Infection prevention and control and related practices in African neonatal units: The Pan-African neonatal care assessment study (PANCAS)

Irene Frantzis; Stéphanie Levasseur; Jack Huebner; Maitry Mahida; Philip Larussa; Wilmot James; Workeabeba Abebe; Crispen Ngwenya; Ezekiel Mupere; Susan L Rosenthal; Janna Patterson; Julia Johnson; Renate Strehlau; Sileshi Lulseged; Lawrence R Stanberry; Lisa Saiman

doi:10.1016/j.ijheh.2024.114357

Infection prevention and control and related practices in African neonatal units: The Pan-African neonatal care assessment study (PANCAS)

Int J Hyg Environ Health. 2024 Apr 1:259:114357. doi: 10.1016/j.ijheh.2024.114357. Online ahead of print.

Authors

Irene Frantzis¹, Stéphanie Levasseur², Jack Huebner², Maitry Mahida², Philip Larussa², Wilmot James³, Workeabeba Abebe⁴, Crispen Ngwenya⁵, Ezekiel Mupere⁶, Susan L Rosenthal⁷, Janna Patterson⁸, Julia Johnson⁹, Renate Strehlau¹⁰, Sileshi Lulseged¹¹, Lawrence R Stanberry², Lisa Saiman¹²

Affiliations

¹ Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA. Electronic address: If2281@cumc.columbia.edu.
² Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.
³ Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA.
⁴ Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia.
⁵ Paediatrics department at Midlands State University faculty of Medicine, Gweru, Zimbabwe.
⁶ Department of Paediatrics and Child Health School of Medicine College of Health Sciences, Makerere University, Kampala, Uganda.
⁷ Departments of Pediatrics and Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
⁸ Global Child Health and Life Support, American Academia of Pediatrics, Itasca, IL, USA.
⁹ Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁰ VIDA Nkanyezi Research Unit, Department of Paediatrics and Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹¹ Department of Pediatrics and Child Health, College of Health Sciences, Addis Abbaba, Ethiopia.
¹² Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA; Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York, NY, USA.

PMID: 38564877
DOI: 10.1016/j.ijheh.2024.114357

Abstract

Background: The burden of neonatal mortality is primarily borne by low- and middle-income countries (LMICs), including deaths due to healthcare-associated infections (HAIs). Few studies have assessed infection prevention and control (IP&C) practices in African units caring for small and/or sick newborns aimed to reduce HAIs.

Methods: We performed a mixed-methods study composed of a survey and virtual tour to assess IP&C and related practices. We created a survey composed of multiple-choice and open-ended questions delivered to site respondents via Zoom or video equivalent. Respondents provided a virtual tour of their unit via video and the study team used a checklist to evaluate specific practices.

Results: We recruited 45 units caring for small and sick newborns in 20 African countries. Opportunities to optimize hand hygiene, Water, Sanitation and Hygiene (WASH) practices, Kangaroo Mother Care, and IP&C training were noted. The virtual tour offered further understanding of IP&C challenges unique to individual sites. All respondents expressed the need for additional space, equipment, supplies, education, and IP&C staff and emphasized that attention to maternal comfort was important to IP&C success.

Discussion: This study identified opportunities to improve IP&C practices using low-cost measures including further education and peer support through learning collaboratives. Virtual tours can be used to provide site-specific assessment and feedback from peers, IP&C specialists and environmental engineering experts.

Keywords: Africa; Global health; Infection prevention; Neonates; Newborns.