiopia	General hospital	Cross-sectional	Obstetrics	Women	Own	384	6.8
Ghali et al. 2018 [65]	Northern	Tunisia	University/Teaching hospital	Prospective	Surgical	All	CDC	349	8.6
Gomaa et al. 2021 [58]	Northern	Egypt	Tertiary hospital	Case–control	Obstetrics	Women	NR	15,502	5.3
Hafez et al. 2012 [59]	Northern	Egypt	University/Teaching hospital	Prospective	Urology, Cardiothoracic	All	CDC	1062	17.6
Hajjej et al. 2014 [66]	Northern	Tunisia	Tertiary hospital	Prospective	Surgical ICU	Adults	IDSA	260	12.3
Halawi et al. 2018 [27]	Eastern	Ethiopia	University/Teaching hospital	Prospective	Surgical	All	Adapted CDC	131	20.6
Hassan et al. 2020 [60]	Northern	Egypt	Tertiary hospital	Prospective	All	All	NR	6912	3.7
Iwuafor et al. 2016 [78]	Western	Nigeria	University/Teaching hospital	Prospective cohort	ICU	Adults	Own	71	63.4
Jamoussi et al. 2018 [67]	Northern	Tunisia	University/Teaching hospital	PPS	ICU	Adults	Own	103	31.1
Kakupa et al. 2016 [105]	Middle	D.R. Congo	University/Teaching hospital	Cross-sectional	All	All	WHO	171	34.5
Kallel et al. 2010 [68]	Northern	Tunisia	University/Teaching hospital	Prospective cohort	ICU	Adults	CDC	261	21.1
Kefale et al. 2020 [28]	Eastern	Ethiopia	General hospital	Cross-sectional	Surgical	Adults	NR	281	19.6
Ketata et al. 2021 [69]	Northern	Tunisia	University/Teaching hospital	PPS	All	All	CDC/NHSN^a	898	9.0
Ketema et al. 2020 [29]	Eastern	Ethiopia	Tertiary hospital	Prospective cohort	Obstetrics	Women	CDC	520	25.4
Kibwana et al. 2022 [73]	Eastern	Tanzania	University/Teaching hospital	Cross-sectional	Urology	All	NR	182	22.0
Kisibo et al. 2017 [74]	Eastern	Tanzania	Tertiary hospital	Cross-sectional	Orthopaedics	Adults	Own	300	24.0
Labi et al. 2019 [91]	Western	Ghana	Tertiary hospital	PPS	All	All	ECDC	2107	8.2
Lakoh et al. 2022 [96]	Western	Sierra Leone	Tertiary hospital	Prospective cohort	Surgical	Adults	CDC, ECDC	338	11.5
Lakoh et al. 2022 (2) [97]	Western	Sierra Leone	Tertiary hospital	Prospective	Surgical	Adults	CDC, ECDC	417	8.2
Laloto et al. 2017 [30]	Eastern	Ethiopia	University/Teaching hospital	Prospective	Surgical	All	CDC	105	19.0
Lijaemiro et al. 2020 [31]	Eastern	Ethiopia	Tertiary hospital	Prospective cohort	Obstetrics	Women	NR	166	15.1
Lubega et al. 2017 [104]	Eastern	Uganda	Tertiary hospital	Prospective	Surgical	All	Own	110	16.4
Lukuke et al. 2017 [106]	Middle	D.R. Congo	Tertiary hospital	Longitudinal	Obstetrics	Women	WHO	207	15.5
Mamo et al. 2017 [32]	Eastern	Ethiopia	University/Teaching hospital	Retrospective	Obstetrics	Women	CDC	384	9.4
Maoulainine et al. 2014 [99]	Northern	Morocco	Tertiary hospital	Prospective	Neonatal ICU	Neonates	CDC	702	13.0
Mawalla et al. 2011 [75]	Eastern	Tanzania	Tertiary hospital	Cross-sectional	Surgical	All	CDC	250	26.0
Melaku et al. 2012 [33]	Eastern	Ethiopia	Tertiary hospital	Cross-sectional	Surgical, gynaecology and obstetrics	Adults	CDC	1254	9.4
Mezemir et al. 2020 [35]	Eastern	Ethiopia	University/Teaching hospital	Cross-sectional	Surgical	All	CDC, NNIS^a	249	24.5
Misha et al. 2021 [36]	Eastern	Ethiopia	University/Teaching hospital	Prospective	Surgical	Adults	NR	251	21.1
Misha et al. 2021 (2) [37]	Eastern	Ethiopia	University/Teaching hospital	Prospective cohort	Surgical	Adults	CDC	251	21.1
Mohamed et al. 2022 [38]	Eastern	Ethiopia	Tertiary hospital	Retrospective	Paediatric ICU	Children	NR	223	20.2
Molla et al. 2019 [39]	Eastern	Ethiopia	General hospital	Cross-sectional	Obstetrics	Women	CDC	334	8.1
Mpogoro et al. 2014 [76]	Eastern	Tanzania	Tertiary hospital	Prospective cohort	Obstetrics	Adults	CDC	312	10.9
