title: [Incidence of surgical site infections in sub-Saharan Africa: systematic review and meta-analysis].
abstract: BACKGROUND
  Surgical Site Infections (SSI) cause morbi-mortality and additional healthcare expenditures. Developing countries are the most affected. The objective was to estimate the pooled incidence of SSI in Sub-Saharan Africa and describe its major risk factors.
  
  
  METHODS
  Systematic review and meta-analysis were conducted using the databases of the World Health Organization Regional Office for Africa, PubMed and standard search to select electronic articles published between 2006 and 2015. Only articles investigating SSI impact and risk factors in Sub-Saharan African countries were retained.
  
  
  RESULTS
  Out of 95 articles found, 11 met the inclusion criteria. Only 9 countries out of 45 have contributed, with a huge amount of information coming from Nigeria (5 articles out of 11). The impact of SSI ranged from 6.8% to 26% with predominance in general surgery. The pooled incidence of SSI was 14.8% (95% CI: 15,5-16,2%) with significant heterogeneity according to the specialty and the method of monitoring. Most cited risk factors were long procedure length and categories 3 and 4 of Altemeier contamination class. Other factors included hospital environment, inadequate care practices and underlying pathologies.
  
  
  CONCLUSIONS
  SSI incidence is high in Sub-Saharan Africa. Studies in this area could improve knowledge, prevention and control of these multiple risk factors.
authors: Service de Chirurgie, Hôpital Régional de Ngaoundéré, Cameroun; Département des Sciences Biomédicales, Université de Ngaoundéré, Cameroun.
authors: Ngaroua
authors: Neurochirurgie, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Cameroun.
authors: Joseph Eloundou
authors: JE
authors: Ngah
authors: Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, France; Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France.
authors: Thomas
authors: T
authors: Bénet
authors: Département des Sciences Biomédicales, Université de Ngaoundéré, Cameroun.
authors: Yaouba
authors: Y
authors: Djibrilla
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D003906:Developing Countries; D006801:Humans; D015994:Incidence; D061646:Operative Time; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology
keywords: Incidence; Sub-Saharan Africa; Surgical site infections; risk factors