Incidence of respiratory syncytial virus-associated lower respiratory tract illness in infants in low- and middle-income regions during the Coronavirus disease 2019 pandemic

DATA AVAILABILITY : Study data and documents can be requested for further research from www.clinicalstudydatarequest.com.BACKGROUND : Incidence data of respiratory syncytial virus–associated lower respiratory tract illness (RSV-LRTI) are sparse in low- and middle-income countries (LMICs). We estimated RSV-LRTI incidence rates (IRs) in infants in LMICs using World Health Organization case definitions. METHODS : This prospective cohort study, conducted in 10 LMICs from May 2019 to October 2021 (largely overlapping with the coronavirus disease 2019 [COVID-19] pandemic), followed infants born to women with low-risk pregnancies for 1 year from birth using active and passive surveillance to detect potential LRTIs, and quantitative reverse-transcription polymerase chain reaction on nasal swabs to detect RSV. RESULTS : Among 2094 infants, 32 (1.5%) experienced an RSV-LRTI (8 during their first 6 months of life, 24 thereafter). Seventeen (0.8%) infants had severe RSV-LRTI and 168 (8.0%) had all-cause LRTI. IRs (95% confidence intervals [CIs]) of first RSV-LRTI episode were 1.0 (.3–2.3), 0.8 (.3–1.5), and 1.6 (1.1–2.2) per 100 person-years for infants aged 0–2, 0–5, and 0–11 months, respectively. IRs (95% CIs) of the first all-cause LRTI episode were 10.7 (8.1–14.0), 11.7 (9.6–14.0), and 8.7 (7.5–10.2) per 100 person-years, respectively. IRs varied by country (RSV-LRTI: 0.0–8.3, all-cause LRTI: 0.0–49.6 per 100 person-years for 0- to 11-month-olds). CONCLUSIONS : RSV-LRTI IRs in infants in this study were relatively low, likely due to reduced viral circulation caused by COVID-19–related nonpharmaceutical interventions. CLINICAL TRIALS REGISTRATION : NCT03614676.https://academic.oup.com/ofidhj2024Medical MicrobiologySDG-03:Good heatlh and well-bein

Implementing a national policy for hepatitis B birth dose vaccination in Philippines: Lessons for improved delivery

Background: An estimated seven million Filipinos (10-12% of the population) are chronically infected with hepatitis B virus (HBV). Achieving high birth dose coverage with hepatitis B vaccine is critical for achieving the World Health Organization's Western Pacific Regional goal of reducing the prevalence of chronic HBV among children 5 years of age to <2% by 2012. Methods: Seven months after the Philippines adopted a hepatitis B vaccine birth dose policy, hospitals with the highest number of deliveries were invited to participate in an assessment of implementation of the birth dose policy. Additionally, in metro Manila birth dose coverage was estimated before and after conducting a training workshop and supervisory follow-up for practitioners conducting home deliveries or deliveries at lying-in clinics. Results: Of the country's largest 150 hospitals in terms of authorized bed capacity, 85(56%) were included in this assessment. These hospitals had 55,719 deliveries during July-September 2007. Of these, 54% infants had a documented birth dose; however, only 22% were vaccinated within 24 h of delivery. Having a copy of the hepatitis B vaccine vaccination policy (prevalence odds ratio [pOR] = 4.7, 95% confidence interval [CI] = 1.2-18.0), having standing orders pOR = 4.8, 95% Cl = 1.3-18.1 and providing training pOR = 18.9, 95% CI = 5.3-67.0 were associated with >50% birth dose coverage in a hospital. In metro-Manila, regardless of place of birth, the training workshop and supervisory follow-up significantly improved hepatitis B vaccine administration within 24h after birth, increasing from 19% before to 74% after the training workshop and follow-up. Conclusions: Experience in the Philippines showed that actions by national, regional and health facility policy makers such as establishing national policies, distributing detailed and specific guidelines, conducting effective training and supervision, and having hospital standing orders substantially increased hepatitis B vaccine birth dose coverage

Impact of an International Nosocomial Infection Control Consortium multidimensional approach on catheter-associated urinary tract infections in adult intensive care units in the Philippines: International Nosocomial Infection Control Consortium (INICC) findings

