title: Health-care-associated infection in Africa: a systematic review.
abstract: OBJECTIVE
  To assess the epidemiology of endemic health-care-associated infection (HAI) in Africa.
  
  
  METHODS
  Three databases (PubMed, the Cochrane Library, and the WHO regional medical database for Africa) were searched to identify studies published from 1995 to 2009 on the epidemiology of HAI in African countries. No language restriction was applied. Available abstract books of leading international infection control conferences were also searched from 2004 to 2009.
  
  
  RESULTS
  The eligibility criteria for inclusion in the review were met by 19 articles, only 2 of which met the criterion of high quality. Four relevant abstracts were retrieved from the international conference literature. The hospital-wide prevalence of HAI varied between 2.5% and 14.8%; in surgical wards, the cumulative incidence ranged from 5.7% to 45.8%. The largest number of studies focused on surgical site infection, whose cumulative incidence ranged from 2.5% to 30.9%. Data on causative pathogens were available from a few studies only and highlighted the importance of gram-negative rods, particularly in surgical site infection and ventilator-associated pneumonia.
  
  
  CONCLUSIONS
  Limited information is available on the endemic burden of HAI in Africa, but our review reveals that its frequency is much higher than in developed countries. There is an urgent need to identify and implement feasible and sustainable approaches to strengthen HAI prevention, surveillance and control in Africa.
authors.affiliation: Clean Care is Safer Care, World Health Organization Patient Safety, Geneva, Switzerland.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Bagheri Nejad
authors.forename: Benedetta
authors.initials: B
authors.lastname: Allegranzi
authors.forename: Shamsuzzoha B
authors.initials: SB
authors.lastname: Syed
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ellis
authors.forename: Didier
authors.initials: D
authors.lastname: Pittet
mesh_terms: D000349:Africa / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology*; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D011634:Public Health / Q000639:trends; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology
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