Multi-centre point-prevalence survey of hospital-acquired infections in Ghana

Background: There is a paucity of data describing hospital-acquired infections (HAIs) in Africa. Objective: To describe the prevalence and distribution of HAIs in acute care hospitals in Ghana. Methods: Between September and December 2016, point-prevalence surveys were conducted in participating hospitals using protocols of the European Centre for Disease Prevention and Control. Medical records of eligible inpatients at or before 8am on the survey date were reviewed to identify HAIs present at the time of the survey. Findings: Ten hospitals were surveyed, representing 32.9% of all acute care beds in government hospitals. Of 2107 inpatients surveyed, 184 HAIs were identified among 172 patients, corresponding to an overall prevalence of 8.2%. The prevalence values in hospitals ranged from 3.5% to 14.4%, with higher proportions of infections in secondary and tertiary care facilities. The most common HAIs were surgical site infections (32.6%), bloodstream infections (19.5%), urinary tract infections (18.5%) and respiratory tract infections (16.3%). Device-associated infections accounted for 7.1% of HAIs. For 12.5% of HAIs, a micro-organism was reported; the most commonly isolated micro-organism was Escherichia coli. Approximately 61% of all patients surveyed were on antibiotics; 89.5% of patients with an HAI received at least one antimicrobial agent on the survey date. The strongest independent predictors for HAI were the presence of an invasive device before onset of infection and duration of hospital stay. Conclusion: A low HAI burden was found compared with findings from other low- and middle-income countries

Antibiotic Prescribing Patterns in Ghana, Uganda, Zambia and Tanzania Hospitals: Results from the Global Point Prevalence Survey (G-PPS) on Antimicrobial Use and Stewardship Interventions Implemented

Antimicrobial resistance (AMR) remains an important global public health issue with antimicrobial misuse and overuse being one of the main drivers. The Global Point Prevalence Survey (G-PPS) of Antimicrobial Consumption and Resistance assesses the prevalence and the quality of antimicrobial prescriptions across hospitals globally. G-PPS was carried out at 17 hospitals across Ghana, Uganda, Zambia and Tanzania. The overall prevalence of antimicrobial use was 50% (30–57%), with most antibiotics prescribed belonging to the WHO ‘Access’ and ‘Watch’ categories. No ‘Reserve’ category of antibiotics was prescribed across the study sites while antimicrobials belonging to the ‘Not Recommended’ group were prescribed infrequently. Antimicrobials were most often prescribed for prophylaxis for obstetric or gynaecological surgery, making up between 12 and 18% of total prescriptions across all countries. The most prescribed therapeutic subgroup of antimicrobials was ‘Antibacterials for systemic use’. As a result of the programme, PPS data are now readily available for the first time in the hospitals, strengthening the global commitment to improved antimicrobial surveillance. Antimicrobial stewardship interventions developed included the formation of AMS committees, the provision of training and the preparation of new AMS guidelines. Other common interventions included the presentation of findings to clinicians for increased awareness, and the promotion of a multi-disciplinary approach to successful AMS programmes. Repeat PPS would be necessary to continually monitor the impact of interventions implemented. Broader participation is also encouraged to strengthen the evidence base

Trichomoniasis and associated co-infections of the genital tract among pregnant women presenting at two hospitals in Ghana

Abstract Background Trichomonas vaginalis (TV) infection is the most prevalent non-viral sexually transmitted pathogen worldwide. Among pregnant women, the infection may cause adverse birth outcomes such as premature rupture of membranes and premature labour. In view of the paucity of information relating to TV among Ghanaian pregnant women, this study investigated its prevalence and associated co-infections among pregnant women. Methods High vaginal swabs were obtained from 99 pregnant women using sterile cotton swab sticks. Wet preparation, Grams staining, culturing, coagulase and sensitivity testing were carried out to determine the presence of TV and associated microorganisms. Results The prevalence of TV among the pregnant women was found to be 20.2% (n = 20). Concurring with Trichomoniasis, 75% (n = 15) of participants had other infections such as Candida with prevalence of 53% (n = 8), Proteus infection - 20% (n = 3), Streptococcus infection - 13% (n = 2) and other GNRs and Gonococci having 7% each (n = 1). Moreover, there was 86.9% (n = 86) prevalence of Staphylococcus spp. among study participants. There was statistically significant correlation between TV and Gonococci infection at a correlation co-efficient of 0.107 (P < 0.05) as well as significant correlation between TV and Proteus spp. at a correlation co-efficient of 0.189 (P < 0.05). TV infection was high (60%) among the most sexually active age group (19 to 29 yrs). Conclusion There was 20.2% prevalence of TV among the pregnant women presenting at the hospitals, with Gonococci and Proteus infections being statistically significant associated infections

Sero-prevalence of toxoplasmosis among patients visiting the Korle-Bu Teaching Hospital

Abstract Toxoplasmosis is a disease caused by the intracellular protozoan parasite Toxoplasma gondii. It affects up to about one third of the human population worldwide. Toxoplasmosis in neonates and immunocompromised patients can lead to severe disease and even death. However, there is a lack in knowledge concerning the extent of the toxoplasmosis problem in Ghana. In the present study, we determined the seroprevalence of Toxoplasma gondii infection among patients visiting visiting Korle-Bu Teaching Hospital using the enzyme-linked immunosorbent assay (ELISA). Of the 165 patients studied, IgG antibodies were found in 32.7% (95% CI: 25.0 -39.3%). IgM and IgA seroprevalence were 29.7% (95% CI: 22.2 -36.1%) respectively. There was significant association between seroprevalence of Toxoplasma gondii antibodies and gender (P&lt; 0.05), with the male sex being at increased risk of Toxoplasma gondii seropositivity (OR ,95% CI: IgG -2.78,1.34-5.82; IgM -3.31, 1.57-6.981; IgA -3.31, 1.57-6.981). No significant association (P&gt; 0.05) was observed between the age groups and seroprevalence of Toxoplasma gondii antibodies. Ourstudy reveals an overall high seroprevalence of Toxoplasmosis among patients visit ing the Korle-Bu Teaching Hospital. Public campaigns may be necessary to educate the Ghanaians about ways to minimise exposure Toxoplasma gondii