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发展中国家对抗医院获得性感染的新范式

New Paradigm for Battling Hospital-Acquired Infections in Developing Countries.

作者信息

Abbas Muhammad A, Abdullahi Aisha A, Murtala Hassan A, Yusuf Abubakar L, Mukhtar Rahila A, Salihu Hamisu M

机构信息

Department of Community Medicine, College of Health Sciences, Bayero University Kano, Nigeria, Kano State Center for Disease Control and Prevention (Kano CDC), Kano, Nigeria.

Department of Epidemiology and Population Health, Kano Independent Research Centre Trust, Kano, Nigeria.

出版信息

Int J MCH AIDS. 2025 May 9;14:e008. doi: 10.25259/IJMA_52_2024. eCollection 2025.

Abstract

Healthcare-associated infections (HAIs) pose critical threats to maternal and child health in low-resource settings, with Kano State, Nigeria, reporting 6.3% of national HAI burdens and 85% of diphtheria cases. Despite global infection prevention and control (IPC) advancements, implementation gaps persist. This study engaged 50 multidisciplinary stakeholders including Kano State CDC, WHO, UNICEF, healthcare leaders, and community representatives through a three-day participatory workshop to co-develop a context-specific IPC framework. Key outcomes included standardized state IPC guidelines, facility-level monitoring committees, enhanced healthcare worker training, post-exposure prophylaxis (PEP) protocols, and dedicated isolation centers. The initiative reduced HAIs by 42% () in pilot facilities, with notable improvements in pediatric and maternal wards. Barriers such as inconsistent PPE access (reported by 68% of staff) were addressed through localized solutions, including community health worker engagement. Aligned with WHO's Strategic Goal Five and SDG targets for quality care and antimicrobial resistance (AMR) reduction, this model demonstrates how stakeholder-driven IPC strategies can mitigate outbreaks in high-burden settings. Findings advocate for scalable, participatory approaches to strengthen health systems, directly impacting maternal-child survival and AMR containment in Nigeria and similar regions.

摘要

在资源匮乏地区,医疗保健相关感染(HAIs)对母婴健康构成了严重威胁,尼日利亚卡诺州报告称其承担了全国6.3%的HAIs负担以及85%的白喉病例。尽管全球在感染预防与控制(IPC)方面取得了进展,但实施差距依然存在。本研究通过为期三天的参与式研讨会,让包括卡诺州疾病预防控制中心、世界卫生组织、联合国儿童基金会、医疗保健领导者和社区代表在内的50名多学科利益相关者共同制定了一个针对当地情况的IPC框架。主要成果包括标准化的州IPC指南、机构层面的监测委员会、强化的医护人员培训、暴露后预防(PEP)方案以及专门的隔离中心。该倡议使试点机构的HAIs减少了42%(),儿科和产科病房有了显著改善。通过包括社区卫生工作者参与在内的本地化解决方案,解决了诸如个人防护装备获取不一致(68%的工作人员报告)等障碍。该模式与世界卫生组织的战略目标五以及关于优质护理和减少抗菌药物耐药性(AMR)的可持续发展目标相一致,展示了利益相关者驱动的IPC策略如何能够减轻高负担地区的疫情爆发。研究结果倡导采用可扩展的参与式方法来加强卫生系统,这将直接影响尼日利亚及类似地区的母婴生存和AMR控制。

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Diphtheria outbreak in Nigeria.尼日利亚爆发白喉疫情。
Lancet Microbe. 2024 Jan;5(1):e11. doi: 10.1016/S2666-5247(23)00330-0. Epub 2023 Nov 8.
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Gap analysis of infection control practices in low- and middle-income countries.低收入和中等收入国家感染控制措施的差距分析
Infect Control Hosp Epidemiol. 2015 Oct;36(10):1208-14. doi: 10.1017/ice.2015.160. Epub 2015 Jul 22.

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