To assess the impact of a multidimensional infection control approach on the reduction of catheter-associated urinary tract infection (CAUTI) rates in adult intensive care units (AICUs) in two hospitals in the Philippines that are members of the International Nosocomial Infection Control Consortium. This was a before–after prospective active surveillance study to determine the rates of CAUTI in 3183 patients hospitalized in 4 ICUS over 14,426 bed-days. The study was divided into baseline and intervention periods. During baseline, surveillance was performed using the definitions of the US Centers for Disease Control and Prevention and the National Healthcare Safety Network (CDC/NHSN). During intervention, we implemented a multidimensional approach that included: (1) a bundle of infection control interventions, (2) education, (3) surveillance of CAUTI rates, (4) feedback on CAUTI rates, (5) process surveillance and (6) performance feedback. We used random effects Poisson regression to account for the clustering of CAUTI rates across time. We recorded 8720 urinary catheter (UC)-days: 819 at baseline and 7901 during intervention. The rate of CAUTI was 11.0 per 1000 UC-days at baseline and was decreased by 76% to 2.66 per 1000 UC-days during intervention [rate ratio [RR], 0.24; 95% confidence interval [CI], 0.11–0.53; P-value, 0.0001]. Our multidimensional approach was associated with a significant reduction in the CAUTI rates in the ICU setting of a limited-resource country

Impact of an International Nosocomial Infection Control Consortium multidimensional approach on catheter-associated urinary tract infections in adult intensive care units in the Philippines: International Nosocomial Infection Control Consortium (INICC) findings

Summary: Objectives: To assess the impact of a multidimensional infection control approach on the reduction of catheter-associated urinary tract infection (CAUTI) rates in adult intensive care units (AICUs) in two hospitals in the Philippines that are members of the International Nosocomial Infection Control Consortium. Materials and methods: This was a before–after prospective active surveillance study to determine the rates of CAUTI in 3183 patients hospitalized in 4 ICUS over 14,426 bed-days. The study was divided into baseline and intervention periods. During baseline, surveillance was performed using the definitions of the US Centers for Disease Control and Prevention and the National Healthcare Safety Network (CDC/NHSN). During intervention, we implemented a multidimensional approach that included: (1) a bundle of infection control interventions, (2) education, (3) surveillance of CAUTI rates, (4) feedback on CAUTI rates, (5) process surveillance and (6) performance feedback. We used random effects Poisson regression to account for the clustering of CAUTI rates across time. Results: We recorded 8720 urinary catheter (UC)-days: 819 at baseline and 7901 during intervention. The rate of CAUTI was 11.0 per 1000 UC-days at baseline and was decreased by 76% to 2.66 per 1000 UC-days during intervention [rate ratio [RR], 0.24; 95% confidence interval [CI], 0.11–0.53; P-value, 0.0001]. Conclusions: Our multidimensional approach was associated with a significant reduction in the CAUTI rates in the ICU setting of a limited-resource country. Keywords: Philippines, Catheter-associated urinary tract infections, Developing countries, Adult intensive care unit, Multidimensional approach, Bundl

Device-associated infections rates in adult, pediatric, and neonatal intensive care units of hospitals in the Philippines: International Nosocomial Infection Control Consortium (INICC) findings

Background: This study investigated the rate of device-associated health care-associated infection (DA-HAI), microbiological profiles, bacterial resistance, length of stay (LOS), and mortality rate in 9 intensive care units (ICUs) of 3 hospital members of the International Nosocomial Infection Control Consortium (INICC) in the Philippines. Methods: This was an open-label, prospective cohort, active DA-HAI surveillance study of adult, pediatric, and newborn patients admitted to 9 tertiary care ICUs in the Philippines between January 2005 and December 2009, implementing methodology developed by the INICC. Data collection was performed in the participating ICUs, and data were uploaded and analyzed at the INICC headquarters using proprietary software. DA-HAI rates were registered based on definitions promulgated by the Centers for Disease Control and Prevention's National Healthcare Safety Network. Results: Over a 5-year period, 4952 patients hospitalized in ICUs for a total of 40,733 days acquired 199 DA-HAIs, for an overall rate of 4.9 infections per 1,000 ICU-days. Ventilator-associated pneumonia posed the greatest risk (16.7 per 1,000 ventilator-days in the adult ICUs, 12.8 per 1,000 ventilator-days in the pediatric ICU, and 0.44 per 1,000 ventilator-days in the neonatal ICUs), followed by central line-associated bloodstream infections (4.6 per 1,000 catheter-days in the adult ICUs, 8.23 per 1,000 ventilator-days in the pediatric ICU, and 9.6 per 1,000 ventilator-days in the neonatal ICUs) and catheter-associated urinary tract infections (4.2 per 1,000 catheter-days in the adult ICUs and 0.0 in the pediatric ICU). Conclusion: DA-HAIs pose far greater threats to patient safety in Philippine ICUs than in US ICUs. The establishment of active infection control programs that involve infection surveillance and implement guidelines for prevention can improve patient safety and should become a priority