Mukagendaneza et al. 2019 [86]	Eastern	Rwanda	University/Teaching hospital	Prospective	Surgical	Adults	CDC	294	11.6
Nair et al. 2018 [85]	Southern	South Africa	Tertiary hospital	PPS	All	All	CDC	326	7.7
Nanyunja et al. 2022 [103]	Eastern	Uganda	Tertiary hospital	Prospective cohort	Dialysis unit	Adults	Own	121	40.5
Nkurunziza et al. 2019 [87]	Eastern	Rwanda	District hospital	Prospective cohort	Obstetrics	Women	NR	550	10.9
Nouetchognou et al. 2016 [92]	Middle	Cameroon	University/Teaching hospital	Longitudinal	ICU, Gynaecology, Surgical, Neonatal unit	All	Own	307	19.2
Nwanko et al. 2016 [79]	Western	Nigeria	University/Teaching hospital	Prospective	Surgical	All	Own	5800	25.2
Olowo-okere et al. 2018 [80]	Western	Nigeria	University/Teaching hospital	Prospective cohort	Surgical	Adults, Children	CDC	135	25.9
Ouedraogo et al. 2020 [110]	Western	Burkina Faso	Tertiary hospital	Prospective	Surgical	All	CDC	964	11.8
Oumer et al. 2021 [40]	Eastern	Ethiopia	General hospital	Cross-sectional	All	Adults	CDC	231	16.9
Raouf et al. 2020 [61]	Northern	Egypt	Tertiary hospital	Prospective	Surgical	Adults	CDC/NHSN^a	2510	2.3
Sahiledengle et al. 2020 [41]	Eastern	Ethiopia	University/Teaching hospital	Prospective	Paediatrics	Children	CDC/NHSN^a	448	12.7
Saied et al. 2011 [62]	Northern	Egypt	University/Teaching hospital	Prospective	ICU	All	CDC	1575	38.1
Salem et al. 2011 [70]	Northern	Tunisia	University/Teaching hospital	PPS	All	All	CDC	1373	5.4
Sattar et al. 2018 [102]	Eastern	Kenya	University/Teaching hospital	Cross-sectional	ICU	All	Own	92	54.3
Scherbaum et al. 2014 [109]	Middle	Gabon	District hospital	Prospective	All	All	Adapted CDC	2925	1.6
See et al. 2013 [63]	Northern	Egypt	University/Teaching hospital	Prospective	ICU	All	Adapted CDC	523	90.2
Shakir et al. 2021 [42]	Eastern	Ethiopia	Tertiary hospital	Cross-sectional	Surgical	All	NR	306	11.8
Shimi et al. 2015 [100]	Northern	Morocco	University/Teaching hospital	Retrospective	ICU	All	CDC	535	11.2
Titus et al. 2021 [93]	Middle	Cameroon	Tertiary hospital	Cross-sectional	Surgical	Adults	NR	304	12.2
Togo et al. 2010 [111]	Western	Mali	University/Teaching hospital	Prospective	Surgical	All	CDC	460	9.6
Velin et al. 2021 [88]	Eastern	Rwanda	District hospital	Prospective	Obstetrics	Women	NR	795	5.7
Victor et al. 2013 [101]	Eastern	Kenya	University/Teaching hospital	Prospective	Surgical	Adults	CDC	262	6.9
Weldu et al. 2018 [43]	Eastern	Ethiopia	District hospital	Cross-sectional	Surgical	Adults	CDC	280	11.1
Wendmagegn et al. 2018 [44]	Eastern	Ethiopia	Tertiary hospital	Retrospective	Obstetrics	Women	Own	206	11.7
Wodajo et al. 2017 [46]	Eastern	Ethiopia	University/Teaching hospital	Cross-sectional	Obstetrics	Women	CDC	592	11.0
Yallew et al. 2016 [47]	Eastern	Ethiopia	University/Teaching hospital	Cross-sectional	All	All	CDC	908	14.9
Yaouba et al. 2016 [94]	Middle	Cameroon	Tertiary hospital	Prospective	Surgical, Gynaecology	Adults	CDC	75	30.7

HCAI Healthcare associated infection, PPS Point Prevalence Survey, IDSA Infectious Diseases Society of America, ECDC European Centre for Disease Prevention and Control, CDC Centers for Disease Control and Prevention, NHSN National Healthcare Safety Network, NNIS National Nosocomial Infections Surveillance System, ICU Intensive Care Unit, NR Not Reported, WHO World Health Organisation, NINSS National Integrated Non-Communicable Diseases Surveillance System
^aClassified among the CDC definitions

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